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Measuring and evaluating progress towards Universal Health Coverage in China

BACKGROUND: This paper aims to develop a Chinese version of Universal Health Coverage (UHC) indices and to measure China’s progress towards UHC. METHODS: Nineteen indicators were selected based on expert consultations to construct indices of accessibility and affordability to measure UHC. Data were...

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Autores principales: Liu, Xiaoyun, Wang, Ziyue, Zhang, Huan, Meng, Qingyue
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Society of Global Health 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088770/
https://www.ncbi.nlm.nih.gov/pubmed/33981413
http://dx.doi.org/10.7189/jogh.11.08005
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author Liu, Xiaoyun
Wang, Ziyue
Zhang, Huan
Meng, Qingyue
author_facet Liu, Xiaoyun
Wang, Ziyue
Zhang, Huan
Meng, Qingyue
author_sort Liu, Xiaoyun
collection PubMed
description BACKGROUND: This paper aims to develop a Chinese version of Universal Health Coverage (UHC) indices and to measure China’s progress towards UHC. METHODS: Nineteen indicators were selected based on expert consultations to construct indices of accessibility and affordability to measure UHC. Data were drawn from health statistics yearbooks, nationally representative surveys, and health system reform surveillance. The index of accessibility includes absolute accessibility (to essential health services), relative accessibility (to hospital care) and people’s subjective perceptions. The index of affordability includes absolute affordability (the incidence of catastrophic health expenditure, CHE), relative affordability (the composition of health expenditure), and people’s subjective perceptions. RESULTS: The indices of accessibility and affordability both showed steady increases over the 17 years considered. Absolute accessibility had the most significant improvement (from 23.6 in 2002 to 73.8 in 2018), while the index of relative accessibility decreased from 81.4 in 2002 to 67.3 in 2018. The index of absolute affordability decreased significantly from 46.6 in 2002 to 30.5 in 2010 and then exhibited an increasing trend afterwards, reaching 52.1 in 2018. The index of relative affordability continuously increased during the observation period, from 35.3 to 75.4. CONCLUSIONS: China has made great progress in increasing the accessibility and affordability of health services since the health system reforms in 2009. However, integrating primary health care and hospital care and containing escalating medical expenditure to further reduce patients’ financial burdens are key challenges for strengthening the Chinese health system.
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spelling pubmed-80887702021-05-11 Measuring and evaluating progress towards Universal Health Coverage in China Liu, Xiaoyun Wang, Ziyue Zhang, Huan Meng, Qingyue J Glob Health Research Theme 4: Health Transitions in China BACKGROUND: This paper aims to develop a Chinese version of Universal Health Coverage (UHC) indices and to measure China’s progress towards UHC. METHODS: Nineteen indicators were selected based on expert consultations to construct indices of accessibility and affordability to measure UHC. Data were drawn from health statistics yearbooks, nationally representative surveys, and health system reform surveillance. The index of accessibility includes absolute accessibility (to essential health services), relative accessibility (to hospital care) and people’s subjective perceptions. The index of affordability includes absolute affordability (the incidence of catastrophic health expenditure, CHE), relative affordability (the composition of health expenditure), and people’s subjective perceptions. RESULTS: The indices of accessibility and affordability both showed steady increases over the 17 years considered. Absolute accessibility had the most significant improvement (from 23.6 in 2002 to 73.8 in 2018), while the index of relative accessibility decreased from 81.4 in 2002 to 67.3 in 2018. The index of absolute affordability decreased significantly from 46.6 in 2002 to 30.5 in 2010 and then exhibited an increasing trend afterwards, reaching 52.1 in 2018. The index of relative affordability continuously increased during the observation period, from 35.3 to 75.4. CONCLUSIONS: China has made great progress in increasing the accessibility and affordability of health services since the health system reforms in 2009. However, integrating primary health care and hospital care and containing escalating medical expenditure to further reduce patients’ financial burdens are key challenges for strengthening the Chinese health system. International Society of Global Health 2021-05-01 /pmc/articles/PMC8088770/ /pubmed/33981413 http://dx.doi.org/10.7189/jogh.11.08005 Text en Copyright © 2021 by the Journal of Global Health. All rights reserved. https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License.
spellingShingle Research Theme 4: Health Transitions in China
Liu, Xiaoyun
Wang, Ziyue
Zhang, Huan
Meng, Qingyue
Measuring and evaluating progress towards Universal Health Coverage in China
title Measuring and evaluating progress towards Universal Health Coverage in China
title_full Measuring and evaluating progress towards Universal Health Coverage in China
title_fullStr Measuring and evaluating progress towards Universal Health Coverage in China
title_full_unstemmed Measuring and evaluating progress towards Universal Health Coverage in China
title_short Measuring and evaluating progress towards Universal Health Coverage in China
title_sort measuring and evaluating progress towards universal health coverage in china
topic Research Theme 4: Health Transitions in China
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088770/
https://www.ncbi.nlm.nih.gov/pubmed/33981413
http://dx.doi.org/10.7189/jogh.11.08005
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