• Record: found
  • Abstract: found
  • Article: not found

Harnessing the privatisation of China's fragmented health-care delivery.

1 , 2

Lancet (London, England)

Read this article at

      There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.


      Although China's 2009 health-care reform has made impressive progress in expansion of insurance coverage, much work remains to improve its wasteful health-care delivery. Particularly, the Chinese health-care system faces substantial challenges in its transformation from a profit-driven public hospital-centred system to an integrated primary care-based delivery system that is cost effective and of better quality to respond to the changing population needs. An additional challenge is the government's latest strategy to promote private investment for hospitals. In this Review, we discuss how China's health-care system would perform if hospital privatisation combined with hospital-centred fragmented delivery were to prevail--population health outcomes would suffer; health-care expenditures would escalate, with patients bearing increasing costs; and a two-tiered system would emerge in which access and quality of care are decided by ability to pay. We then propose an alternative pathway that includes the reform of public hospitals to pursue the public interest and be more accountable, with public hospitals as the benchmarks against which private hospitals would have to compete, with performance-based purchasing, and with population-based capitation payment to catalyse coordinated care. Any decision to further expand the for-profit private hospital market should not be made without objective assessment of its effect on China's health-policy goals.

      Related collections

      Author and article information

      [1 ] Blavatnik School of Government, University of Oxford, Oxford, UK. Electronic address:
      [2 ] Havard School of Public Health, Boston, MA, USA.
      Lancet (London, England)
      Aug 30 2014
      : 384
      : 9945
      Copyright © 2014 Elsevier Ltd. All rights reserved.


      Comment on this article