Early appraisal of China's huge and complex health-care reforms
TL;DR: The pace of reform should be moderated to allow service providers to develop absorptive capacity, and independent, outcome-based monitoring and evaluation by a third-party are essential for mid-course correction of the plans and to make officials and providers accountable.
About: This article is published in The Lancet.The article was published on 2012-03-03. It has received 971 citations till now. The article focuses on the topics: Health care & Service provider.
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TL;DR: Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.
Abstract: With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China's massive population (1.37 billion), previous national incidence and mortality estimates have been limited to small samples of the population using data from the 1990s or based on a specific year. With high-quality data from an additional number of population-based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population-based cancer registries (2009-2011), representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000-2011). The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age-standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence; 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively). For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (+0.2% per year; P = .1), whereas they increased significantly (+2.2% per year; P < .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males (-1.4% per year; P < .05) and females (-1.1% per year; P < .05). Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.
13,073 citations
TL;DR: A comprehensive assessment of disease burden in China, how it changed between 1990 and 2010, and how China's health burden compares with other nations is done to guide policy responses to the changing disease spectrum in China.
1,636 citations
TL;DR: The aim of this study was to provide evidence that palliative care and pain relief research should be considered as a continuum of treatment for patients with life-threatening illnesses.
683 citations
TL;DR: As China deepens its health-care reform, it has the opportunity to build an integrated, cooperative primary health- care system, generating knowledge from practice that can support improvements, and bolstered by evidence-based performance indicators and incentives.
515 citations
TL;DR: To meet the needs of China's ageing population that is facing an increased NCD burden, this work recommends leveraging strategic purchasing, information technology, and local pilots to build a primary health-care (PHC)-based integrated delivery system by aligning the incentives and governance of hospitals and PHC systems, improving the quality of PHC providers, and educating the public on the value of prevention and health maintenance.
440 citations
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01 Jan 1973
TL;DR: For example, the authors showed that government microcredit services are heavily subsidized and unsustainable, and are viewed by both government and central bank as a social, rather than a financial sector, program.
Abstract: for microfinance. While there are a number of small microfinance projects attempting to apply international lessons, they have minimal outreach in relation to the potential market demand. Far greater outreach is achieved by government microcredit services implemented as part of poverty eradication efforts. These services are heavily subsidized and unsustainable, and are viewed by both government and central bank as a social, rather than a financial sector, program.
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TL;DR: In 2003, China launched a heavily subsidized voluntary health insurance program for rural residents as discussed by the authors, which has increased outpatient and inpatient utilization, and has reduced the cost of deliveries, but it has not reduced out-of-pocket expenses per outpatient visit or inpatient spell.
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TL;DR: The authors describe the deterioration of China's health care system in the 1980s and 1990s in the context of privatization of the Chinese economy and the Chinese government's current efforts to address the crisis.
Abstract: In this report, the authors describe the deterioration of China's health care system in the 1980s and 1990s in the context of privatization of the Chinese economy. They discuss the Chinese government's current efforts to address the crisis in order to improve access to and delivery of health care.
560 citations
TL;DR: The surveillance and intervention mechanisms needed to ameliorate the increasing burden of chronic diseases are developing rapidly, taking account of the lessons learned over the past two decades.
549 citations