Transcript Slide 1
Health social system in China
Lian Tong
Doctoral student (D3)
Sep 29, 2010
Lab of International Community Care and
Lifespan Development
Health sectors/system
Health care system
Provision of health services
(hospital, health care center…)
Health
system
Water
and sanitation
Occupational health
Environment hygiene
Social security
……
Government Health Organization
National level
Ministry of Health
Province level
Department of Health
City level
Bureau of Health
Duty of the Ministry of Health
Make health related policy and strategy
Promote medical reform
Deal with important public health problems…
Smoking
Milk problems
vaccine
Iodized salt
Ministry of Health of China
Ministry of Health
Sub-management bureaus and offices
Rural area
health
Women/child
ren health
Emergence
issue
Drug
management
Medical policy
Hospital
management
Medical
supervision
Health care
Science and
education
International
bureau
Disease
control
Chinese center for disease control and
prevention (CDC)
National level
Province and city
level
CDC in each province
and city
Health care system
Central goal of the health sector is the good
health of the whole population
Health Services and Medical Security
National health policies
Financial Investment
Citizens’ utilization of health services
Health Services and Medical Security in
China
(1) Health Service Institutions
(2)Medical Service Utilization
(3)Preventive Care Services
(4)Cost of Provision of Health Services
(5)Health Insurance Status
Health indicators of China
(1) Health Service Institutions
The number of doctors per thousand citizens is 1.5
(1.5/1000), close to that of Brazil and Egypt, but lower than
USA (2.7), Japan (1.9) and UK (2.0).
The number of registered nurses per thousand people is
1.03 (1.03/1000).
Deficiency of
medical resource
Health indicators of China
Health Service Institutions in city and rural area
(2) Medical Service Utilization
The total number of visits to medical institutions in 2003
was 2.096 billion, with an average of 1.62 visits per capita.
The distribution of hospitalization in 2003 was 70.0% in
comprehensive hospitals, 0.2% in urban community health
centers, 24.3% in township hospitals, 4.6% in women and
children’s hospitals, and 0.9% in other hospitals.
Recourse waste!
Community health centers don’t
play the good role of “guard”!
Medical Service Utilization
(3) Preventive Care Services
Vaccination rate is about 80%-96%
87.8% of pregnant women had at least one pre-natal
examination
The rate of delivery in hospitals was comparatively low averaging only 68.3%, with 92.6% in urban and 62.0% in rural
areas.
A clear difference between
urban and rural areas and
between geographic districts
(4) Cost of Provision of Health Services
The average outpatient expenditure per visit in 2003 was
RMB 108.2, an equivalent of 0.77% of the per capita salary for
urban citizens (RMB 14,040), but 4.2% of that of farmers (RMB
2,622).
Average inpatient expenditure per admission in 2003 was
RMB 3,911, amounting to 27.9% of the per capita urban salary
and 149.1% of per capita farmer income.
Heavy burden of the
cost of health services
for farmers
Over cost/ high price for drug
A patient is
looking at
the bill
Cold
Price
of
drug
Getting
bigger and
bigger
Business
man
Patient
(5) Health Insurance Status
In 2003, 9.5% of rural residents participated in the New
Cooperative Medical Scheme (NCMS) and 11.5% in other forms
of medical insurance schemes, leaving 80% without any form of
medical security.
In urban areas, 30.4% of residents are covered by the basic
medical insurance scheme, 24.8% participate in other insurance
schemes, leaving 44.8% of urban citizens without any form of
medical security.
Need a medical insurance
reform urgently!!!
City
Rural
area
Background of china society
The unbalance in Social Development
How to redistribute resources in China???
Geography
Group/Class
Field
East
West
City
Rural area
Workers
Farmers
Economy/
Hardware
Social
Development/
Software
•Education
• Medicine
• Social welfare
•Culture……
What’s people worry about mostly???
2004
What the most important motivations to save money?
1. Provide for the aged
2. Medicine
3. Education
Medical insurance and
social welfare reform in
2005
2006
What the most important motivations to save money?
1. House
2. Education
3. Medicine
What shall we do???
Medicine
Insurance
system
Social Welfare system
(Old-age Insurance
System)
Hospital System
Reform
New Medicine Insurance system in China
City
Medical Insurance for
Urban Workers
Rural area
New Rural Cooperative
Medical Care
•National government finance
•National government finance
•Company, enterprise and so on
•Local government finance
Individual income
Individual income
From the insurance window, patients can get their
money back proportionally depend on the diseases
and their cost.
Situation of elder population in rural China
There are 900 million people over 60 years old in rural
areas, and the number increase gradually.
There are 39.3% elders living in poverty in rural areas.
Only 1.5% elders in rural areas have endowment
insurance.
4. There are 45.3 % elder in rural areas think that their
lives are no guarantee.
New Social Endowment Insurance for elders
in rural area (2009~2020)
•2009, 10% cities and towns as the sample fields.
•2020, covering the whole country.
The family pay
the basic insurance fee
Government
Compensation
50% fee for east areas
100% fee for west areas
Over 60 years old
Lowest basic
endowment cost
Before reform
75.4% population no medical insurance in 2003,
decreased to 65.7% in 2004……
No Compensation for general elders in rural area
except for handicapped people or elders without child.
After reform
Over 90% population in city and rural area were covered
with insurance.
Almost 100% elders can get the life compensation from
government per month.
Thank you for your attention