Financing strategies to improve essential public health equalization and its effects in China.
Financing strategies to improve essential public health equalization and its effects in China.
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中国改善基本公共卫生均等化的融资策略及其效果
DOI：
10.1186/s12939-016-0482-x
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发表时间：
2016-12-01
影响因子：
4.8
通讯作者：
Fang H
中科院分区：
文献类型：
--
作者：
Yang L;Sun L;Wen L;Zhang H;Li C;Hanson K;Fang H
2009年，中国开始了一项卫生改革，以促进国家基本公共卫生服务计划（NEPHSP）的均衡。不同的方法，并显示了不同地区之间同等改善的证据。
我们回顾了相关文献，并在筛选和质量评估后确定了208篇文章，并进行了六个关键信息的访谈。 。
在2009年之前，政府对初级保健机构（PCIS）的补贴主要用于基本建设，自2009年以来，NEPHSP的新资金大大扩大了服务覆盖率和人口覆盖范围。中央，市政和县政府在中国的税收分配系统中的不同比例。在特定的帐户中，更多的付款方式都采用了更多的付款方式。解决供应和需求方面的问题。但是，东部，中西部地区的差距缩小了，但移民的覆盖范围仍然很低，并且需要提高管理慢性疾病患者的有效性。
自2009年以来，基本公共卫生服务的交付受到公共财政政策的极大影响，而卫生改革的实施则导致公共卫生发展朝着正确的方向发展。作为促进公共卫生服务的质量和区域之间的平等。
BackgroundIn 2009, China launched a health reform to promote the equalization of national essential public health services package (NEPHSP). The present study aimed to describe the financing strategies and mechanisms to improve access to public health for all, identify the strengths and weaknesses of the different approaches, and showed evidence on equity improvement among different regions.MethodsWe reviewed the relevant literatures and identified 208 articles after screening and quality assessment and conducted six key informants’ interviews. Secondary data on national and local government health expenditures, NEPHSP coverage and health indicators in 2003–2014 were collected, descriptive and equity analyses were used.ResultsBefore 2009, the government subsidy to primary care institutions (PCIs) were mainly used for basic construction and a small part of personnel expenses. Since 2009, the new funds for NEPHSP have significantly expanded service coverage and population coverage. These funds have been allocated by central, provincial, municipal and county governments at different proportions in China’s tax distribution system. Due to the fiscal transfer payment, the Central Government allocated more subsides to less-developed western regions and all the funds were managed in a specific account. Several types of payment methods have been adopted including capitation, pay for performance (P4P), pay for service items, global budget and public health voucher, to address issues from both the supply and demand sides. The equalization of NEPHSP did well through the establishment of health records, systematic care of children and maternal women, etc. Our data showed that the gap between the eastern, central and western regions narrowed. However the coverage for migrants was still low and performance was needed improving in effectiveness of managing patients with chronic diseases.ConclusionsThe delivery of essential public health services was highly influenced by public fiscal policy, and the implementation of health reform since 2009 has led the public health development towards the right direction. However China still needs to increase the fiscal investments to expand service coverage as well as promote the quality of public health services and equality among regions. Independent scientific monitoring and evaluation are also needed.
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影响因子：
5.4
作者：
LIU, YL;HSIAO, WCL;REN, MH
通讯作者：
REN, MH
影响因子：
8.3
作者：
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通讯作者：
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影响因子：
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作者：
Niu Hongli;Tian Miaomiao;Zhang Liang
通讯作者：
Zhang Liang
影响因子：
4.5
作者：
Li X;Chongsuvivatwong V;Xia X;Sangsupawanich P;Zheng W;Ma K
通讯作者：
Ma K
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Ding, Yan;Smith, Helen J;Dong, Hengjin
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Dong, Hengjin