TRANSFORMATION OF CHINA RURAL HEALTH-CARE FINANCING
TRANSFORMATION OF CHINA RURAL HEALTH-CARE FINANCING
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DOI：
10.1016/0277-9536(95)00428-a
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发表时间：
1995-10-01
影响因子：
5.4
通讯作者：
REN, MH
中科院分区：
文献类型：
--
作者：
LIU, YL;HSIAO, WCL;REN, MH
1970年代后期，中国开始了农业改革，开始了十年的经济增长和中国社会的重大转变。农业改革改变了农民的激励措施，削弱了社区组织，并减少了中央政府对当地社区的控制。这些变化在很大程度上导致了中国广受赞誉的农村合作医疗体系的崩溃。因此，中国经历了农村卫生工作者的供应减少，疾病负担增加，三层医疗系统的瓦解，初级卫生保健减少以及对医院医疗服务的需求增加。自从中国改变其农业经济体系以来，已经过去了十多年，中国仍在努力寻找一种公平，高效和可持续的方式来融资和组织其农村卫生服务。中国的经验为其他国家提供了几个重要的教训：有必要了解市场力量的局限性，并重新定义政府在市场经济下的农村卫生保健中的作用；社区参与和控制当地卫生融资计划对于发展可持续的农村卫生系统至关重要。农村卫生系统必须是动态的，而不是静态的，以跟上不断变化的人口需求。
In the late 1970s China launched its agricultural reforms which initiated a decade of continued economic growth and significant transformation of the Chinese society. The agricultural reforms altered the peasants' incentives, weakened community organization and lessened the central government's control over local communities. These changes largely caused the collapse of the widely acclaimed rural cooperative medical system in China. Consequently China experienced a decreased supply of rural health workers, increased burden of illnesses, disintegration of the three tier medical system, reduced primary health care, and an increased demand for hospital medical services. More than ten years have elapsed since China changed its agricultural economic system and China is Still struggling to find an equitable, efficient and sustainable way of financing and organizing its rural health services. The Chinese experiences provided several important lessons for other nations: there is a need to understand the limits of the market forces and to redefine the role of the government in rural health care under a market economy; community participation in and control of local health financing schemes is essential in developing a sustainable rural health system; the rural health system needs to be dynamic, rather than static, to keep pace with changing demand and needs of the population.