How hospital autonomy affects provider payment reform effectiveness.

Background: Provider payment reforms (PPRs) have demonstrated mixed results for improving health system efficiency. Since PPRs require health care organisations to interpret and implement policies, the organizational characteristics of hospitals may affect the effectiveness of PPRs. Hospitals with more autonomy have the flexibility to respond to PPRs more efficiently, but they may not if the autonomy previously facilitated behaviours that counter the PPR's objective.

Quality of care in large Chinese hospitals: an observational study.

Objective: To empirically assess the quality of hospital care in China and trends over a 5-year period during which the government significantly increased its investment in healthcare.

Design: Retrospective, observational study comparing hospital quality between two periods: October 2012-March 2013 and October 2017-March 2018.

Setting: 1-2 of the most reputable large tertiary hospitals in each of the 25 provinces in Mainland China (total of 33).

Managing health expenditure inflation under a single-payer system: Taiwan's National Health Insurance.

As nations strive to achieve and sustain universal health coverage (UHC), they seek answers as to what health system structures are more effective in managing health expenditure inflation. A fundamental macro-level choice a nation has to make is whether to adopt a single- or a multiple-payer health system. Using Taiwan's National Health Insurance (NHI) as a case, this paper examines how a single-payer system manages its health expenditure growth and draws lessons for other countries whose socioeconomic development is similar to Taiwan's.

[Impact of primary care oriented outpatient benefit package design in new rural cooperative medical system on hypertension outpatient services utilization].

Objective: To study the impact of primary care oriented outpatient benefits package design of outpatient services coverage and ladder reimbursement of county, town and village levels in the new rural cooperative medical system (NRCMs) on hypertension outpatient services utilization.

Methods: The panel data of treatment and control groups in 2009 and 2011 before and after the policy reform were drawn from the household survey data of the innovative payment system project. The difference in difference (DID) method was used for data analysis.

Realigning demand and supply side incentives to improve primary health care seeking in rural China.

China's recent and ambitious health care reform involves a shift from the reliance on markets to the reaffirmation of the central role of the state in the financing and provision of services. In collaboration with the Government of the Ningxia province, we examined the impact of two key features of the reform on health care utilisation using panel household data. The first policy change was a redesign of the rural insurance benefit package, with an emphasis on reorientating incentives away from inpatient towards outpatient care.

Early appraisal of China's huge and complex health-care reforms.

China's 3 year, CN¥850 billion (US$125 billion) reform plan, launched in 2009, marked the first phase towards achieving comprehensive universal health coverage by 2020. The government's undertaking of systemic reform and its affirmation of its role in financing health care together with priorities for prevention, primary care, and redistribution of finance and human resources to poor regions are positive developments. Accomplishing nearly universal insurance coverage in such a short time is commendable.

Realignment of incentives for health-care providers in China.

Inappropriate incentives as part of China's fee-for-service payment system have resulted in rapid cost increase, inefficiencies, poor quality, unaffordable health care, and an erosion of medical ethics. To reverse these outcomes, a strategy of experimentation to realign incentives for providers with the social goals of improvement in quality and efficiency has been initiated in China. This Review shows how lessons that have been learned from international experiences have been improved further in China by realignment of the incentives for providers towards prevention and primary care, and incorporation of a treatment protocol for hospital services.

Ethno-psychometric evaluation of the General Health Questionnaire in rural China.

Background: Most mental health research tools are developed in Western, urban contexts. Few studies have evaluated the applicability of these research tools in rural populations of non-Western countries. We examined the cultural acceptance and psychometric performance of the 12-item General Health Questionnaire (GHQ) in China's rural villages.

The impact of quality on the demand for outpatient services in Cyprus.

Health policy reforms in a number of countries seek to improve provider quality by sharpening the incentives they face, for example by exposing them to greater competition. For this to succeed, patients must be responsive to quality in their choice of provider. This paper uses data from Cyprus to estimate the effect of quality on patients' choice between public and private outpatient care.

Impact of separating drug prescribing and dispensing on provider behaviour: Taiwan's experience.

In many Asian countries, physicians both prescribe and dispense drugs. This practice is hypothesized to have caused high drug expenditure and widespread prescription of antibiotics in Asia. Recently, Taiwan implemented the separation policy on an experimental basis.