Thursday, July 10, 2008

[EQ] A Comparison of the Health Systems in China and India

 

A Comparison of the Health Systems in China and India


Sai Ma, Neeraj Sood

Center for Asia Pacific Policy - The RAND Corporation, 2008


Available online as PDF file [60p.] at: http://www.rand.org/pubs/occasional_papers/2008/RAND_OP212.pdf

 

“…..In this paper, the authors compare the health systems of China and India—the world’s two most populous countries, each of which is undergoing dramatic demographic, societal, and economic transformations—to determine what approaches to improving health in these two countries do and do not work. In particular, we compare the health systems of China and India along three dimensions: policy levers, intermediate outcomes, and ultimate ends.

 

- Policy levers are policies or behaviors that affect the financing, organization, and regulation of health care.

- Intermediate outcomes are the efficiency, quality, and level of access to care.
- The ultimate ends of a health care system are to promote better health, reduce the financial risks associated with medical care, and increase consumer satisfaction.

 

This paper identifies priority areas for reform in each country that can help improve the performance of each health system. Both countries must

- restructure health care financing to reduce the burden of out-of-pocket medical care costs on individual patients

- increase access to care, especially in rural areas

- reduce dependence on fee-for-service contracts that promote overutilization of medical care

- build capacity for addressing and monitoring emerging diseases

- match hospital capabilities with local needs.

 

CONTENT

 

CHAPTER ONE Analytical Framework
A Demographic Overview of the Two Countries


CHAPTER TWO A Brief History of the Health Systems in China and India

Health System Evolution in China

Health System Evolution in India


CHAPTER THREE Overall Performance in Achieving Ultimate Ends

Health Status
Key Health Indicators

Other Vital Health Indicators

Financial Risk Protection

Consumer Satisfaction


CHAPTER FOUR Intermediate Outcomes: Access, Quality, and Efficiency


CHAPTER FIVE Policy Levers of Health Systems in China and India

Financing Structures

The Role of Insurance

Payment

Organization

China: Public Entities Dominate

India: Private Entities Dominate

Comparing Organization in China and India

Regulation

China: Coercion

India: Laissez-Faire

Behavior


CHAPTER SIX Policy Implications

Key Challenges and Associated Policy Implications

Reduce the Out-of-Pocket Burden on Individual Consumers

Reduce Overutilization of Services

Increase Access to Care for the Poor

Build Capacity for Addressing and Monitoring Emerging Diseases (Such as HIV and Obesity)

Match Hospital Capabilities with Local Needs

What Can China Learn from India?

Greater Private-Sector Involvement

Reduced Regulation of Drug and Procedure Prices

What Can India Learn from China?

Increased Spending on Health, Especially Infrastructure, Providers, and Basic Necessities

Better Control of Communicable Diseases and Improvements in Maternal and Infant Health

Conclusions

Bibliography

 

 

   *      *      *     *  
         This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate 
         information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic 
         health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics; 
         Information Technology - Virtual libraries; Research & Science issues.  [DD/ KM
S Area] 

         “Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
         and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
         Health Organization PAHO/WHO or its country members”.

         ---------------------------------------------------------------------------------------------------
         PAHO/WHO Website: http://www.paho.org/ 
         EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html  

 

 

 

 

 

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[EQ] Quality in and Equality of Access to Healthcare Services

Quality in and Equality of Access to Healthcare Services

 

The study was coordinated by the European Health Management Association  with the scientific lead of the European Centre for Social Welfare Policy and Research.

European Commission - Directorate-General for Employment, Social Affairs and Equal Opportunities, 2008

 

            Available online PDF [59p.] at: http://www.euro.centre.org/data/1215506214_37409.pdf

 

Summary at: http://www.euro.centre.org/data/1215506103_53222.pdf

 

“….This study reviews barriers of access to health care that persist in EU countries and presents an analysis of what policies countries have adopted to mitigate these barriers. It has a focus on the situation of migrants, older people with functional limitations, and people with mental disorders.

 

What are the barriers to accessing high quality health care for people  at risk of social exclusion? What are the interdependencies between poverty, social exclusion and problems of accessing health care? What policies have EU Member States put in place to improve access and quality of health care for vulnerable groups of the population?

 

The study is based on eight country reports: Finland, Germany, Greece, the Netherlands, Poland, Romania, Spain, and the United Kingdom. This was complemented with findings from the literature and European comparisons….”

 

“…Ensuring equitable access to high-quality healthcare constitutes a key challenge for health systems throughout Europe. Despite differences in health system size, structure and financing, evidence suggests that across Europe particular sections of the population are disproportionately affected by barriers to accessing healthcare. Studies have also shown that difficulties in accessing healthcare are compounded by poverty and social exclusion, and that poverty and social exclusion compound difficulties in accessing healthcare…”

 

 

Contents

Executive summary

Part 1

1 Introduction

1.1 The European policy context

1.2 Previous research initiatives

1.2.1 Health inequalities across socio-economic groups in Europe

1.2.2 Inequalities in access to and utilisation of healthcare services

1.3 The scope of the study

 

Part 2

2 Barriers of Access to Health Care

2.2 Coverage and cost-sharing barriers

2.3 Conclusions and Recommendations


3 Broader System Barriers

3.1 Introduction

3.2 Geographical barriers of access to health services

3.3 Organisational barriers

3.4 Supply-side responsiveness

3.5 Health literacy, voice and health beliefs

3.6 Conclusions and Recommendations

 

Part 3

4 Migrants, asylum seekers and illegal immigrants

4.2 Migrants and ethnic minorities

4.3 Asylum seekers and refugees

4.4 Illegal immigrants: ‘sans papiers’ or ‘undocumented migrants’

4.5 The situation of older migrants

4.6 Conclusions

4.7 Recommendations

 

5 Older people with functional limitations

5.1 Introduction

5.2 Age, functional limitation and compounded health risks

5.3 Barriers to access

5.4 Barriers to Access – context specific

5.5 Policy initiatives

5.6 Conclusions

5.7 Recommendations

 

6 People with mental health problems

6.1 General health care needs of people with mental health disorders

6.2 Access to health care for people with mental health disorders

6.3 Barriers in access to general health care for people with mental health disorders

6.4 Policy initiatives and their impact on access to general health care for people with mental health disorders

6.5 Conclusions

6.6 Recommendations

 

Part 4

7 Conclusion and Policy Recommendations

7.1 Conclusions

7.2 Policy Recommendations

7.2.1 General recommendations

7.2.2 Migrants, asylum seekers and illegal immigrants

7.2.3 Older people with functional limitations

7.2.4 People with mental health problems

References

 

Report Authors:

Manfred Huber, Anderson Stanciole, European Centre for Social Welfare Policy and Research, Vienna; Jeni Bremner, European Health Management Association, Brussels, Kristian Wahlbeck, National Research & Development Centre for Welfare & Health (STAKES), Finland.

 

Contact: Manfred Huber, Director Health and Care, huber@euro.centre.org

Website: http://www.euro.centre.org/detail.php?xml_id=866

 

   *      *      *     *  
         This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate 
         information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic 
         health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics; 
         Information Technology - Virtual libraries; Research & Science issues.  [DD/ KM
S Area] 

         “Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
         and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
         Health Organization PAHO/WHO or its country members”.

         ---------------------------------------------------------------------------------------------------
         PAHO/WHO Website: http://www.paho.org/ 
         EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html  

 

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.