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Towards universal health coverage: lessons from 10 years of healthcare reform in China
  1. Wenjuan Tao1,
  2. Zhi Zeng1,
  3. Haixia Dang2,
  4. Bingqing Lu3,
  5. Linh Chuong4,
  6. Dahai Yue4,
  7. Jin Wen1,
  8. Rui Zhao5,
  9. Weimin Li6,
  10. Gerald F Kominski4,7
  1. 1Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China
  2. 2Research Center of Tradtional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
  3. 3Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
  4. 4Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA
  5. 5Department of drug policy and evaluation research, China National Health Development Research Center, Beijing, China
  6. 6President's Office, West China Hospital, Sichuan University, Chengdu, China
  7. 7UCLA Center for Health Policy Research, Los Angeles, California, USA
  1. Correspondence to Professor Gerald F Kominski; kominski{at}ucla.edu; Professor Weimin Li; weimi003{at}yahoo.com; Professor Jin Wen; huaxiwenjin{at}163.com

Abstract

Universal health coverage (UHC) is driving the global health agenda. Many countries have embarked on national policy reforms towards this goal, including China. In 2009, the Chinese government launched a new round of healthcare reform towards UHC, aiming to provide universal coverage of basic healthcare by the end of 2020. The year of 2019 marks the 10th anniversary of China’s most recent healthcare reform. Sharing China’s experience is especially timely for other countries pursuing reforms to achieve UHC. This study describes the social, economic and health context in China, and then reviews the overall progress of healthcare reform (1949 to present), with a focus on the most recent (2009) round of healthcare reform. The study comprehensively analyses key reform initiatives and major achievements according to four aspects: health insurance system, drug supply and security system, medical service system and public health service system. Lessons learnt from China may have important implications for other nations, including continued political support, increased health financing and a strong primary healthcare system as basis.

  • health policy
  • health systems
  • public health
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Footnotes

  • Handling editor Seye Abimbola

  • WT and ZZ contributed equally.

  • Contributors WT and ZZ wrote the first draft of the manuscript, collected and analysed the data, produced the tables and figures and interpreted the results. HD contributed to the paper’s formulation. WT and BL did the literature search and review. LC was involved in editing each draft. DY, JW and RZ provided comments and suggestions in revisions of the paper. WL designed the study and set the research direction. GFK critically revised the paper and provided overall guidance. All authors approved the final submitted version.

  • Funding This work was supported by the National Natural Science Foundation of China (Grant No 71874115) and China Scholarship Council (CSC; No 201806240304).

  • Disclaimer The funders had no role in the study design, data collection, data analysis, data interpretation and in writing the manuscript.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No additional data are available.

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