Equity and Public Governance in Health System Reform : Challenges and Opportunities for China

Brixi, Hana; Mu, Yan; Targa, Beatrice; Hipgrave, David

dc.creator	Brixi, Hana
dc.creator	Mu, Yan
dc.creator	Targa, Beatrice
dc.creator	Hipgrave, David
dc.date	2012-03-19T17:59:52Z
dc.date	2012-03-19T17:59:52Z
dc.date	2011-01-01
dc.date.accessioned	2023-02-17T20:54:03Z
dc.date.available	2023-02-17T20:54:03Z
dc.identifier	http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20110113134311
dc.identifier	http://hdl.handle.net/10986/3303
dc.identifier.uri	http://localhost:8080/xmlui/handle/CUHPOERS/244174
dc.description	Achieving the objective of China's current health system reform, namely equitable improvements in health outcomes, will be difficult not least because of the continuously growing income disparities in the country. The analysis in this paper shows that since 2000, disparity in selected health outcomes has been declining across provinces, largely due to earmarked central government allocations. By contrast, public expenditure on health is increasingly regressive (positively correlated with local income per capita) across provinces, and across prefectures and lower levels within provinces. The increasing inequity in public expenditure at sub-national levels indicates that incentives, responsibilities, and resources at sub-national levels are not well aligned with China's national priorities. To address the weaknesses in equity and efficiency that characterize China's health system and health outcomes, China's health system reform may require complementary reforms to improve governance for public service delivery across sectors.
dc.language	English
dc.relation	Policy Research working paper ; no. WPS 5530
dc.rights	CC BY 3.0 IGO
dc.rights	http://creativecommons.org/licenses/by/3.0/igo/
dc.rights	World Bank
dc.subject	ACCOUNTING
dc.subject	BASIC EDUCATION
dc.subject	BREAST CANCER
dc.subject	CATASTROPHIC HEALTH EXPENDITURE
dc.subject	CATASTROPHIC HEALTH SPENDING
dc.subject	CENTRAL BUDGET
dc.subject	CENTRAL GOVERNMENT SPENDING
dc.subject	CHILD HEALTH
dc.subject	CHILD MORTALITY
dc.subject	CHILD MORTALITY RATES
dc.subject	CHILD SURVIVAL
dc.subject	CITIES
dc.subject	CITIZEN
dc.subject	CITIZENS
dc.subject	COST-EFFECTIVENESS
dc.subject	CULTURAL CHANGE
dc.subject	DEATHS
dc.subject	DELIVERY OF HEALTH CARE
dc.subject	DETERMINANTS OF HEALTH
dc.subject	DEVELOPMENT POLICY
dc.subject	DEVELOPMENT STRATEGIES
dc.subject	DOCTORS
dc.subject	DRINKING WATER
dc.subject	DRUGS
dc.subject	ECONOMIC GROWTH
dc.subject	ECONOMIC PERFORMANCE
dc.subject	ENFORCEMENT OF LAWS
dc.subject	EPIDEMIOLOGY
dc.subject	EQUALIZATION
dc.subject	ESSENTIAL MEDICINES
dc.subject	ESSENTIAL SOCIAL SERVICES
dc.subject	FAMILY MEMBERS
dc.subject	FINANCIAL RESOURCES
dc.subject	FISCAL DECENTRALIZATION
dc.subject	FOLIC ACID
dc.subject	GENERAL PRACTITIONERS
dc.subject	GOVERNMENT AGENCIES
dc.subject	GOVERNMENT INITIATIVES
dc.subject	GOVERNMENT SPENDING
dc.subject	HEALTH CENTERS
dc.subject	HEALTH DATA
dc.subject	HEALTH ECONOMICS
dc.subject	HEALTH EDUCATION
dc.subject	HEALTH EXPENDITURE
dc.subject	HEALTH EXPENDITURE PER CAPITA
dc.subject	HEALTH EXPENDITURES
dc.subject	HEALTH FACILITIES
dc.subject	HEALTH FINANCING
dc.subject	HEALTH FUNDING
dc.subject	HEALTH INDICATORS
dc.subject	HEALTH INITIATIVES
dc.subject	HEALTH INTERVENTIONS
dc.subject	HEALTH OUTCOMES
dc.subject	HEALTH REFORM
dc.subject	HEALTH RESOURCES
dc.subject	HEALTH SECTOR
dc.subject	HEALTH SECTOR REFORM
dc.subject	HEALTH SERVICE
dc.subject	HEALTH SERVICE UTILIZATION
dc.subject	HEALTH SERVICES
dc.subject	HEALTH SPENDING
dc.subject	HEALTH SYSTEM
dc.subject	HEALTH SYSTEM PERFORMANCE
dc.subject	HEALTH SYSTEM REFORM
dc.subject	HEALTH SYSTEM STRENGTHENING
dc.subject	HEPATITIS B
dc.subject	HOSPITAL
dc.subject	HOSPITALIZATION
dc.subject	HOSPITALS
dc.subject	HOUSEHOLD INCOME
dc.subject	HOUSEHOLD LEVEL
dc.subject	HOUSING
dc.subject	HUMAN DEVELOPMENT
dc.subject	HUMAN RESOURCES
dc.subject	ILLNESSES
dc.subject	IMMUNIZATION
dc.subject	IMPROVEMENTS IN MORTALITY
dc.subject	INCENTIVE STRUCTURES
dc.subject	INCOME COUNTRIES
dc.subject	INCOME HOUSEHOLDS
dc.subject	INCOME POPULATION
dc.subject	INEQUITIES
dc.subject	INEQUITY IN HEALTH
dc.subject	INFANT
dc.subject	INFANT MORTALITY
dc.subject	INFANT MORTALITY RATE
dc.subject	INFANT MORTALITY RATES
dc.subject	INFLATION
dc.subject	INPATIENT CARE
dc.subject	INSURANCE
dc.subject	INSURANCE SCHEMES
dc.subject	INTERVENTION
dc.subject	JOURNAL OF MEDICINE
dc.subject	LAWS
dc.subject	LIVE BIRTHS
dc.subject	LOCAL GOVERNMENTS
dc.subject	LOW INCOME
dc.subject	MACROECONOMIC PERFORMANCE
dc.subject	MATERNAL MORTALITY
dc.subject	MATERNAL MORTALITY RATE
dc.subject	MATERNAL MORTALITY RATIO
dc.subject	MATERNAL MORTALITY RATIOS
dc.subject	MEDICAL BILLS
dc.subject	MEDICAL EQUIPMENT
dc.subject	MEDICAL INSURANCE
dc.subject	MEDICINES
dc.subject	MILLENNIUM DEVELOPMENT GOALS
dc.subject	MINISTRY OF EDUCATION
dc.subject	MINISTRY OF HEALTH
dc.subject	MORTALITY
dc.subject	MUNICIPALITIES
dc.subject	NATIONAL DEVELOPMENT
dc.subject	NATIONAL GOVERNMENT
dc.subject	NATIONAL GOVERNMENTS
dc.subject	NATIONAL HEALTH
dc.subject	NATIONAL HEALTH SERVICE
dc.subject	NATIONAL HEALTH SERVICES
dc.subject	NATIONAL INITIATIVES
dc.subject	NATIONAL LEVEL
dc.subject	NATIONAL LEVELS
dc.subject	NATIONAL POLICIES
dc.subject	NATIONAL POLICY
dc.subject	NATIONAL PRIORITIES
dc.subject	NEWBORN
dc.subject	NURSES
dc.subject	OLD-AGE
dc.subject	OUTPATIENT CARE
dc.subject	PATIENT
dc.subject	PATIENTS
dc.subject	PENSIONS
dc.subject	POCKET PAYMENT
dc.subject	POCKET PAYMENTS
dc.subject	POLICY DISCUSSIONS
dc.subject	POLICY RESEARCH
dc.subject	POLICY RESEARCH WORKING PAPER
dc.subject	POPULATION GROUPS
dc.subject	PRIMARY CARE
dc.subject	PRIMARY HEALTH CARE
dc.subject	PRIMARY HEALTH CARE SYSTEM
dc.subject	PROGRESS
dc.subject	PROVIDER PAYMENT
dc.subject	PROVINCIAL GOVERNMENTS
dc.subject	PUBLIC
dc.subject	PUBLIC DEBATE
dc.subject	PUBLIC EXPENDITURE
dc.subject	PUBLIC EXPENDITURE ON HEALTH
dc.subject	PUBLIC HEALTH
dc.subject	PUBLIC HEALTH PROGRAMS
dc.subject	PUBLIC HEALTH SPENDING
dc.subject	PUBLIC HOSPITALS
dc.subject	PUBLIC RESOURCES
dc.subject	PUBLIC SECTOR
dc.subject	PUBLIC SERVICE
dc.subject	PUBLIC SERVICE DELIVERY
dc.subject	PUBLIC SERVICES
dc.subject	PUBLIC SPENDING
dc.subject	QUALITY OF CARE
dc.subject	RESOURCE ALLOCATION
dc.subject	RESOURCE ALLOCATIONS
dc.subject	RESPECT
dc.subject	ROADS
dc.subject	RURAL AREAS
dc.subject	RURAL COUNTIES
dc.subject	RURAL HEALTH CARE
dc.subject	RURAL RESIDENTS
dc.subject	RURAL WOMEN
dc.subject	SAFE MOTHERHOOD
dc.subject	SAFE WATER
dc.subject	SANITATION
dc.subject	SCREENING
dc.subject	SERVICE DELIVERY
dc.subject	SERVICE PROVIDERS
dc.subject	SERVICE PROVISION
dc.subject	SERVICE UTILIZATION
dc.subject	SOCIAL DEVELOPMENT
dc.subject	SOCIAL POLICY
dc.subject	SOCIAL PROGRESS
dc.subject	SOCIAL SECTOR
dc.subject	SOCIAL SECTORS
dc.subject	SOCIAL SERVICES
dc.subject	TREASURY
dc.subject	UNDER-FIVE MORTALITY
dc.subject	UNFPA
dc.subject	UNIVERSAL ACCESS
dc.subject	URBAN AREAS
dc.subject	URBAN COMMUNITY
dc.subject	URBAN DEVELOPMENT
dc.subject	URBAN INFRASTRUCTURE
dc.subject	URBAN SERVICES
dc.subject	VACCINATION
dc.subject	WORLD HEALTH ORGANIZATION
dc.subject	YOUNG CHILD
dc.title	Equity and Public Governance in Health System Reform : Challenges and Opportunities for China
dc.type	Publications & Research :: Policy Research Working Paper
dc.coverage	East Asia and Pacific
dc.coverage	East Asia and Pacific
dc.coverage	East Asia
dc.coverage	Asia
dc.coverage	China