Equity in health and health care: the Chinese experience.
This paper examines the changes in equality of health and health care in China during its transition from a command economy to market economy. Data from three national surveys in 1985, 1986, and 1993 are combined with complementary studies and analysis of major underlying economic and health care factors to compare changes in health status of urban and rural Chinese during the period of economic transition. Empirical evidence suggests a widening gap in health status between urban and rural residents in the transitional period, correlated with increasing gaps in income and health care utilization. These trends are associated with changes in health care financing and organization, including dramatic reduction of insurance cover for the rural population and relaxed public health. The Chinese experience demonstrates that health development does not automatically follow economic growth. China moves toward the 21st century with increasing inequality plaguing the health component of its social safety net system.
Liu
Y
Y
Department of Health Policy and Management, Harvard School of Public Health, Cambridge, MA 02138, USA. yuanliu@hsph.harvard.edu
Hsiao
W C
WC
Eggleston
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D018166:Health Care Reform; D019981:Health Care Sector / Q000639:trends; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D007182:Income; D007348:Insurance, Health / Q000639:trends; D008297:Male; D008875:Middle Aged; D011634:Public Health / Q000639:trends; D012423:Rural Health; D012935:Social Justice; D014504:Urban Health