title: A community-based approach to non-communicable chronic disease management within a context of advancing universal health coverage in China: progress and challenges.
abstract: Paralleled with the rapid socio-economic development and demographic transition, an epidemic of non-communicable chronic diseases (NCDs) has emerged in China over the past three decades, resulting in increased disease and economic burdens. Over the past decade, with a political commitment of implementing universal health coverage, China has strengthened its primary healthcare system and increased investment in public health interventions. A community-based approach to address NCDs has been acknowledged and recognized as one of the most cost-effective solutions. Community-based strategies include: financial and health administrative support; social mobilization; community health education and promotion; and the use of community health centers in NCD detection, diagnosis, treatment, and patient management. Although China has made good progress in developing and implementing these strategies and policies for NCD prevention and control, many challenges remain. There are a lack of appropriately qualified health professionals at grass-roots health facilities; it is difficult to retain professionals at that level; there is insufficient public funding for NCD care and management; and NCD patients are economically burdened due to limited benefit packages covering NCD treatment offered by health insurance schemes. To tackle these challenges we propose developing appropriate human resource policies to attract greater numbers of qualified health professionals at the primary healthcare level; adjusting the service benefit packages to encourage the use of community-based health services; and increase government investment in public health interventions, as well as investing more on health insurance schemes.
authors.forename: Nanzi
authors.initials: N
authors.lastname: Xiao
authors.forename: Qian
authors.initials: Q
authors.lastname: Long
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Tang
authors.forename: Shenglan
authors.initials: S
authors.lastname: Tang
mesh_terms: D002681:China / Q000453:epidemiology; D002908:Chronic Disease / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D003153:Community Health Services / Q000191:economics / Q000458:organization & administration*; D006291:Health Policy; D006302:Health Services Research; D006801:Humans; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration*; D019472:Universal Health Insurance / Q000458:organization & administration*
references.citation: Lancet. 2010 Mar 27;375(9720):1120-30
references.pmid: 20346818
references.citation: Lancet. 2012 Mar 3;379(9818):833-42
references.pmid: 22386036
references.citation: Zhonghua Liu Xing Bing Xue Za Zhi. 2005 Jul;26(7):478-84
references.pmid: 16334996
references.citation: Soc Sci Med. 2009 Jan;68(2):201-9
references.pmid: 19019519
references.citation: Diabetes Care. 1997 Nov;20(11):1664-9
references.pmid: 9353605
references.citation: Lancet. 2005 Nov 19;366(9499):1821-4
references.pmid: 16298221
references.citation: J Hypertens. 2010 Mar;28(3):432-8
references.pmid: 20087215
references.citation: Health Policy Plan. 2013 Dec;28(8):809-24
references.pmid: 23221008
references.citation: Int J Equity Health. 2009 Dec 09;8:42
references.pmid: 20003188
references.citation: Zhonghua Liu Xing Bing Xue Za Zhi. 1998 Oct;19(5):282-5
references.pmid: 10322687
references.citation: BMJ. 2012 Aug 21;345:e5466
references.pmid: 22915666
references.citation: Zhonghua Yu Fang Yi Xue Za Zhi. 2012 May;46(5):409-13
references.pmid: 22883726
references.citation: Int J Health Plann Manage. 2014 Apr-Jun;29(2):160-74
references.pmid: 23877959
references.citation: Diabetologia. 2003 Sep;46(9):1190-8
references.pmid: 12879248
references.citation: JAMA. 2013 Sep 4;310(9):948-59
references.pmid: 24002281