Organisational reform in healthcare in China: impacts on the social functions of public hospitals

Abstract

Public hospital reform in China since the mid 1980s has had detrimental effects on hospitals' social functions,especially the provision of care for poor people. This study of hospitals in Northern China, using a range of economicmeasurements, indicated that there has been an overall decline in social functions since 1985, especially in secondaryand tertiary level hospitals. Reason for this include the increasingly competitive medical market in China and, underthe decentralisation reforms, the imperative for hospitals to generate revenue. We put forward policies to strengthenhospital social functions, including funding for essential packages of services to specifically benefit the poor andvulnerable, and increased government subsidies to support social functions in primary level hospitals where care canbe more easily accessed.