6638733

pubmed:Citation

5

http://linkedlifedata.com/resource/pubmed/keyword/Asia, http://linkedlifedata.com/resource/pubmed/keyword/CHINA, http://linkedlifedata.com/resource/pubmed/keyword/Delivery Of Health Care, http://linkedlifedata.com/resource/pubmed/keyword/Demographic Factors, http://linkedlifedata.com/resource/pubmed/keyword/Developing Countries, http://linkedlifedata.com/resource/pubmed/keyword/Distance, http://linkedlifedata.com/resource/pubmed/keyword/Eastern Asia, http://linkedlifedata.com/resource/pubmed/keyword/Financing, Government, http://linkedlifedata.com/resource/pubmed/keyword/Geographic Factors, http://linkedlifedata.com/resource/pubmed/keyword/HOSPITALS, http://linkedlifedata.com/resource/pubmed/keyword/Health, http://linkedlifedata.com/resource/pubmed/keyword/Health Facilities, http://linkedlifedata.com/resource/pubmed/keyword/Health Services Administration, http://linkedlifedata.com/resource/pubmed/keyword/Health Services--cost, http://linkedlifedata.com/resource/pubmed/keyword/Locale, http://linkedlifedata.com/resource/pubmed/keyword/MANAGEMENT, http://linkedlifedata.com/resource/pubmed/keyword/Organization And Administration, http://linkedlifedata.com/resource/pubmed/keyword/Population, http://linkedlifedata.com/resource/pubmed/keyword/Population Characteristics, http://linkedlifedata.com/resource/pubmed/keyword/Residence Characteristics, http://linkedlifedata.com/resource/pubmed/keyword/Rural Health Services, http://linkedlifedata.com/resource/pubmed/keyword/Rural Population, http://linkedlifedata.com/resource/pubmed/keyword/Spatial Distribution, http://linkedlifedata.com/resource/pubmed/keyword/Urban Population

http://linkedlifedata.com/resource/pubmed/journal/0372351

MEDLINE

0003-4819

Print

NLM

727-8

PIP: It is important, when considering the impact of the Chinese health care model, on developing countries, to reexamine this system as China heightens its drive toward modernization. 2 questions about the system are the concern of this report: how good is access to tertiary care; and what is the cost of this care. To gain information on access of patients to the health care system, the pattern of admissions during a 3-month period of all patients to an infectious disease ward were studied. A well established referral pattern was used by the hospitals to send patients to higher levels of care. The distance to tertiary care centers, as well as limited transportation available, leads to more frequent use of tertiary care centers by urban rather than rural populations. Ironically, many patients are simply too sick to travel to more elaborate facilities. Although policies discourage the use of higher level facilities, Chinese patients (particularly those in urban areas), used various strategies to gain access to facilities that they thought would best serve their needs. Insurance reimbursement policies may discourage rural patients from seeking admission to tertiary care facilities. The cost of health care in the ward was analyzed by studying records from randomly selected patients. Hospital bills differed greatly, and the overall cost of hospitalization was markedly affected by duration and the use of medications. In sharp contrasts to US hospitals, diagnostic testing had only a minor effect on costs, primarily because of limited availability of equipment and circumspect use of resources. At no time was "defensive medicine" as in the use of laboratory or roentgenographic testing observed. Medications, the largest portion of a patient's charges, were used freely even in situations without documented efficacy. The average cost of hospitalization was $119, but at the time of this study, the average Chinese citizen earned approximately $250 per year. Marked differences between regions and sectors persisted, and the ratio in per capita income between urban and rural populations was estimated at 3 to 1. For most city workers and government employees, health care costs are completely covered by work units, if the patient's care is delivered according to the appropriate referral channels. Among rural peasants, 80% of the population, the amount of insurance coverage depends on the financial stability of the commune, and reimbursement may represent as little as 50% of patient charges. 1 of the most important questions facing health care planners in China is the way the system will be modernized and resources properly distributed.

1983

Journal Article