Meng Q, Liu X, Shi J
Institute of Social Medicine and Health Policy, Shandong Medical University, Jinan, Shandong, People's Republic of China.
Health Policy Plan. 2000 Dec;15(4):349-56. doi: 10.1093/heapol/15.4.349.
After 15 years eradication of the private health sector in Socialist China, private practice was restored in 1980 along with the market oriented economic reform. In recent years, however, debates on its pros and cons are increasing. Arguments against private practice have led to a ban on private practice in some rural counties. The arguments against private practice state that the service quality of private clinics tends to be lower than that of public ones; private clinics are less likely to provide preventive care; and private clinics are more likely to provide over-treatment. This paper presents the major findings from a study conducted in China, aiming at comparing private and public village health clinics in terms of quality of services, willingness to provide preventive care and over-prescription of drugs. While it was found that the quality of services was poor and a large proportion of patient expenditure was due to over-treatment for all village clinics, there was no difference between public and private clinics. Both private and public clinics were willing to provide preventive services if they were subsidized for the provision. This study finds no evidence that care provided by private clinics is inferior to that of public clinics.
在社会主义中国消除私营医疗部门15年后，随着市场经济改革，1980年恢复了私人执业。然而近年来，关于其利弊的争论日益增多。反对私人执业的观点导致一些农村县禁止私人执业。反对私人执业的观点认为，私人诊所的服务质量往往低于公立诊所；私人诊所提供预防保健的可能性较小；私人诊所更有可能提供过度治疗。本文介绍了在中国进行的一项研究的主要发现，旨在比较私立和公立村级诊所的服务质量、提供预防保健的意愿以及药物过度开方情况。虽然发现所有村级诊所的服务质量都很差，而且很大一部分患者支出是由于过度治疗，但私立诊所和公立诊所之间没有差异。如果提供预防服务有补贴，私立和公立诊所都愿意提供。这项研究没有发现证据表明私人诊所提供的医疗服务不如公立诊所。
