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中国的医疗保健:非政府提供者的作用。

Health care in China: the role of non-government providers.

作者信息

Liu Yuanli, Berman Peter, Yip Winnie, Liang Haocai, Meng Qingyue, Qu Jiangbin, Li Zhonghe

机构信息

Department of Population and International Health, Harvard School of Public Health, SPH1-1210, 665 Huntington Avenue, Boston, MA 02115, USA.

出版信息

Health Policy. 2006 Jul;77(2):212-20. doi: 10.1016/j.healthpol.2005.07.002. Epub 2005 Aug 22.

Abstract

While China's health services are primarily financed by out-of-pocket spending (private financing), health care providers, especially the hospital industry, are still dominated by state ownership and government control (public provision). Even though the private sector plays an increasing role in the ambulatory sector, private services are not included in the social insurance benefit package, and thus, it primarily serves self-paying patients. The ambiguity of the government policy toward private provision stems from concerns that an increasing private sector would drive up costs and its services may be of questionable quality. This paper tries to gather evidence on the relative performance of private and public sector in China. Neither literature review nor our primary data analysis provides any support for the notion that the private sector charges a higher price and they serve primarily the better-off people. Quite on the contrary, available data seem to suggest that not only the private sector tends to serve disproportionately the low-middle income groups (this may well be due to its relative lower direct and indirect costs), consumer satisfaction also seems to be higher with regards to certain dimensions of the private than public sector.

摘要

在中国,医疗服务主要由自费支出(私人融资)提供资金,但医疗服务提供者,尤其是医院行业,仍由国有和政府控制主导(公共提供)。尽管私营部门在门诊服务领域发挥着越来越重要的作用,但私人服务并不包括在社会保险福利套餐中,因此,它主要服务于自费患者。政府对私人提供服务的政策模糊不清,源于担心私营部门的增加会推高成本,且其服务质量可能存疑。本文试图收集有关中国私营部门和公共部门相对绩效的证据。无论是文献综述还是我们的原始数据分析,都没有为私营部门收取更高价格且主要服务于富裕人群这一观点提供任何支持。恰恰相反,现有数据似乎表明,不仅私营部门往往不成比例地服务于中低收入群体(这很可能是由于其相对较低的直接和间接成本),而且在某些方面,消费者对私营部门的满意度似乎高于公共部门。

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