Liu Ziyu, Buijsen Martin
1Law & Health Care (R & G),Erasmus School of Health Policy and Management,Erasmus University Rotterdam,Rotterdam,The Netherlands.
2Law & Health Care (R & G),Erasmus School of Health Policy and Management,c/o Erasmus School of Law,Erasmus University Rotterdam,Rotterdam,The Netherlands.
Prim Health Care Res Dev. 2019 Jan;20:e9. doi: 10.1017/S1463423618000555. Epub 2018 Aug 16.
AimTo assess the regulation of the Chinese healthcare system in assisting a nationwide implementation of general practitioner (GP) services. BACKGROUND: Along with the perennial problems of unaffordable and inequitable healthcare, a rapidly ageing population and the increasing burden of non-communicable diseases pose challenges to the Chinese healthcare system. Recognising these challenges and to satisfy people's demands for more and better healthcare, China has initiated a plan, named 'Healthy China 2030', based on the findings from a two-year joint study by the World Health Organization (WHO) and the World Bank Group (WBG) in collaboration with Chinese agencies. The Chinese healthcare plan, officially approved in 2016, is an attempt to use the people-centred, integrated care (PCIC) model recommended by the WHO and WBG to shape the Chinese healthcare system. In accordance with PCIC, China began the implementation of gatekeeping primary care by introducing GP services to local communities. METHODS: A comparative analysis was employed to point out the importance of introducing GP services. A systematic assessment was carried out to evaluate the regulatory sector of the Chinese healthcare system, including a critical review of related legal norms and a theoretical exploration of external impediments (eg, cultural attitudes, government capacity and interest groups).FindingsResults demonstrate that the current regulatory sector of the Chinese healthcare system needs to be improved in order to assist the nationwide implementation of GP services and to strengthen its gatekeeping role. Major deficiencies include the problematic relationship between legal norms and health policies, the lack of effective and consistent new legislation, the low rate of social acceptance, and lack of support from agencies. To address those challenges, this paper recommends that preliminary efforts be devoted, in part, to two changes in the legal structure: enacting a specific law, and creating an independent regulatory oversight body.
评估中国医疗体系在助力全科医生服务全国性实施方面的监管情况。背景：除了长期存在的医疗费用高昂和不公平问题外，人口迅速老龄化以及非传染性疾病负担加重给中国医疗体系带来了挑战。认识到这些挑战并为满足人们对更多更好医疗服务的需求，中国根据世界卫生组织（WHO）和世界银行集团（WBG）与中国机构合作开展的为期两年的联合研究结果，启动了一项名为“健康中国2030”的计划。2016年正式获批的中国医疗计划，旨在尝试采用WHO和WBG推荐的以人民为中心的整合照护（PCIC）模式来塑造中国医疗体系。按照PCIC，中国通过在当地社区引入全科医生服务开始实施守门人初级保健。方法：采用比较分析指出引入全科医生服务的重要性。进行系统评估以评价中国医疗体系的监管部门，包括对相关法律规范的批判性审查以及对外部阻碍（如文化态度、政府能力和利益集团）的理论探索。研究结果：结果表明，中国医疗体系当前的监管部门需要改进，以助力全科医生服务在全国的实施并强化其守门人作用。主要不足包括法律规范与卫生政策之间存在问题的关系、缺乏有效且一致的新立法、社会接受率低以及机构支持不足。为应对这些挑战，本文建议初步努力部分致力于法律结构的两项变革：制定一部专门法律，并设立一个独立的监管监督机构。
