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Review
. 2023 Aug 30;21(1):59.
doi: 10.1186/s12962-023-00461-9.

Successes and challenges of China's health care reform: a four-decade perspective spanning 1985-2023

Mihajlo Jakovljevic  1   2   3 , Hanyu Chang  4 , Jay Pan  5   6 , Chao Guo  7 , Jin Hui  8 , Hao Hu  9 , Danko Grujic  10 , Zhong Li  11 , Lizheng Shi  12
Affiliations
Review

Successes and challenges of China's health care reform: a four-decade perspective spanning 1985-2023

Mihajlo Jakovljevic et al. Cost Eff Resour Alloc. .

Abstract

Chinese health system remains the crucial one for understanding the wider healthcare landscape across the Global South and in particular the leading Emerging Markets. Purpose of our observation was to understand the inner dynamics of mainland Chinese health reforms adopting a lengthy time horizon. We have analysed the public reports and seminal evidence on Chinese of multiple waves of national health reforms taking place since 1980s in terms of medical care and pharmaceuticals provision and financing. Chinese international trade with ASEAN nations and wider South-East Asia is accelerating its growth after the recovery of trade routes. In terms of health sector this means that global demand and supply of medical goods, services and pharmaceuticals remains largely driven by Chinese domestic developments. Furthermore, Chinese domestic manufacturing and sales of decent quality medical devices and services have grown exponentially. Some temporary pitfalls and increasing in rural-urban inequalities in equity of access and affordability of medical care and pharmaceuticals did take place. Despite these difficulties to generate a balanced development strategy for the largest global market, this is a clear path upwards. Further upcoming improvements expanding health insurance coverage are in strong demand for certain layers of the society. Domestic bottleneck weaknesses yet remain manufacturing, import and market penetration of cutting-edge pharmaceuticals such as monoclonal antibodies and targeted oncology agents. Yet some of these obstacles are likely to be overcome in foreseeable future with the adoption of responsible strategies by governmental agencies in health care arena.

Keywords: Chinese health reform; Demand; Industry; Insurance policy; Manufacturing; Market; Medical care; Medical devices; Perspective; Pharmaceuticals; Standards; Supply.

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Conflict of interest statement

The authors declare that Mihajlo Jakovljevic is Editor-in-Chief of the journal, and they declare no conflict of interest. The funding agency had no role in designing the study, conducting the analysis, interpreting the data or writing the manuscript.

Figures

Fig. 1
Fig. 1
A framework of the key tasks of deepening overall reform of the medical and health care system in 2022
Fig. 2
Fig. 2
Hospital number, China, 2009 to 2019
See this image and copyright information in PMC

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