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Health service delivery in China: a literature review

2007/09/20 by Karen Eggleston, Li Ling, Meng Qingyue +4
Economics, Econometrics and Finance · Health Professions · #Global Health Care Issues #Healthcare Policy and Management #Healthcare Systems and Reforms

paper · doi:10.1002/hec.1306

openalex publication_date 2007/09/20 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/28

Abstract

We report the results of a review of the Chinese- and English-language literatures on service delivery in China, asking how well China's health-care providers perform and what determines their performance. Although data and methodological limitations suggest caution in drawing conclusions, a critical reading of the available evidence suggests that current health service delivery in China leaves room for improvement, in terms of quality, responsiveness to patients, efficiency, cost escalation, and equity. The literature suggests that these problems will not be solved by simply shifting ownership to the private sector or by simply encouraging providers -- public and private -- to compete with one another for individual patients. By contrast, substantial improvements could be (and in some places have already been) made by changing the way providers are paid -- shifting away from fee-for-service and the distorted price schedule. Other elements of 'active purchasing' by insurers could further improve outcomes. Rigorous evaluations, based on richer micro-level data, could considerably strengthen the evidence base for service delivery policy in China.

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