A Comparison of the Health Systems in China and India

A Comparison of the Health Systems in China and India

Sai Ma
Neeraj Sood
Copyright Date: 2008
Edition: 1
Published by: RAND Corporation
Pages: 58
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  • Book Info
    A Comparison of the Health Systems in China and India
    Book Description:

    The health status of residents of China and India lags behind relative to other populations, and health gains in each country have been uneven across subpopulations. Each health system provides little protection against financial risk, and patient satisfaction is a lower priority than it should be. This paper compares the Chinese and Indian health systems to determine what approaches to improving health in these two countries do and do not work.

    eISBN: 978-0-8330-4537-9
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iv)
  3. Table of Contents
    (pp. v-vi)
  4. Figures
    (pp. vii-viii)
  5. Tables
    (pp. ix-x)
  6. Acknowledgements
    (pp. xi-xii)
  7. Abbreviations
    (pp. xiii-xiv)
  8. CHAPTER ONE Introduction
    (pp. 1-4)

    China and India have much in common. Both have rapidly developing economies and large populations. Together, their more than 2 billion residents account for one-third of the total world population. Over the past 50 years, both countries have also made substantial gains in health, including increased life expectancy, reduced infant mortality, and the eradication of several diseases. Yet, despite these gains, the health status of residents of China and India still lags that of other populations, and the health gains in each country have been uneven across subpopulations. This raises an important question: How can health in these two countries...

  9. CHAPTER TWO A Brief History of the Health Systems in China and India
    (pp. 5-12)

    In this chapter, we briefly review the historical, social, and political forces that shaped the health systems in China and India over the past 50 years. During that period, both countries gained independence (in the late 1940s) and increased economic and social openness (in the 1980s and 1990s). We also identify the successes achieved and lessons learned as health systems evolved in each country.

    After the establishment of the People’s Republic of China in 1949, the country was recovering from the chaos of long conflicts both internally and with Japan. As a result, Chinese health conditions had declined, with health...

  10. CHAPTER THREE Overall Performance in Achieving Ultimate Ends
    (pp. 13-18)

    The WHO’s 2000 report entitledThe World Health Report 2000—Health Systems: Improving Performancestates that a health system should have three fundamental objectives:

    improving the health of the population it serves

    responding to people’s expectations

    providing financial protection against the costs of ill health.

    In this chapter, we compare how China and India fare in achieving these goals.

    Overall, people in China live longer and are healthier than people in India (see Table 3.1). According to WHO’s statistics, a woman born in India in 2004 has a life expectancy of 63 years, whereas a woman born in China at...

  11. CHAPTER FOUR Intermediate Outcomes: Access, Quality, and Efficiency
    (pp. 19-22)

    In Chapter Three, we discussed the current overall performance of the Chinese and Indian health systems vis-à-vis achieving ultimate ends. In this chapter, we discuss the intermediate outcomes (i.e., access, quality, and efficiency) that lead to the overall performance of health systems. Although intermediate outcomes can affect the ultimate ends of a health system, they are “only intermediate and partial results” (Hsiao, 2003).

    Access, here defined aseffective availability, measures how easy it is for people to overcome barriers (e.g., physical, financial, timing, and service availability obstacles) to get care (Roberts et al., 2004). Although both China and India determined...

  12. CHAPTER FIVE Policy Levers of Health Systems in China and India
    (pp. 23-34)

    As discussed in Chapter One, we adopt an analytical framework that separates a health system into policy levers, intermediate outcomes, and ultimate ends. We compared the overall and intermediate performance of the health systems in China and India in Chapters Three and Four; in this chapter, we discuss in depth how policy levers used in these two countries lead to the current performance of the national health systems.

    The following five factors influence the ultimate performance of a health system and can be affected by policy: the financing, payment, and organization of health care delivery; regulation; and consumer behavior.


  13. CHAPTER SIX Policy Implications
    (pp. 35-38)

    Both China and India have achieved substantial health gains since independence. Nevertheless, each country’s health system faces challenges, some common to both countries and some unique. We conclude this paper by identifying key challenges and policy implications and describing the lessons that China and India can learn from each other.

    Both countries rely heavily on out-of-pocket health care payments. However, as many health economists have argued, “moving away from out-of-pocket to prepayment mechanisms is the key to reducing financial catastrophe” (Xu et al., 2007). This challenge can be met by providing the nationalized or social insurance common in Europe, or...

  14. Bibliography
    (pp. 39-44)