Abstract:
:This article provides an overview of the current Chinese health care system with particular emphasis on rural-urban differences. China's post-1978 economic reforms, although they improved general living standards, created some unintended consequences, as evidenced by the disintegration of the rural cooperative medical system and the sharp reduction in the number of "barefoot doctors", both of which were essential elements in the improvement of health status in rural China. The increase in the elderly population and their lack of health insurance and pensions will also place enormous pressure on services for their care. These changes have disproportionately affected the rural health care system, leaving the urban system basically intact, and have contributed to the rural-urban disparity in health care. Based on recent data the article compares current rural-urban differences in health care policy, systems, resources, and outcomes, and proposes potential solutions to reduce them. :China has made significant achievements in reducing mortality, increasing life expectancy, and providing primary health care. Hospital medical costs show an increase of 30-50% annually during 1978-90. Charges include 29-63% of actual costs of services for outpatients, in-patients, and operations. This paper portrays a view of the Chinese health care system and urban-rural differences. An overview and statistical support is given for health care resources of personnel and beds during 1949-87. Current major problems are identified as funding variability between local and provincial areas and urban-rural disparity in health outcomes and access to care. The most adversely affected are the rural elderly. The cost of medical services has increased, and many rural populations lack health insurance or pensions. A major policy change occurred in 1978 with a shift to a fee for service system rather than a barefoot doctor supported cooperative medical system. The health system now is comprised of a State Council which controls 30 provinces. County governments, which supervise township governments or the former people's communes, are lower units followed by the village unit (the former brigade). Each province has about 71 counties. Each county has about 25 townships. Each township has about 14 villages of about 1000 population. Every level of government has hospitals and other specialized health units, but the main levels are care are at the village, township, and county levels. Provincial and lower levels are responsible for their own finances. A reward-penalty system operates in urban hospitals. Health care spending, resource allocation, and distribution of facilities and professionals varies widely between rural and urban areas. Differences in health outcomes are apparent, and urban residents have a better health status. Health insurance coverage is assured for most of urban government employees, college communities, and state enterprises with over 100 employees, which means most working people in urban areas. The rural elderly are the most affected by the changes. There is a need for a new elderly support system, a universal and compulsory system of financing, and evaluation of health professional needs.
journal_name
Bull World Health Organjournal_title
Bulletin of the World Health Organizationauthors
Shi Lsubject
Has Abstractpub_date
1993-01-01 00:00:00pages
723-36issue
6eissn
0042-9686issn
1564-0604journal_volume
71pub_type
杂志文章,评审abstract::As culture filtrates of Mycobacterium tuberculosis have been shown by numerous workers to be antigenically heterogeneous, a series of experiments has been started to identify some of the different antigens likely to be useful in laboratory tests for measuring the antibodies in human blood. The work involves the fracti...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1955-01-01 00:00:00
abstract::The usefulness of a recently developed portable haemoglobinometer in primary health care was assessed in a survey of anaemia carried out in an isolated Indian community living in the jungles of northern Peru. This haemoglobinometer requires only one drop of blood to be added to a disposable cuvette without predilution...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::The unacceptably high mortality related to acute respiratory infections (ARI) in children, recognition of the importance of bacteria in the causation of severe acute lower respiratory infection in developing countries, and the established effectiveness of antimicrobial and supportive treatment in averting death make a...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::All sewage and water treatment processes remove or destroy viruses. Some treatment methods are better than others, but none is likely to remove all of the viruses present in sewage or in raw water. Primary settling of solids probably removes a great many of the viruses in sewage because viruses are largely associated ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章,评审
doi:
更新日期:1973-01-01 00:00:00
abstract:OBJECTIVE:To examine the prevalence of multiple types of maltreatment (MTM), potentially confounding factors and associations with depression, anxiety and self-esteem among adolescents in Viet Nam. METHODS:In 2006 we conducted a cross-sectional survey of 2591 students (aged 12-18 years; 52.1% female) from randomly-sel...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/BLT.08.060061
更新日期:2010-01-01 00:00:00
abstract::Reported is the use of a simplified methodology for carrying out a community-based epidemiological assessment that is compatible with the goals of primary health care research. For this purpose, a current-status life table analysis of data from 1131 women who were served by community health workers in the State of Méx...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::The One Health concept covers the interrelationship between human, animal and environmental health and requires multistakeholder collaboration across many cultural, disciplinary, institutional and sectoral boundaries. Yet, the implementation of the One Health approach appears hampered by shortcomings in the global fra...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/BLT.17.202705
更新日期:2018-03-01 00:00:00
abstract::A simple technique for achieving high yields of Plasmodium falciparum parasites on a continuous basis is described. The technique is applicable in any laboratory. The culture apparatus is also simple and inexpensive and allows multiple cultures to be run simultaneously. A total of approximately 1-2 x 10(9) parasites c...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract:PROBLEM:In many countries, the tuberculosis (TB) annual case detection rate is below the target of 70%. In the Lao People's Democratic Republic in 2005, it did not exceed 55% APPROACH:The DOTS strategy promotes passive case detection of TB. In order to increase the detection rate, we validated a questionnaire targetin...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/blt.06.038539
更新日期:2007-09-01 00:00:00
abstract::The gene for dieldrin resistance has been artificially male-linked so that females can be selectively killed with dieldrin. By intercrossing different sibling species of the Anopheles gambiae complex, batches consisting of sterile males only can be reared. This seems to have potential for use in genetic control operat...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::The magnitude of antigenic change of the Hong Kong strains from the earlier influenza A2 strains was compared with previous antigenic changes among the type A viruses. Representative type A strains recovered from man during the years 1933 through 1969 were examined by reciprocal haemagglutination-inhibition, neutraliz...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1969-01-01 00:00:00
abstract::Representatives of the WHO influenza programme recently proposed a standard method of determining neuraminidase activity and neuraminidase inhibition (NI) antibody titres. Logit transformation of the data obtained with the WHO method for the NI assay permits a more efficient performance of the test and easy calculatio...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::Since the first attempt at vaccination more than 200 years ago, debate has been ongoing about the relative benefits and risks. However, debate was overshadowed by the threat of crippling illness and death. Over the years, vaccination programs succeeded in its goals: eradication of smallpox, near eradication of polio,...
journal_title:Bulletin of the World Health Organization
pub_type: 评论,杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:To develop a Bayesian hierarchical model for human onchocerciasis with which to explore the factors that influence prevalence of microfilariae in the Amazonian focus of onchocerciasis and predict the probability of any community being at least mesoendemic (>20% prevalence of microfilariae), and thus in need o...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract::The efficacy of BCG vaccine in preventing the clinical manifestations of leprosy in a tuberculosis-free area of Papua New Guinea is reported. Between 1963 and 1966 a total of 5356 subjects, randomized to receive BCG or saline inoculations, were examined for leprosy before the vaccination and surveillance was continued...
journal_title:Bulletin of the World Health Organization
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-01-01 00:00:00
abstract::Pretreatment cultures of bacilli from Indian patients with active pulmonary tuberculosis admitted to a controlled domiciliary chemotherapy study by the Tuberculosis Chemotherapy Centre, Madras, were subjected to a series of in vitro tests designed to identify the bacilli as human or bovine tubercle bacilli, or as anon...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1961-01-01 00:00:00
abstract::In the course of an investigation in 1962-64 into the natural occurrence of brucellosis among grey foxes in Argentina, agglutination tests were performed on 728 sera of the foxes Dusicyon gymnocercus antiquus and D. griseus griseus, captured in the provinces of Buenos Aires and Rio Negro. Agglutination titres of from ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1966-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the screening measures that would have been required to assess all travellers at risk of transporting A(H1N1)pdm09 out of Mexico by air at the start of the 2009 pandemic. METHODS:Data from flight itineraries for travellers who flew from Mexico were used to estimate the number of international air...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/BLT.12.114777
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:To examine infant feeding intentions of HIV-infected and uninfected women and the appropriateness of their choices according to their home resources; and to determine their adherence to their intentions in the first postnatal week. METHODS:Feeding intentions of pregnant women were compared against four resou...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/blt.06.032441
更新日期:2007-04-01 00:00:00
abstract::It is often impossible to measure the reference standard of cardiorespiratory fitness (the maximum oxygen intake) directly, and there is thus a need for subsidiary standard procedures based on body responses to submaximal exercise. In order to reach agreement on such procedures, a recent international working party ha...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1968-01-01 00:00:00
abstract::Monoclonal antibody NYS4 recognizes a single 140 kDa antigen on the surface of Plasmodium yoelii sporozoites, an antigen which is distinct from the extensively characterized circumsporozoite (CS) protein. To more thoroughly characterize this additional surface component, a genomic expression library was screened with ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::The age-adjusted incidence rate of cervical cancer in Bombay has decreased over the last 20 years, whereas over the same period that of breast cancer increased slightly. Studies indicate that the incidence of cervical cancer is lower in successively later-born cohorts, but no cohort effect has been observed for breast...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::Eighteen patients with Plasmodium falciparum infection were studied in Port-au-Prince, Haiti, to monitor the response of the malaria parasite to sulfadoxine-pyrimethamine. In all infections the parasitaemia was cleared rapidly following treatment with standard dose of the drug combination; no recrudescence was observe...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::Structural quality is a key element in the quality of care provided at the primary level, which aims to offer health care interventions of proven efficacy. This assessment of the structural quality of Tanzanian primary health services indicated serious weaknesses in the available physical infrastructure, as well as su...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract::WHO's reference protocol for post-exposure rabies vaccination advises five intramuscular injections on days 0, 3, 7, 14, and 30; in addition, rabies immunoglobulins (RIG) must be given to serious cases of exposure (grade III severity). Some studies indicate that these immunoglobulins suppress the immunogenicity of rab...
journal_title:Bulletin of the World Health Organization
pub_type: 临床试验,杂志文章,多中心研究
doi:
更新日期:1998-01-01 00:00:00
abstract::This paper is an attempt to relate modifications observed in general and infant mortality rates with the dynamic changes in transmission induced by malaria control measures. The observations indicated relationships between the efficacy of control and a decrease in mortality. The daily parasitological inoculation rate ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract::Schistosoma mansoni and Schistosoma haematobium are widely distributed throughout East Africa, each being transmitted by several intermediate hosts. It is feared that the increased use of irrigation, which is proposed in Tanganyika to expand agricultural productivity, will also increase the incidence and intensity of ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1965-01-01 00:00:00
abstract::James Chau talks to Ana Lesher Treviño about the challenges faced in communicating about public health. ...
journal_title:Bulletin of the World Health Organization
pub_type: 新闻
doi:10.2471/BLT.19.030819
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:We aimed to determine the burden of bacillary dysentery in China, its cross-regional variations, trends in morbidity and mortality, the causative bacterial species and antimicrobial resistance patterns. METHODS:We extracted and integrated governmental statistics and relevant medical literature published from...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/blt.05.023853
更新日期:2006-07-01 00:00:00
abstract::The findings from an epidemiological survey of bacillary dysentery in three villages in south-west Serbia are reported. Factors in the transmission of infection-in particular, living conditions and standards of hygiene-are discussed, and an attempt is made to assess the value of various popular remedies, such as herba...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1954-01-01 00:00:00