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Annu Rev Public Health. 2017 Mar 20;38:431-448. doi: 10.1146/annurev-publhealth-031816-044247. Epub 2017 Jan 11.

China's Health Reform Update.

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National School of Development, Peking University, Beijing 100871, China; email:
Department of Political Science, University of Wisconsin-Madison, Madison, Wisconsin 53706; email:
School of Management, Beijing University of Chinese Medicine, Beijing 10029, China; email:


China experienced both economic and epistemological transitions within the past few decades, greatly increasing demand for accessible and affordable health care. These shifts put significant pressure on the existing outdated, highly centralized bureaucratic system. Adjusting to growing demands, the government has pursued a new round of health reforms since the late 2000s; the main goals are to reform health care financing, essential drug policies, and public hospitals. Health care financing reform led to universal basic medical insurance, whereas the public hospital reform required more complex measures ranging from changes in regulatory, operational, and service delivery settings to personnel management. This article reviews these major policy changes and the literature-based evidence of the effects of reforms on cost, access, and quality of care. It then highlights the outlook for future reforms. We argue that a better understanding of the unintended consequences of reform policies and of how practitioners' and patients' interests can be better aligned is essential for reforms to succeed.


China; essential drug policies; health care reform; hospital management; medical insurance

[Indexed for MEDLINE]

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