Chinese health care system and clinical epidemiology

Figures & data

Figure 1 Chinese health care system.

Notes: ^aThe numbers provided in the figure are from China Statistical Yearbook – 2015 for year 2014.³ Urban subdistrict and village residents committee/community residents committee are not government organizations. ^bA total of 31 provincial governments including four municipalities, five autonomous regions, and 22 provinces (Taiwan, Hong Kong, and Macau are not included). ^cThe following types of health institutions are not listed: health inspection institutions, specialized disease prevention and treatment, health education institutions, first aid centers, blood gathering and supplying institutions, health supervision and inspection agencies, sanatoriums, clinical laboratory centers, medical scientific research institutions, on-job training institutions, medical examination centers.
Abbreviations: CDC, Centers for Disease Control and Prevention; HFPC, Health and Family Planning Commission; MCH, Maternal and Child Health Institutions.

Table 1 Summary of China’s three health insurance programs

Contents	UEBMI	URBMI	NRCMS
Target population	Urban employees	Urban residents, eg, children, students, elderly people without previous employment	Rural residents
Unit of enrollmente	Individuals	Individuals	Households
Type of enrollmente	Compulsory	Voluntary	Voluntary
Source of premium	Employer and individual	Government and individual	Government and individual
Benefits package	Inpatient and outpatient care	Inpatient and outpatient care and critical illness insurance	Inpatient and outpatient care and critical illness insurance
Management level of pooling funde	Prefecture/municipality	Prefecture/municipality	County
Number of pools of risk fund (approx)e	330	330	2600
Overseeing government	MOHRSS	MOHRSS	NHFP
Year of pilote	1994a	2007	2003
Year of formal launche	1998	2009	2006
Facts in 2014
Enrollment rate, %	>95	>95	98.9
Number of enrollees, million	283	315	736
Proportion of population,b %	21	23	54
Premium per capita (Yuan)	1962c	410	411
Benefit coverage
Reimbursement rate for inpatient care, %	80	70	75
Reimbursement rate for outpatient care, %	50, 70, 80d	50	50
Number of reimbursable serious illnesses	–	22	22

Notes:

a Before 1994, employees were insured through the government insurance system and the labor insurance system. In 1994, both of them were converted into the UEBMI.

b The total population in 2014 was 1.367 billion.

c The premium, which is obtained from Yu,² is for year 2011 since we did not get the information for year 2014.

d The reimbursement rates differ for different insured populations in different provinces. The numbers are reimbursement rates for current employees, retired employees under 70 years of age, and retired employees of 70 years of age and older in Beijing after payment for certain nonrefundable amounts.⁶⁹

e Adapted from Liang, Lilin; Langenbrunner, John C. The Long March to Universal Coverage : Lessons from China. UNICO Study Series; No. 9. World Bank, Washington DC. 2013. © World Bank. https://openknowledge.worldbank.org/handle/10986/13303 License: CC BY 3.0 IGO. Creative Commons license and disclaimer available from: http://creativecommons.org/licenses/by/4.0/legalcode.¹⁰

Abbreviations: MOHRSS, Ministry of Human Resource and Social Security; NHFP, National Health and Family Planning Commission; NRCMS, New Rural Cooperative Medical Scheme; UEBMI, Urban Employee Basic Medical Insurance; URBMI, Urban Residence Basic Medical Insurance.

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