Health system strengthening in China: progress, challenges and ways forward

Resumo

China's health system reform, launched in 2009, has been a comprehensive effort to enhance healthcare accessibility and quality while addressing the challenges of escalating costs, an aging population, and the rise in non-communicable diseases. The reform has achieved near-universal health insurance coverage, leading to reduced out-of-pocket expenses and improved financial protection for citizens. It has also focused on public hospital reform, aiming to improve management efficiency, eliminate financial dependency on drug sales, and introduce new payment models to curb over-prescription. Strengthening primary care has been a cornerstone, with investments in infrastructure and workforce to enhance local healthcare services and introduce a family doctor system for continuous care. The Essential Medicines Program has made medications more affordable and accessible. Despite these advancements, challenges such as service delivery fragmentation, quality of care inconsistencies, and health financing issues persist. The Healthy China 2030 vision, building on these reforms, aims to further integrate health services, enhance governance, and promote preventive care to achieve a more equitable and sustainable healthcare system. The article underscores the importance of robust governance, financial investment, and policy innovation in realizing health reform goals and offers lessons for other nations facing similar health system challenges.