Despite recent reductions in prevalence, China still faces a substantial tuberculosis (TB) burden, with future progress dependent on the ability of rural providers to appropriately detect and refer TB patients for further care. This study (a) provides a baseline assessment of the ability of rural providers to correctly manage presumptive TB cases; (b) measures the gap between provider knowledge and practice and; (c) evaluates how ongoing reforms of China’s health system—characterized by a movement toward “integrated care” and promo- tion of initial contact with grassroots providers—will affect the care of TB patients.
It has been well established that better educated individuals enjoy better health and longevity. In theory, the educational gradients in health could be flattening if diminishing returns to improved average education levels and the influence of earlier population health interventions outweigh the gradient-steepening effects of new medical and health technologies. This paper documents how the gradients are evolving in China, a rapidly developing country, about which little is known on this topic.
Historically, improvements in the quality of municipal drinking water made important contributions to mortality decline in wealthy countries. However, water disinfection often does not produce equivalent benefits in developing countries today. We investigate this puzzle by analyzing an abrupt, large-scale municipal water disinfection program in Mexico in 1991 that increased the share of Mexico’s population receiving chlorinated water from 55% to 85% within six months.
Expanding access through insurance expansion can increase health‐care utilization through moral hazard. Reforming provider incentives to introduce more supply‐side cost sharing is increasingly viewed as crucial for affordable, sustainable access. Using both difference‐in‐differences and segmented regression analyses on a panel of 1,466 hypertensive and diabetic patients, we empirically examine Shandong province's initial implementation of China's 2009 Essential Medications List policy. The policy reduced drug sale markups to providers but also increased drug coverage benefits for patients.
"Health Insurance and Chronic Disease Control: Quasi-experimental Evidence from Hypertension in Rural China" is a chapter within the volume China's Healthcare System and Reform. The volume provides a comprehensive review of China’s healthcare system and policy reforms in the context of the global economy. Following a valuechain framework, the 16 chapters cover the payers, the providers, and the producers (manufacturers) in China’s system.
Most civilian casualties in war are not the result of direct exposure to bombs and bullets; they are due to the destruction of the essentials of daily living, including food, water, shelter, and health care. These “indirect” effects are too often invisible and not adequately assessed nor addressed by just war principles or global humanitarian response.
The ongoing decline in under-5 mortality ranks among the most significant public and population health successes of the past 30 years.
Value-driven payment system reform is a potential tool for aligning economic incentives with the improvement of quality and efficiency of health care and containment of cost. Such a payment system has not been researched satisfactorily in full-cycle cancer care.
To examine the association of outcomes and medical expenditures with a bundled-payment pay-for-performance program for breast cancer in Taiwan compared with a fee-for-service (FFS) program.
Sex differences in mortality vary over time and place as a function of social, health, and medical circumstances. The magnitude of these variations, and their response to large socioeconomic changes, suggest that biological differences cannot fully account for sex differences in survival. Drawing on a wide swath of mortality data across countries and over time, we develop a set of empiric observations with which any theory about excess male mortality and its correlates will have to contend.
This chapter highlights evidence that links women’s health challenges in LMICs to economics at every stage of life. It advances the notion that discrimination against women persists for sociocultural and economic reasons and is embodied in ill health and disability across the life span.
There is something deeply troubling about a death that goes unnoticed. Beyond the humane impulse to provide solace through collective acknowledgment and community support lies the recognition that an unnoticed death implies an unnoticed life. There can be no doubt that the accurate counting and causal attribution of morbidity and mortality provide technical information that is essential for public health planning, evaluation, and improvement in program performance.
Efforts to address the global healthcare workforce crisis focus heavily on traditional service providers such as physicians and nurses. Yet, improving health systems also necessitates involvement from a wide range of management and support workers.
Development assistance from high-income countries to the health sectors of low- and middle-income countries (health aid) is an important source of funding for health in low- and middle-income countries. However, the relationship between health aid and the expected health improvements from those expenditures—the cost-effectiveness of targeted interventions—remains unknown. We reviewed the literature for cost-effectiveness of interventions targeting five disease categories: HIV; malaria; tuberculosis; noncommunicable diseases; and maternal, newborn, and child health.
David Studdert and colleagues explore how to balance public health, individual freedom, and good government when it comes to sugar-sweetened drinks. Over the last decade, many national, state, and local governments have introduced laws aimed at curbing consumption of sugar-sweetened beverages (SSBs), especially by children.
We examine how variation in local economic conditions has shaped the AIDS epidemic in Africa. Using data from over 200,000 individuals across 19 countries, we match biomarker data on individuals' serostatus to information on local rainfall shocks, a large source of income variation for rural households. We estimate infection rates in HIV-endemic rural areas increase by 11% for every recent drought, an effect that is statistically and economically significant.
In response to the current outbreak, the international community has endorsed the clinical use of unregistered treatments for Ebola. Even with this accelerated pathway to in-human testing and use, radically novel approaches to drug development will be needed to improve the likelihood that a treatment is realised.