Abstract
This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the “Result Chain” logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impact. Health care system reform was evaluated using the weighted TOPSIS and weighted Rank Sum Ratio methods. Ultimately, the study established a set of indicators including four grade-1 indicators, 16 grade-2 indicators and 76 grade-3 indicators. The effects of the reforms increased year by year from 2009 to 2011 in Hubei Province. The health status of urban and rural populations and the accessibility, equity and quality of health services in Hubei Province were improved after the reforms. This sub-national case can be considered an example of a useful approach to the evaluation of the effects of health care system reform, one that could potentially be applied in other provinces or nationally.
Highlights
In April 2009, China had announced a health reform blueprint for achieving universal coverage by2020 [1]
The indicator system of the health care system reform evaluation is composed of four parts: Inputs and Process, Outputs, Outcomes, and Impact
From 2009 to 2011, performance in three of the domains (Inputs and Process, Outputs, Impact) of health care system reform increased year by year in both evaluation methods, whereas the performance ranking results in the “Outcomes” domain differed across the different methods
Summary
In April 2009, China had announced a health reform blueprint for achieving universal coverage by2020 [1]. To meet the overall design and working requirements for expanding health care system reform in China and to ensure that health care system reform will proceed in a planned and orderly manner, the Center for Health Statistics and Information (CHIS) has conducted an evaluation titled Monitoring and Evaluation of China’s Health Care System Reform. The establishment of a scientific evidence-based monitoring and evaluation system is needed to answer a series of questions: How has Hubei Province’s health care system performed? The health care system reform evaluation has three aims: managing the health investment, monitoring the reform process and providing evidence-based assessment of reform policies. We conducted a comprehensive evaluation of health care system reform in Hubei Province from 2009 to 2011 by establishing an indicator system for performance evaluation.
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