Study On Foreign Countries' Health And Rural Health System Under The Framework Of It

The study of this dissertation is based on the following background:the problem of "seeing a doctor is costly and hard" upsets Chinese society for a long time.There's no breakthrough on the reform of health as yet.This reflects the lack of equity during the process of social development.The most inequity in health exists prominently between urban and rural areas,namely there's huge diversity of health,inequity in public health and medical resource configuration,and in service utilization between urban and rural areas.In general,Chinese rural health system is not suitable for increasing health demand of rural residents,and rural health system is urgently established and ameliorated.This requires us standing in domestic conditions in the construction of health system,then exploring a syetem mode or route which has our own feature.At the same time,we need also learn essential experiences from foreign countries'health systems.Therefore,it is necessary to go further into ecomomic and social background behind it and study the experiences of process and tendency of it through historical and developing view,then puts forword policy advice which can reform and ameliorate Chinese rural health system on the foundation of summarizing the experiences and rules.This dissertation is arranged from the view of public policy,public management and social development.It sets out to analyse from multi-layer and multi-angle by using the theories of politics,economics and sociology which come from the new institutional economics and social policy for development. It studies systematically diffetent health system and reforming trends about foreign countries,especially rural areas of them,and sums up some experiences and trends which are possessed of commom character,then puts forword feasible advice of system design .It aims to provide systemic reference for Chinese rural health system reform by learning from foreign countries' experiences.Health system includes three modes:national welfare health mode,market-led health mode and social insurance health mode.This dissertation introduces them one by one through typical cases of developed countries such as Britain,United States and Germany.It also compares and summarizes them theoretically,and consider that those modes have respectively some deficiencies on aspects of equity,efficiency and suitability.There's no perfect health system modes.After describing developing countries' health financing and service delivering systems from macro-view,it comes to a conclusion that developing countries should pay more attention on primary health and public health.As for theoretical foundation of health system, according to the clue of health system development,after tidying up those theories,it answered the following questions:the causes of establishing health care system,the relationship between equity and efficiency in health system,the track of impelling benign development of system, the status and function of government in health system.Rural health situation in developed countries is commonly inferior to that of urban,this reflects that there exists health inequity between urban and rural areas in developed countries. At the same time,rural areas is possessed of the characters in nature,society and market which are distinct from urban areas,and rural residents are distinctive from urban ones in health situation and need.Therefore,it is indispensable to study rural health systems specially and thoroughly.In the analysis of typical case,this dissertation selects rural health systems of four countries(United States,Australia,Germany and Japan)to study thoroughly,then sums up the characteristics which developed countries'rural health systems is universally possessed.They include:(1)the gap between rural and urban health service is not huge;(2)government has dominant role in aspects of health financing and service supply;(3)means of planning and marketing are both used in health service;(4)equity and efficiency are equally considered in health system.Compared to that of developed countries,rural health systems in developing countries have much meaningful to Chinese rural health system construction.The standard of economic development in developing countries is lower,and health investment is less accordingly.As a whole, developing countries are suffering from "dual burden of sickness "which includes traditional diseases such as infectious disease,malnutrition and new-born syndrome on the one hand,on the other hand, rapidly spreading AIDS and increasing non-infectious disease.Developing countries are confronted with the mission of how to provide the public with universal essential health care service.This dissertation selects four developing countries(India,Thailand,Brazil and Mexico)which are similar to China regarding standard of economic development and demography,then analyses thoroughly their health systems.These countries'governments pay attention on rural health systems construction,and make great efforts to guarantee that rural residents can enjoy commom treatment,explore a way of system innovation which has themselves own feature lastly.Through analysis,we think that rural health systems in developing countries has following characteristics:(1)paying attention to health equity;(2)paying highly attention to primary health care;(3)paying newly attention to rural health systems construction ;(4)establishing multi-level medical care systems;(5)endeavoring to explore rural health systems which has their own countries'feature.Based on the analysis of foreign countries'health systems,especially rural health systems,according to the structure of health system,this dissertation sums up experiences which have learning meaning to Chinese rural health system construction from three sides of health regulation,health service supply and medical care. Aiming at those questions which exist in Chinese health system,by learning from those experiences,it puts forward advice of policy which may reform and ameliorate Chinese rural health system construction.Several causes lead to the fact that health situation of rural residents is inferior to those of urban.However,many countries'health systems are actually centred around urban areas.Those systems reflect urban residents'health needs and tendencies,not rural ones.Reviewing the whole content, this dissertation points out that in order to make rural residents enjoying more equitable health services,government should have rational and effective system design in the field of rural health. Aiming at huge inequity in Chinese rural health,it bring forward ardent expectation strengthening the study of Chinese health equity.