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The health system is largely a system of private financing and public provision, with public expenditures left to fill gaps, provide employment-based social health insurance and address shortfalls in public health services.

In the past 20 years, an over-reliance on household payments to finance health care operating costs has led to increasing inequities in access health services. As a proportion of GDP, the share of public social sector health expenditure has steadily gone down in real terms. National Health Accounts data show that while total health expenditures have risen over time as a share of GDP, government’s share of total health expenditures dropped from 36% to 15% from 1980 to 1999.

The Urban Employee Basic Medical Insurance System, established in 1998, now covers over 100 million people. Reforms are underway to expand the coverage of the urban insurance system and improve the efficiency of service delivery. In rural areas, the central Government has decided to establish a new Rural Cooperative Medical System (RCMS). The proposed system includes a health service network with basic health facilities and equipment, a professional rural health service team and an efficient rural health management team. A number of pilot projects have been undertaken in selected poor countries in several central and western provinces.

By the end of 2003, there were 305 000 health care institutions in China, including 64 000 hospitals and health care stations, 3058 maternal and child health care institutions, and 1811 specialized health institutions or stations. Hospitals and health care institutions in China had a total capacity of 2.9 million beds. There were 4.24 million health workers in China, including 1.83 million practising doctors and assistant doctors and 1.24 million registered nurses.

(Source: WHO Country Health Information profile 2004)

General information (estimation 2004)