Achieving universal health coverage-the case of Zhuhai city

Universal health coverage cannot be achieved without evidence from research, which requires national and international support. We hope that our careful documentation of one of China's local experience in designing and implementing the basic health insurance coverage, and our analysis of how it helped to achieve universal health coverage, will inform other systems in China as well as other relevant countries on their way to universal coverage.

The paper first presents the development of Zhuhai's basic health insurance system chronologically; then comprehensively describes the background and the key components of the common disease outpatient benefit package; followed by a comparison with the common practices of outpatient benefit package of other areas of China and four neighboring countries. It also summarizes the strengths and weakness of the package, and lists the remaining research questions for future studies.

The common disease outpatient benefit package of Zhuhai has helped to improve the universal health coverage of Zhuhai in the following aspects: securing all citizens' access to the common disease outpatient services under the basic health insurance coverage; containing the rapid growth of health expenditures; enhancing provider awareness of expenditure and encouraging cost-effective interventions through appropriate financial incentives; and shifting the focus from treatment to prevention and preventing the development of common diseases into serious conditions with high cost specialist services. The common disease outpatient benefit package greatly improved and strengthened the basic health insurance system through secured equal access to affordable outpatient care for common conditions.

Limited health resources are used more efficiently by pooling the risks and by implementing capitated provider payment, which enhances the cost awareness by health care providers, to improves efficiency and creates positive incentives for health professionals for using the most cost-effective health interventions.