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Understanding medical corruption in China: a mixed-methods study.

Hongqiao Fu1, Yi Lai2, Yuanyuan Li1

  • 1Department of Health Policy and Management, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Beijing 100191, China.

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|February 17, 2023
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Summary

Medical corruption in China, primarily bribery, is driven by financial pressure and weak oversight. Recent interventions show positive progress in reducing corrupt practices, offering lessons for developing nations.

Keywords:
ChinaMedical corruptionbriberyembezzlementhealth system researchinformal paymentinsurance fraudmixed methods

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Area of Science:

  • Public Health
  • Health Policy
  • Criminology

Background:

  • Medical corruption hinders global health goals, particularly in developing nations.
  • Understanding medical corruption in China, the largest developing country, is crucial.
  • Existing research on medical corruption patterns and drivers in China is limited.

Purpose of the Study:

  • To examine patterns of medical corruption in China.
  • To explore the key drivers of medical corruption.
  • To investigate the perceived effectiveness of anti-corruption interventions in China.

Main Methods:

  • Mixed-methods design combining data from three sources.
  • Analysis of 3546 medical corruption cases from China Judgments Online (2013-2019).
  • Nationally representative household survey (2011-2018) and key informant interviews (n=17).

Main Results:

  • Bribery (68.1%) was the predominant form of medical corruption, followed by embezzlement (22.8%) and insurance fraud (9.1%).
  • Healthcare providers were major bribe-takers, while suppliers of pharmaceuticals and medical equipment were key bribe-givers.
  • Informal payments from patients remained low (0.4% outpatients, 1.4% inpatients in 2018).
  • Financial pressure and weak oversight identified as primary drivers.
  • Anti-corruption campaigns, procurement reforms, and fraud crackdowns were perceived to reduce corruption opportunities.

Conclusions:

  • Medical corruption in China is multifaceted, with bribery being the most prevalent form.
  • Financial pressures and inadequate oversight significantly contribute to corrupt practices.
  • Recent anti-corruption initiatives demonstrate positive impacts, suggesting progress in combating medical corruption in China and offering valuable insights for other developing countries.