Universal health coverage in China part 1: progress and gaps

Area of Science:

• Health Services Research
• Public Health Policy
• Global Health

Background:

• China has demonstrated substantial progress in healthcare service coverage over the past two decades, particularly in reproductive, maternal, newborn, and child health (RMNCH), infectious diseases, and service accessibility.
• Coverage in these key areas now rivals that of high-income nations, with notable reductions in service coverage inequalities.
• Despite these advancements, significant disparities persist in chronic disease service coverage, and progress in controlling chronic disease risk factors has been minimal in the last decade.

Purpose of the Study:

• To comprehensively evaluate China's progress towards achieving universal health coverage (UHC) by the 2030 target.
• To identify specific achievements and persistent gaps in healthcare service coverage critical for UHC.
• To assess the extent of financial risk protection for the population, particularly concerning catastrophic health expenditure.

Main Methods:

• The study involves a comprehensive evaluation of China's healthcare system performance.
• Analysis focuses on key indicators of service coverage across different health areas, including RMNCH, infectious diseases, and chronic diseases.
• Assessment includes examining trends in health inequalities and the prevalence of catastrophic health expenditure.

Main Results:

• China has achieved high coverage rates comparable to high-income countries for RMNCH and infectious diseases, with reduced inequalities.
• Service coverage for most chronic diseases remains lower than in high-income countries, with limited progress in managing risk factors.
• China experiences a disproportionately high incidence of catastrophic health expenditure compared to countries at similar economic development levels.

Conclusions:

• While China has made strides towards universal health coverage, particularly in RMNCH and infectious diseases, substantial gaps remain in chronic disease management and financial risk protection.
• Addressing the challenges in chronic disease service coverage and mitigating catastrophic health expenditure are crucial for China to meet its 2030 UHC goals.
• Continued policy focus and investment are necessary to ensure equitable and comprehensive healthcare access for all citizens.