ReviewLancet (London, England)2014
Harnessing the privatisation of China's fragmented health-care delivery.
Review in Lancet (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 213 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
213 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Complications of Cochlear Implant Surgery in Low- and Middle-Income Countries: A Systematic Review.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Pooled it
- Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: a systematic review and policy gap analysis.BMC public health · 2020Pooled it
- A study on the clinical effectiveness of a tiered management model for type 2 diabetes based on a three-level linkage mechanism in the context of residency training: a randomized controlled trial.Frontiers in endocrinology · 2025Trial
- Effects of integrated chronic care models on hypertension outcomes and spending: a multi-town clustered randomized trial in China.BMC public health · 2017Trial
- Contract incentives and behaviours of medical consultants in Ireland.Nature human behaviour · 2026Article
- Does more generous health insurance reimbursement lead to moral hazard? Evidence from large-scale administrative data in China.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Mismatch between urban eco-sanitation improvement and health service supply capacity: evidence from Chinese city panel data and interpretable machine learning.BMC health services research · 2026Article
- An unintended complementarity: how the outpatient pooling policy increases inpatient services in China.Health policy and planning · 2026Article
- Urban residents' choice preferences for hospitals at different tiers and influencing factors: a study based on latent class analysis and Andersen's model of health service utilization.BMC primary care · 2026Article
- Provider behavior from FFS to DRGs payment: experimental evidence from real physicians.Health economics review · 2026Article
- Bridging evidence and care for knee osteoarthritis in China: a randomized feasibility trial with RE-AIM-guided process evaluation of the PEAK-CHN model of care.Implementation science communications · 2026Article
- Strengthening clinical research and practice in China's healthcare system: a decade of action via the NEJM pilot initiative.Medical review (2021) · 2026Article
- Efficiency assessment of gynecological resource allocation in tertiary hospitals: a Data Envelopment Analysis approach.BMC health services research · 2026Article
- Development and validation of dual-time-window readmission prediction models under China's medical insurance multi-payment reform.Frontiers in public health · 2026Article
- Spatiotemporal evolution and spatial benefit analysis of the coupling coordination of China's three medical systems.Frontiers in public health · 2026Article
- Epidemiological characteristics and changing patterns of hospitalizations among middle-aged and elderly patients in Northwest China, 2020-2024: A retrospective cohort study.SAGE open medicine · 2026Article
- Impact of the compact county medical service community policy on healthcare resource allocation and healthcare service utilization in village clinics: a difference-in-differences analysis in rural Sichuan, China.Frontiers in public health · 2026Article
- Study on edge villages based on cross-region healthcare-seeking behavior.International journal of health geographics · 2025Article
- Two-Way Referrals in Chinese Medical Consortia Under the Framework of Hierarchical Diagnosis and Treatment: Progress and Challenges.Journal of evidence-based medicine · 2025Review
- Article
153 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although China's 2009 health-care reform has made impressive progress in expansion of insurance coverage, much work remains to improve its wasteful health-care delivery. Particularly, the Chinese health-care system faces substantial challenges in its transformation from a profit-driven public hospital-centred system to an integrated primary care-based delivery system that is cost effective and of better quality to respond to the changing population needs. An additional challenge is the government's latest strategy to promote private investment for hospitals. In this Review, we discuss how China's health-care system would perform if hospital privatisation combined with hospital-centred fragmented delivery were to prevail--population health outcomes would suffer; health-care expenditures would escalate, with patients bearing increasing costs; and a two-tiered system would emerge in which access and quality of care are decided by ability to pay. We then propose an alternative pathway that includes the reform of public hospitals to pursue the public interest and be more accountable, with public hospitals as the benchmarks against which private hospitals would have to compete, with performance-based purchasing, and with population-based capitation payment to catalyse coordinated care. Any decision to further expand the for-profit private hospital market should not be made without objective assessment of its effect on China's health-policy goals.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.