Introduction
Shanghai is a municipal city of China. China is divided into 18 districts and 1 county. There are 132 towns, 3 townships and 99 sub-district committees. Economic development in China was consistently pacing since 1990’s. The boom in economic development and further reforms of the economic system has assisted and set a platform for the development and encouragement of health reforms and introducing new health care systems and its development.
With the increasing population rate in Shanghai, the need of the reforms in the health care system and developing new health care systems are encouraged. Shanghai started taking initiatives for developing the health care systems just after the founding of the People’s Republic of China in 1949. That initial system provided many medical facilities and services to the local residents.
The health care system in China was a mixed system. Shanghai Municipal Health Bureau (SMHB) was a part of the public health services system. At the end of 2001, the sub agency of SMHB included 432 hospitals, 5 nursing homes, 57 institutes for disease prevention and health care. Whereas, there were 14 medical research institutions and other 75 health organizations. In Shanghai, Community-based health care services were also important as they played a central role in improving and maintaining the health services and also the quality of life for the elders and children (Willy L. De Geyndt, 1994)
They did not only provided services limited to increase quality and efficiency of the health programs for the elderly, but they were also responsible for effectively controlling the expenses incurred in providing health facilities and other medical expenses and also taking initiatives for increasing the health quality. The expenditure of health services was estimated to be 1.601 billion in 2001, which accounted for only 2.20% of the total expenditures occurred for the public in Shanghai.
Shanghai Municipal Centre for Disease Control and Prevention (Shanghai CDC) provided services to improve the public health services in Shanghai. The main goals of the Shanghai CDC were to provide the facilities to the community and also health needs of the individuals. Shanghai CDC was the non-profitable organization, it was also liable to implement public health management services such as ensuring the food safety, also providing health care for the children and women and also health-related products to the public.
According to the study and survey at the end of 1998, it was calculated that only one-fourth of the staff in community hospitals had an undergraduate qualification, background, and it was proved to be not enough for providing the health care services to the public. It was decided to increase the education of the staff in the hospitals in future to increase the knowledge and skills of the company.
It was necessary to upgrade the skills of the staff to solve the problems in their fields and also providing best services to the public. There were steps taken to increase the education in practice/family medicine by the universities so that the pass outs from those universities could be well educated and had knowledge for providing their services to the community and more efficient services for the elderly (Mooney, Paul, 2006).
The government took initiatives for the new reforms, which included the goals of ensuring the public health insurance coverage and increasing the role of the government in developing new and healthier facilities and providing more care and services to the greater part of the population. Previously, the government encouraged the private investments in the health sector to increase the development in this sector and also so that the health sector should be independent and they should stop depending on the government support. The private investments were also encouraged as the government wanted to increase the quality of services provided by the health cares.
1) Shanghai Health Care System
A) General Description
During the 80’s when China was going through economic changes, the health care system of China also experienced changes such as the government was being the owner, sponsor, and the provider of the system, but it changed in a way that the government started to get out of the picture. The government limited itself to only specific roles and the private investments were encouraged in the health care sector. These changes were made to free the health care sector from being dependent on the government outlays.......................
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