Contents Forew0rd.·····… Acknowledgements Executive Summary...·····. Abbreviations..····· XXV Introduction............. xxvii Background:Impressive Gains in Health Outcomes, but Substantial Challenges Ahead Aging,chronic disease,and risk factors..................................... 2 Quality of care…………… 6 Inefficient service delivery:hospital-centrism,fragmentation and Distorted incentives..................................................... 6 Risk of low value care:Diminishing gains in health with escalating Health spending....… 10 Spending projections.………… 11 Part I Service Delivery Levers 17 Shaping tiered health care delivery system in accordance with People-Centered Integrated Care Model (Lever 1) 19 Introduction .................. 19 DEEPENING HEALTH REFORM IN CHINA 计DEEPENING HEALTH REFORM IN CHINA iii Contents Foreword ............................................................... ix Acknowledgements .......................................................xi Executive Summary ...................................................... xv Abbreviations .......................................................... xxv Introduction .......................................................... xxvii Background: Impressive Gains in Health Outcomes, but Substantial Challenges Ahead 1 Aging, chronic disease, and risk factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Quality of care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Inefficient service delivery: hospital-centrism, fragmentation and Distorted incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Risk of low value care: Diminishing gains in health with escalating Health spending . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Spending projections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Part I Service Delivery Levers 17 Shaping tiered health care delivery system in accordance with People-Centered Integrated Care Model (Lever 1) 19 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19