vi DEEPENING HEALTH REFORM IN CHINA Boxes L.1 What is Value in Health Care?.....................................xxviii L.2 Suggestions of the CPC Central Committee on the 13th Five-year Plan for National Economic and Social Development on the promotion of a "Healthy China"(pp.42-43,English translation).......................xxix L.3 Report Structure......... L.4 Nomenclature,Name and Location for Commissioned Case Studies........xxxiv 2.1 Defining People-Centered Integrated Care...............................20 2.1 Impacts of PCIC-like models..........................................21 2.1 The Potential Benefits of People-Centered Integrated Care...................22 3.1 What is Quality?Why Quality is important?.............................37 3.2 Existing evidence of over-utilization of drugs and health interventions.. ..39 3.3 Core action areas and implementation strategies to improve healthcare quality...40 4.1 Why is citizen engagement important?..................................51 4.2 Citizen Engagement to improve health care:core action areas and corresponding implementation strategies.................................52 4.3 Health Education in the UK:Skilled For Health...........................54 4.4 Social marketing in China:Prevention and control of Hepatitis B............. 5 4.5 The Million Hearts Campaign...... .56 4.6 Encouraging self-management of health:Examples from the UK and India......59 4.7 Improving patient involvement at the Beth Israel Deaconess Medical Center 4.8 Decision Aid for Stable Coronary Heart Disease by the Informed Medical Decisions Foundation 4.9 Health Coaching to Coordinate Care in Singapore......................... 61 4.10 Examples of using nudging and regulation to change target behaviors..........64 5.1 Management Practice Domains... .68 6.1 Examples of provider payment reforms in China ............ …85 9.1 Distinguishing Features of an Effective Service Planning Approach...........108 9.2 Horizon's Three Step Model.........................................111 9.3 Physical Redesign of Northern Ireland's Health System Model .115 10.1 Government Administrative Reforms and International Experience... .127 Figures ES.1 8-in-1 Interlinked Reform Levers..................................... xviii ES.2 Reform Implementation Roadmap................................... xxiv 1.1 Share of the Elderly in China will Rapidly Catch up with the OECD …2 1.2 Prominence of NCDs in the Burden of Disease and Causes of Mortality 3 1.3 Management of Hypertension and Diabetes.................... .4 1.4 Smoking and Alcohol Consumption in China Compared to Other Nations.......5 1.5 Hospital beds in China compared to OECD,2000-2013.....................7 1.6 Rapid Growth in the Number of Hospitals and Shift toward Higher Level Facilities...................................................... 1.7 Rising Health Care Cost in China......................................11 1.8 Health Care Expenditure Growth Rate in China..........................13 1.9 Composition of Health Spending in China,1997-2013............ ….14 1.10 Trend in Life Expectancy Compared to Total Spending on Health,1995-2015...14 1.11 Diverse Paths to Better Health.........................................15 2.1 Illness Burden Scorecard to risk stratify patients...........................26vi DEEPENING HEALTH REFORM IN CHINA Boxes I.1 What is Value in Health Care? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxviii I.2 Suggestions of the CPC Central Committee on the 13th Five-year Plan for National Economic and Social Development on the promotion of a “Healthy China” (pp. 42–43, English translation) . . . . . . . . . . . . . . . . . . . . . . . xxix I.3 Report Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxxi I.4 Nomenclature, Name and Location for Commissioned Case Studies . . . . . . . . xxxiv 2.1 Defining People-Centered Integrated Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 2.1 Impacts of PCIC-like models . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 2.1 The Potential Benefits of People-Centered Integrated Care . . . . . . . . . . . . . . . . . . .22 3.1 What is Quality? Why Quality is important? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37 3.2 Existing evidence of over-utilization of drugs and health interventions. . . . . . . . . .39 3.3 Core action areas and implementation strategies to improve healthcare quality . . .40 4.1 Why is citizen engagement important? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 4.2 Citizen Engagement to improve health care: core action areas and corresponding implementation strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52 4.3 Health Education in the UK: Skilled For Health . . . . . . . . . . . . . . . . . . . . . . . . . . .54 4.4 Social marketing in China: Prevention and control of Hepatitis B . . . . . . . . . . . . .55 4.5 The Million Hearts Campaign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56 4.6 Encouraging self-management of health: Examples from the UK and India . . . . . .59 4.7 Improving patient involvement at the Beth Israel Deaconess Medical Center in the US . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60 4.8 Decision Aid for Stable Coronary Heart Disease by the Informed Medical Decisions Foundation 4.9 Health Coaching to Coordinate Care in Singapore . . . . . . . . . . . . . . . . . . . . . . . . .61 4.10 Examples of using nudging and regulation to change target behaviors . . . . . . . . . .64 5.1 Management Practice Domains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .68 6.1 Examples of provider payment reforms in China . . . . . . . . . . . . . . . . . . . . . . . . . .85 9.1 Distinguishing Features of an Effective Service Planning Approach . . . . . . . . . . .108 9.2 Horizon’s Three Step Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 9.3 Physical Redesign of Northern Ireland’s Health System Model . . . . . . . . . . . . . . .115 10.1 Government Administrative Reforms and International Experience . . . . . . . . . . .127 Figures ES.1 8-in-1 Interlinked Reform Levers .....................................xviii ES.2 Reform Implementation Roadmap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiv 1.1 Share of the Elderly in China will Rapidly Catch up with the OECD . . . . . . . . . . . .2 1.2 Prominence of NCDs in the Burden of Disease and Causes of Mortality . . . . . . . . .3 1.3 Management of Hypertension and Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 1.4 Smoking and Alcohol Consumption in China Compared to Other Nations . . . . . . .5 1.5 Hospital beds in China compared to OECD, 2000–2013 . . . . . . . . . . . . . . . . . . . . .7 1.6 Rapid Growth in the Number of Hospitals and Shift toward Higher Level Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 1.7 Rising Health Care Cost in China . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 1.8 Health Care Expenditure Growth Rate in China . . . . . . . . . . . . . . . . . . . . . . . . . .13 1.9 Composition of Health Spending in China, 1997–2013 . . . . . . . . . . . . . . . . . . . . .14 1.10 Trend in Life Expectancy Compared to Total Spending on Health, 1995–2015 . . .14 1.11 Diverse Paths to Better Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 2.1 Illness Burden Scorecard to risk stratify patients . . . . . . . . . . . . . . . . . . . . . . . . . . .26