The Health Care System and Public Health in China
اسلاید 1: www.tabaye.ir
اسلاید 2: The Health Care System and Public Health in China
اسلاید 3: China’s Health Care SystemPublic Health in ChinaI will discuss…
اسلاید 4: Basic Statistics/Economic statusSystem overviewWho pay for health services?Government’s health policies China and its Health Care System
اسلاید 5: Area: 9.6 million km2Total population: 1.27 billion (2000)Population in rural areas: 63.8％Administrative Region: 31 provincesGDP: 8,940.4 billion RMBNumber of health agencies: 330 thousandNumber of health workers: 5.568 millionNumber of school of public health: 36 China:Basic Statistics Source : China statistical year book,2001
اسلاید 6: Economic Status by Province, 1999Source : China statistical year book,2000
اسلاید 7: Health Care SystemThe organization structure of Chinese health Care systemState Department Government of Provincial, Municipal, Autonomous RegionProv Dept of Health Local Dept.of Health Chinese Academy of Medical ScienceChinese Academy of Preventive Medicine Medical Colleges and UniversitiesDrug and Bioengineering Product Research Institute The Ministry of Health General and Specialized hospitalEpidemic Prevention StationMaternity and Children Health Care Hospital (Clinic)Drug Inspection StationRegional Administrative OfficeGeneral and Specialized hospitalEpidemic Prevention StationMaternity and Children Health Care Hospital (Clinic)Drug Inspection StationGovernment of Municipal, County, DistrictTownship hospital (clinic), District hospitalOutpatient clinicMunicipal (District) hospital, County hospital, Epidemic Prevention Station, Endemic Disease Prevention StationMaternity and Children Health Care Hospital (Clinic), Secondary Health SchoolTownship government, Subdistrict OfficeVillagers’ committee, Neighborhood residents’ committeeVillage health station, Red Cross health stationDistrict department of HealthThree tiered prevention and health care system
اسلاید 8: County Hospital Agencies: 2008Workers:487684Township hospital(Clinic) Agencies: 47928Workers:1163700 County Maternity and Child Health HospitalAgencies: 1387Workers:49313Township hospitalsAgencies:693518Workers:1282310Health Network of Three Tiered in Rural Area County Epidemic Prevention StationAgencies: 1657Workers:87468
اسلاید 9: China Health Information SystemMinistry of Health, P.R.ChinaChina CDCCenter of Information of MOHInstitute of Medical Information, CAMSOtherHealth ProjectResearch Institutionsof Medical ScienceMedical Colleges PreventionMedicineEducationResearch, and ExecutionFacilitiesFacilities ofDiseasesControl and HealthSupervisionat all levelsHealth UnitsLocal Health Dept Local Health Dept Provincial Dept of Health Univ.directly under MOH
اسلاید 10: Who pay for health services ?1949-1977 free health services for the entire urban population, government pay system1978-1996 government & hospital paid health services 1996-now government, collective & individual paid health services
اسلاید 11: The Medical Expenditure Per Capital Outpatient (Unit: RMB)Average medical expenditure to per person-timeContainContainContainContainThe range of increase (%)Average medical expenditure to per person-timeThe cost of drug The cost of drug The cost of Treatment and examinationThe cost of Treatment and examinationThe range of increase (%)Absolute numberproportionAbsolute numberproportion199010.9 7.467.9 2.119.312.4199539.925.664.2 9.122.833.8199761.637.861.4 9.715.717.4199979.047.459.514.418.214.8200085.850.358.616.819.6 8.6
اسلاید 12: Change Trend of the Medical Expenditure Per Capital Outpatient and Inpatient (Unit: RMB)Treatment of Person-Time Out-PatientTreatment of Person-Time Out-PatientExpenditure of Patient In- PatientExpenditure of Patient In- PatientTreatment expenditureCost of Drug Treatment expenditureCost of Drug1990 10.9 7.4 473.0 260.61998 68.8 42.72596.81278.81999 79.0 47.42891.11363.62000 85.8 50.33083.71421.9Rate of increase (%) Average rate 90-98 25.9 24.5 23.7 22.0 Average rate 1999 14.8 11.0 11.3 6.6 Average rate 2000 8.6 6.1 6.7 4.3
اسلاید 13: Total Health Expenditure 1995-2000 Unit:RMBIndex1995199619971998199920001.Total health expenditure（100 000 000）卫生总费用2257.82857.23384.93776.54178.64764.0 The budgetary health expenditure by Gov.(%) 政府预算支出 17.0 16.115.415.615.314.9 Health expenditure by society （%） 社会卫生支出 32.729.627.726.625.524.5 Health expenditure by individual （%） 个人卫生支出 50.354.356.957.859.260.62.The total health expenditure by per capita 人均卫生总费用110.1143.3179.7205.2245.6318.13。The percentage to GDP by health expenditure(%) 卫生总费用占GDP% 3.86 4.21 4.55 4.82 5.10 5.334。GDP(100 000 000) 国内生产总值 58478 67885 74463 783458206889404The absolute value of the national total health expenditure and total health expenditure per capita increased in successive yearsThis proportion of GDP showed increasing trend, but it is still lower than that of the countries of OECD.The percentage of the individual expenditure showed increasing, Gov. and society expenditure showed decreasing trend
اسلاید 14: The proportion of the total health expenditure in China1990-1995The percentage to GDP(%)
اسلاید 15: UrbanRural Population%26 .473.6Maldistribution of Health Resources 29.970.1 Population%19911997Distribution of Resource%80.719.346.753.5Distribution of Resource%
اسلاید 16: Total Health Expenditure As Percentage of GDP
اسلاید 17:
اسلاید 18: Comparison the proportion of health expenditure to GDP in Five Countries in 1995
اسلاید 19: Health Policy in China(1950s) Meet health needs of the workers, peasants and soldiersPut the prevention firstCombine the Western and Chinese Traditional Medicine Link the health care work with the mass movement
اسلاید 20: Health Policy in China(1980s)Put the prevention firstRely on the advanced scientific progressMobilize the whole society to participate in Equal emphasis on the Western and Chinese Traditional Medicine Serve for people’s health
اسلاید 21: Health Policy in China(2000s) --The 1996 Health Meeting of China’s Central Gov. Emphasize on the health work in the rural areasPut the prevention firstEqual emphasis on the Western and Chinese traditional medicine Rely on the science and education Mobilize the whole society to participate in
اسلاید 22: History of Public Health Public Health Achievements Public Health ChallengesPublic Health in China
اسلاید 23: Brief History of PH in ChinaBefore the Eighteenth CenturyThe Eighteenth –Nineteenth CenturyThe 20s-30s of the Twentieth CenturyThe 50s-70s of the Twentieth CenturyThe 80s-90s of the Twentieth Century
اسلاید 24: Brief History of PH in China --before of the eighteenth centuryThe Yellow Emperor’ s Canon Medicine – the earliest and most comprehensive theory of traditional Chinese medicine The Ancientry philosophy of PH: The best medical doctor should know how to deal a disease before it developedDisease involves two aspects: pathogen and body resistance, both should be considered when dealing with disease prevention.Holistic health: regular life, a proper diet, an appropriate exercise, harmony in mental and emotional activities
اسلاید 25: Book on epidemic febrile diseases Experience of diagnosing and treatingWestern(modern) medicine into China in 1830s, by Christian missionariesBrief History of PH in China -- the 18th –19th century
اسلاید 26: The western medical hospital in China, represented by Peking Union Medical College Hospital The first Department of Public Health within PUMC in 1921, by Dr. John B. Grant, who was the Far-East representative of RFA model of health-care community in Ding County, Hebei province, as an educational field of department of PH in 1928An early example of primary health care system was established in Ding county during 1932-1937 by Prof. Chen Zhi-qian Brief History of PH in China -- the 20s-30s of 20th century
اسلاید 27: Coping the public health system of the former Soviet Union in 1950sSetting up an anti-epidemic system in 1950sSeparate public health school from clinical medicine in 1950sForming Patriotic Health Campaign, established PHC Barefoot doctor system in rural areas in 1960sRed cross clinic system in urban areas in 1960sBrief History of PH in China -- the 50s-70s of 20th century
اسلاید 28: The great sanitary awakening Preventing acute infectious diseases Health education Free basic immunizationEstablished three-tiered PHC networkA war against ‘four devils’: flies, mice, mosquitoes and sparrowsIn the 1960s-1970s controlled many serious epidemics of communicable diseases, such as cholera, plague and malariaBrief History of PH in China -- the 50s-70s of 20th century
اسلاید 29: The rapid development of public health in China reform and open policy development of science and technology and education the primary health care in China international collaborationEstablished and perfected health three-tiered network Strengthened maternal and child health Expanded program immunization Brief History of PH in China -- the 80s-90s of 20th century
اسلاید 30: The Development and improvement Establishment Before 18th century18th –19th century20s-30s 20th century50s-70s 20th century80s-90s 20th centuryTimeline of History of public Health Traditional medicine of ChinaWestern medicineThe Beginning
اسلاید 31: Birth rate(BR). Infant mortality rate(IMR). Crude death rate(CDR). Life expectancy(LE)
اسلاید 32: Leading Causes of Death
اسلاید 33: Birth Rate (‰)36 (‰)16.6 (‰)Birth Rate Decreased
اسلاید 34: The Incident Rate of Communicable Disease in China(1965~1998)发病率（1/10万）
اسلاید 35: 30 million/year 30 thou.40‘s90‘s 12 million 750 thou.Parasitic Diseases:Under ControlPatient ‘s umber of MalariaPatient ‘s number of Schistose
اسلاید 36: Proportion of different infectious disease cases 1965-1995 (%)Transmitted by sex or bloodRespiratoryGastrointestinalVector-borne and natural endemicYear
اسلاید 37: Patriotic Sanitation CampaignClear environment Kill mouse污水处理Sewage Sanitary privy
اسلاید 38: Strengthening Health legislation- issued 9 laws, 24 rule of laws and more than 400 regulations
اسلاید 39: Development of Epidemic Prevention Institutions 28300059002500500
اسلاید 40: World Health Report 2000 Selected Indicators Attainment of Goals达标成就Attainment of Goals达标成就Attainment of Goals达标成就Performance效能Performance效能Health level 健康水平DALYResponsiveness反应性水平Fairness in financial contribution资金捐助公正性On level of health按健康水平评估 Overall health system整体效能USA24154-557237Sweden41012-152123Japan168-11910China8288-8918861144Thailand10033128-13010247
اسلاید 41: The Experts of the World Bank Evaluate Primary Health Care in China: “Truly, Declare of Alma-Ata in 1978 about the realization ‘Health for all by the year 2000’ by primary health care was deeply influenced by Chinese model”
اسلاید 42: Change of PopulationUrbanization and industrialization Double burdens of diseasesBehavioral and Environmental Unreasonable of allocationChallenges
اسلاید 43: Trend of Age Composition Change1999 yearChina:0.126 billion Asia:0.314 billion World: 0.593 billion 2050 yearChina:0.440 billionAsia:1.239 billionWorld: 1.969 billion
اسلاید 44: 02468101214161819531964198219901995200020151949 total 0.58 billionAging 8%Trend of Population and Aging （0.1 Billion)2050 Aging 25%2000 total 0.126 BAging 10%20502015 Aging 14%
اسلاید 45: The change trends of the structure of population, dependency ratio and medical vulnerable population in China from 1980 to 2025
اسلاید 46:
اسلاید 47: Urbanization and IndustrializationEnvironmental pollutionLife and work stressInjuryImmigrant
اسلاید 48: The Natural Ecological Environment —— PollutionThe comparison of the sewage discharge between 1998 and 1999 Wastewater↗4.6%↘1.6%↗1.5
اسلاید 49: The amount of urban refuse in China BeijingIn 1996 the amount of urban refuse cleared and transportedIn 2000Waste residue↗8.98%↗ 15%~20%1.08×108 t 1.2×108 t ~1.4×108 t
اسلاید 50: In 1999, the coal smoke type was still the main type of air pollution in ChinaWaste gasThe major pollutants were total suspended particulates (TSP) and sulfur dioxideA few megalopolises were the complex type of coal smoke and automobile exhaust pollution
اسلاید 51: Double Burdens of DiseaseThreats of communicable disease and parasitic disease still existsChronic and non-communicable disease growth rapidly
اسلاید 52: Threats of Infectious Disease and Parasitic Disease Still Exists Threats from old infectious diseases such as Tuberculosis and hepatitis still exists New threats from new arising communicable diseases such as AIDS
اسلاید 53: 1957 Year1999 Year Changing Trend of Case of Death In urban
اسلاید 54: RespiratoryHeart diseasecerebrovascularcancerMetabolized diseaseDigestive diseaseThe prevalence and mortality rate of chronic and non-communicable diseases rises continuously ( In urban areas, 1954-1998)
اسلاید 55: Behavioral Risk FactorsSmokingDrinkingDirt
اسلاید 56: SmokingAt present China has turned into the biggest country of tobacco consumption in the worldAccounting for more than 30% of the total tobacco consumption in the whole worldIncreasing at the speed of 5.3% annually
اسلاید 57: Production and Marketing of tobacco in ChinaSource:The Report of Tobacco in China
اسلاید 58: It is expected that it will reach 47.2624 million tons in 20001952~1978: The annual growth rate was 5.3% DrinkingThe statistics of the annual sales volume of drink in China1982~1989: The annual growth rate was 13.3% 1990~1995: The annual growth rate was 13.1%
اسلاید 59: DietThe comparison of food consumption by residents between 1991 and 1997 in the city and country of Chongqing municipality (kg/year·person)CityCountryGrain↓117.9→71.1↘250.3→245.5
اسلاید 60: The prevalence of overweight18.28%The prevalence of obesity2.48%In Chinese population aged 20+Overweight240 millionObesityMore than 30 millionObesity: BMI ≥30kg/m2Overweight: BMI≥25kg/m2
اسلاید 61: Social population environmentNatural ecological environmentWorking environmentLiving environmentEnvironments Risk Factors
اسلاید 62: The new concept of environment and healthSpiritMindBodyFamilyPersonalBehaviorPsycho-Socio-EconomicEnvironmentHumanBiologyPhysicalEnvironmentPersonalTimeUrbanSystemWorkLifestyleCultureBiosphereThe model of the Human Ecosystem ——Hancock and Perkins, 1985
نقد و بررسی ها
هیچ نظری برای این پاورپوینت نوشته نشده است.