Email updates

Keep up to date with the latest news and content from BMC Health Services Research and BioMed Central.

Open Access Research article

A case study of the counterpart technical support policy to improve rural health services in Beijing

Weiyan Jian1, Kit Yee Chan12*, Shunv Tang1 and Daniel D Reidpath3

Author Affiliations

1 Department of Health Policy and Management, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, Haidian District, Beijing, 100191, China

2 Nossal Institute for Global Health, University of Melbourne, Carlton, Victoria, 3010, Australia

3 School of Medicine and Heath Sciences, Jalan Lagoon Selatan, Bandar Sunway, Selangor, DE, 46150, Malaysia

For all author emails, please log on.

BMC Health Services Research 2012, 12:482  doi:10.1186/1472-6963-12-482

Published: 29 December 2012

Abstract

Background

There is, globally, an often observed inequality in the health services available in urban and rural areas. One strategy to overcome the inequality is to require urban doctors to spend time in rural hospitals. This approach was adopted by the Beijing Municipality (population of 20.19 million) to improve rural health services, but the approach has never been systematically evaluated.

Methods

Drawing upon 1.6 million cases from 24 participating hospitals in Beijing (13 urban and 11 rural hospitals) from before and after the implementation of the policy, changes in the rural–urban hospital performance gap were examined. Hospital performance was assessed using changes in six indices over-time: Diagnosis Related Groups quantity, case-mix index (CMI), cost expenditure index (CEI), time expenditure index (TEI), and mortality rates of low- and high-risk diseases.

Results

Significant reductions in rural–urban gaps were observed in DRGs quantity and mortality rates for both high- and low-risk diseases. These results signify improvements of rural hospitals in terms of medical safety, and capacity to treat emergency cases and more diverse illnesses. No changes in the rural–urban gap in CMI were observed. Post-implementation, cost and time efficiencies worsened for the rural hospitals but improved for urban hospitals, leading to a widening rural–urban gap in hospital efficiency.

Conclusions

The strategy for reducing urban–rural gaps in health services adopted, by the Beijing Municipality shows some promise. Gains were not consistent, however, across all performance indicators, and further improvements will need to be tried and evaluated.

Keywords:
Rural–urban health service inequality; Counterpart technical support policy; Health service reform; Health services accessibility; Healthcare disparities; Rural population; Urban population; National health programs; China