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'Reforming China's Rural Health System' examines the performance and workings of China's rural health system leading up to the reforms of the 2000s, outlines the reforms, and presents some early evidence on their impacts. The authors outline ideas for building on these reforms to further strengthen China's rural health system, covering health financing and health insurance, service delivery, and public health. The authors conclude by using the experiences of the Organisation for Economic Co-operation and Development countries to gaze into China's future, asking not only what China's health system might look like, but also how China might get there from where it is today. 'Reforming China's Rural Health System' will be of interest to health care policy makers, public health officials, university researchers, and others working to improve rural health and health service delivery in China and in other countries especially those in East and South Asia.

Drawing on the expertise of Chinese and Western academics and practitioners, the contributors to this volume aim to advance the understanding of philanthropy for health in China in the 20th century and to identify future challenges and opportunities. Considering government, NGO leaders, domestic philanthropists, and foreign foundations, the volume examines the historical roots and distinct stages of philanthropy and charity in China, the health challenges philanthropy must address, and the role of the Chinese government, including its support for Government Organized Non-Governmental Organizations (GONGOs). The editors discuss strategies and practices of international philanthropy for health; the role of philanthropy in China's evolving health system; and the prospects for philanthropy in a country beginning to engage with civil society.

In recent years, in order to provide patients with seamless and integrated healthcare services, some models of collaboration between public hospitals and community health centres have been piloted in some cities in China. The main goals of this study were to assess the nature and characteristics of these collaboration models. Three cases of three different collaboration models in three Chinese cities were selected to analyse using descriptive statistics, Pearson χ (2) and ordinal logistic regression. Results showed that the Direct Management Model in Wuhan exhibited better structure indicators than the other two models. Staff in the Direct Management Model had the highest satisfaction level (77.6%) with respect to patient referral. Communications between hospitals and community health centres and among care providers were generally inadequate. Publicity about hospital-community health centre collaboration was inadequate, resulting in low awareness among patients and even among health professionals. Results can inform health service delivery integration efforts in China and provide crucial information for the assessment of similar collaborations in other countries.

This study shows how a small number of medical reformers introduced modern healthcare services between 1928-1945 in China when Chinese people were suffering by the millions from infectious disease, maternal child mortality, and battlefield casualties.

China's 3 year, CN¥850 billion (US$125 billion) reform plan, launched in 2009, marked the first phase towards achieving comprehensive universal health coverage by 2020. The government's undertaking of systemic reform and its affirmation of its role in financing health care together with priorities for prevention, primary care, and redistribution of finance and human resources to poor regions are positive developments. Accomplishing nearly universal insurance coverage in such a short time is commendable. However, transformation of money and insurance coverage into cost-effective services is difficult when delivery of health care is hindered by waste, inefficiencies, poor quality of services, and scarcity and maldistribution of the qualified workforce. China must reform its incentive structures for providers, improve governance of public hospitals, and institute a stronger regulatory system, but these changes have been slowed by opposition from stakeholders and lack of implementation capacity. The pace of reform should be moderated to allow service providers to develop absorptive capacity. Independent, outcome-based monitoring and evaluation by a third-party are essential for mid-course correction of the plans and to make officials and providers accountable.

Eager to build an integrated community-based mental health system, in 2004 China started the ‘686 Programme’, whose purpose was to integrate hospital and community services for patients with serious mental illness. In 2015, the National Mental Health Working Plan (2015–2020) proposed an ambitious strategy for implementing this project. The goal of this review is to assess potential opportunities for and barriers to successful implementation of a community-based mental health system that integrates hospital and community mental health services into the general healthcare system. We examine 7066 sources in both English and Chinese: the academic peerreviewed literature, the grey literature on mental health policies, and documents from government and policymaking agencies. Although China has proposed a number of innovative programmes to address its mental health burden, several of these proposals have yet to be fully activated, particularly those that focus on integrated care. Integrating mental health services into China’s general healthcare system holds great promise for increased access to and quality improvement in mental health services, as well as decreased stigma and more effective management of physical and mental health comorbidities. This article examines the challenges to integrating mental health services into China’s general healthcare system, especially in the primary care sphere, including: accurately estimating mental health needs, integrating mental and physical healthcare, increasing workforce development and training, resolving interprofessional issues, financing and funding, developing an affordable and sustainable mental health system, and delivering care to specific subpopulations to meet the needs of China’s diverse populace. As China’s political commitment to expanding its mental health system is rapidly evolving, we offer suggestions for future directions in addressing China’s mental health needs. 为建立以社区为基础的综合精神卫生体系, 中国于 2004 年启 动了” 686 项目”, 旨在整合重性精神疾病的医院和社区服 务。2015 年, 《全国精神卫生工作规划 （2015-2020 年）》 提出了实施这一项目的宏伟战略。本综述目的是评估将医院 和社区精神卫生服务整合到卫生体系中, 建立以社区为基础的 精神卫生体系可能面临的机遇和障碍。我们回顾了 7066 份 中英文文献, 包括同行审议的学术文献、精神卫生政策的灰色 文献, 以及政府和决策机构的文件。虽然中国提出了一系列有 创造性的项目来应对精神卫生负担, 但有部分提案尚未完全启 动, 尤其是关注综合服务的项目。将精神卫生服务纳入中国的 卫生保健体系有望提高精神卫生服务可及性, 改善精神卫生服 务质量, 消除精神疾病污名, 更有效地管理躯体合并精神疾 病。本文探讨了将精神卫生服务整合入中国卫生保健体系的 挑战, 尤其是在初级保健方面, 包括：准确估计精神卫生需求, 整合精神和躯体疾病保健, 加强人员发展和培训, 解决跨专业 问题, 筹资和资金, 建立可负担、可持续的精神卫生体系, 以 及为特定人群提供服务从而满足中国百姓多样化需求。随着 中国政府越来越重视健全精神卫生体系, 我们为未来解决中国 精神卫生需求的方向提供了建议。 Deseosa de construir un sistema integrado de salud mental basado en la comunidad, China inició en el 2004 el ‘Programa 686’, cuyo propósito era integrar servicios hospitalarios y comunitarios para pacientes con enfermedades mentales graves. En 2015, el Plan Nacional de Salud Mental (2015-2020) propuso una estrategia ambiciosa para la implementación de este proyecto. El objetivo de esta revisión es evaluar las potenciales oportunidades y barreras para la implementación exitosa de un sistema de salud mental basado en la comunidad que integre los servicios de salud mental del hospital y de la comunidad al sistema de atención médica general. Examinamos 7,066 fuentes tanto en inglés como en chino: la literatura académica revisada por pares, la literatura ‘gris’ sobre políticas de salud mental y los documentos del gobierno y de las agencias de formulación de políticas. Aunque China ha propuesto un número de programas innovadores para abordar su carga de salud mental, varias de estas propuestas aún no se han activado por completo, en particular las que se centran en la atención integrada. La integración de los servicios de salud mental en el sistema general de salud de China es una gran promesa para obtener un mayor acceso y una mejora de la calidad en los servicios de salud mental, así como un menor estigma y un manejo más efectivo de las comorbilidades físicas y de salud mental. Este artículo examina los desafíos de la integración de servicios de salud mental en el sistema de salud general de China, especialmente en la esfera de atención primaria, que incluye: estimar con precisión las necesidades de salud mental, integrar la salud mental y física, aumentar el desarrollo y capacitación de la fuerza de trabajo, la resolución de problemas interprofesionales, el financiamiento y los fondos, desarrollar un sistema de salud mental asequible y sostenible, y brindar atención a subpoblaciones específicas para satisfacer las necesidades de la población diversa de China. A medida que el compromiso político de China para expandir su sistema de salud mental evoluciona rápidamente, ofrecemos sugerencias para direcciones futuras para abordar las necesidades de salud mental de China.

Qingyue Meng and colleagues assess what China’s health system reform has achieved and what needs to be done over the next decade