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Washington, D.C., World Bank, 1992. xxvii, 133 p. (World Bank Country Study)In the early 1990s, the World Bank sent a team of specialists in demography, medicine, hospital administration, health policy, personnel, medical technology, and finance to China to examine the present health status of the population and to protect its future status. Before making any projections, however, they had to learn what demographic and epidemiologic factors would basically determine future health status. The main factors driving China's health transition included aging of the population; increased risk of developing chronic disease caused by changes in life style, dietary, environmental, and occupational risk factors; and changing morbidity and mortality patterns (i.e., shift from infectious to disabling and chronic diseases). The team mapped out specific strategies, which can indeed be achieved, to avert a health care crisis. The strategies revolved around a sustained effort of primary prevention of chronic diseases, especially circulatory diseases, which caused considerable premature mortality. The team illustrated how different formulas of total health expenditures would affect epidemiologic outcomes. The team learned that health care costs would probably increase due to unavoidable demographic trends (especially demographic aging), epidemiologic forces, and utilization and unit cost changes. Suggested primary prevention strategies alone would not be enough to control health expenditures to a level where feasible equity can be maintained. China must also greatly improve efficiency of hospital services, personnel, and technologies. The evaluation team concluded that the government needs to reassess policies for financing primary and preventive health services, the basis and conditions of insurance, and the role of prices and incentives in directing use and provision of services.
Paris, France, Organisation for Economic Co-operation and Development [OECD], 1988. 90 p. (Demographic Change and Public Policy)This is the first in a planned series of volumes published by the Organisation for Economic Co-operation and Development (OECD) concerning the economic and social consequences of demographic aging in OECD member countries. "This detailed statistical analysis of demographic trends in the 24 OECD countries examines the implications for public expenditure on education, health care, pensions and other social areas, and discusses the policy choices facing governments." Data are from official sources. (EXCERPT)
China: long-term development issues and options. The report of a mission sent to China by the World Bank.
Baltimore, Maryland, Johns Hopkins University Press, 1985. xiii, 183 p. (World Bank Country Economic Report)This report summarizes the conclusions of a World Bank study undertaken in 1984 to identify the key development issues China is expected to face in the next 20 years. Among the areas addressed by chapters in this monograph are agricultural prospects, energy development, spatial issues, international economic strategy, managing industrial technology, human development, mobilizing financial resources, and development management. China's economic prospects are viewed as dependinding upon success in mobilizing and effectively using all available resources, especially people. This in turn will depend on sucess in reforming the system of economic management, including progress in 3 areas: 1) greater use of market regulation to stimulate innovation and efficiency; 2) stronger planning, combining indirect with direct economic control; and 3) modification and extension of social institutions and policies to maintain the fairness in distribution that is basic to socialism in the face of the greater inequality and instability that may result from market regulation and indirect controls. Over the next 2 decades, China can be expected to become a middle-income country. The government has set the goal of quadrupling the gross value of industrial and agricultural output between 1980 and 2000 and increasing per capita income from US$300 to $800. China's size and past emphasis on local self-sufficiency offer opportunities for enormous economic gains through increased specialization and trade among localities. Increased rural-urban migration seems probable and desirable, although an increase in urban services and infrastructure will be required. The expected slow rate of population increase is an important foundation for China's favorable economic growth prospects. On the other hand, it may not be desirable to hold fertility below the replacement level for very long, given the effects this would have on the population's age structure. The increase in the proportion of elderly people will be a serious social issue in the next century, and reforms of the social security system need to be considered.