Table 2 Revenue sources for community health stations before and after the 2008 reform in Weifang, compared to City Y
From: Contracting with private providers for primary care services: evidence from urban China
Revenue sources | Weifang, 2007 (pre-reform) | Weifang, 2009 (post-reform) | City Y, 2009 (comparison city) | |||
|---|---|---|---|---|---|---|
Public | Private | Public | Private | Public | Private | |
Subsidies for preventive services* 1 | Yes, according to the preventive services provided. | No. | Yes, decided by number of served residents and evaluation based on the contract. | Yes, same as for public CHS. | Yes, decided by number of served residents and evaluation based on the contract. | Yes, same as for public CHS. |
Subsidies for staff training | No. | No. | Yes, government provides some free training programs. | Yes, same as for public CHS. | Yes. | No. |
Subsidies for personnel | Yes, per capita budget and payment for retirees’ social insurance. | No. | Yes, same as before. | No. | Yes. | No. |
Subsidies for rental or purchase of land and clinic space | Yes, but amount differs according to CHS scale and scope. | No. | Yes, same as before. | No. | Yes. | No. |
Subsidies for equipment | Yes. | No. | Yes, one time 60,000RMB investment. | Yes, one time 60,000RMB investment. Refund to government if CHS withdraws from the CHS network. | Yes. | No. |
Subsidies for EML drugs* 2 | N/A (EML drug policy not yet launched.) | N/A (EML drug policy not yet launched.) | Yes, sell at acquisition price to patient; government pays the CHS the original 15% mark up for dispensing EML drugs. | Yes, same as for public CHS | N/A (EML drug policy not yet launched.) | N/A (EML drug policy not yet launched.) |
Fee for service from out-of-pocket payments | Patients charged according to government-set fixed or “guide” prices. | CHS has autonomy in setting prices. | Same as before. | CHS retains price-setting autonomy, but cannot exceed government “guide” prices. | Patients charged according to government-set fixed or “guide” prices. | CHS has autonomy in setting prices. |
Fee for service paid by urban employee insurance * 4 | Covered, but no difference from hospital outpatient care in terms of patient co-payment. | Not covered by the social insurance network. | Covered, and at a more generous rate than hospitals. Patient co-payments are lower than for hospital outpatient visits. | Yes, same as for public CHS. | Covered, but no difference from hospital outpatient care in terms of patient co-payment. | Not covered by the social insurance network. |
Fee for service paid by urban residents insurance * 4 | N/A (Urban residents insurance not yet launched.) | N/A (Urban residents insurance not yet launched.) | Covered, and at a more generous rate than hospitals. Patient co-payments are lower than for hospital outpatient visits. | Yes, same as for public CHS | Covered, but no difference from hospital outpatient care in terms of patient co-payment. | Not covered by the social insurance network. |