Health policy and systems research in China has rapidly developed over the past two decades, which helps evidence-based policy making and health systems strengthening.This article aims at reviewing and analyzing, and to come up with a summary of the major progress and future development trend in health policy and systems research are reviewed and analyzed.This article discusses also the current challenges and opportunities of health policy and systems research prevailing in China.

In order to meet the health needs of people, China’s health service system needs continuous reforms and adjustments. Health needs, equity and efficiency, quality of service, and the development history and current situation of the health service system are the four main dimensions to be considered during the building process of the system. This paper argues that building a people-centered health service system is the direction, and it describes its connotation from five different aspects, including human care, interrelated interests, primary health care-oriented, continuous integration, and conditions for support. This paper proposes the strategies and paths to build a people-cen-tered health service system, including to promoting the quality of primary health care, integrating health service sys-tems, and strengthening government’s responsibility.

In this paper, 172 non-public hospitals have been investigated covering east, central and western regions with structured and semi-structured questionnaire and group interviews. We found that the health insurance policies were the most concerned policies by non-public hospitals, accounting for 26.5% of the total. We also found that non-public hospitals from different areas, levels profit nature have different policy expectations, for example Eastern regional institutions wanted to make a breakthrough of the planning policies, the central region wanted to change the health personnel policy, while the western region is considered to be limited by land policy. Tertiary hospitals were more concerned about research projects and land policy, and secondary hospitals were more concerned about access policy. There were 44.8% of the surveyed institutions considered that regulatory policywasmore stringent public hospitals and public hospitals, and there were no difference between profit and non-profit hospitals. According to the survey results, this paper puts forward suggestion that we should implement more targeted policies, purchasing more services from non-public hospitals and enhanced supervision. Considering the survey results research team puts forward sensitive advice as: provide preferential policies in according with different kinds of institutions reinforce purchasing service and enhance non-public hospitals supervision.

Encouraging and providing guidance to social forces to invest in health care industry is one of the key elements determined to deepen the health care reform.From four aspects of the unclear conception and undefinable functions of non-public hospitals, ambiguity of property rights of non-profit non-public hospitals, gradual reduction of traditional management measures, and deficiency of effective supervision on daily operations, this paper summarizes the major policy issues in non-public hospitals.To solve these problems, this paper conducts a systemic analysis of the historical experiences of the United States, Germany, Japan, and Taiwan.On this basis, this paper suggests that the government should clearly determine the connotation and extension of non-public hospitals, improve non-profit non-public hospital policy system, play a guiding role in planning and health insurance guidance, and strengthen the supervision of business operations.

This paper aims at describing and comparing the changes of health resources allocation before and after new health system reform during 2006—2015 . Methods:Province-level data were used to analyze the inequities of licensed ( assistant) doctors and beds. 31 provinces were divided into 5 groups by GDP per capita and 3 groups by geographical regions. Absolute difference, relative ratio and concentration index were respectively used to compare and measure the absolute difference, relative difference and inequities in different groups before and after the new health system reform. Results:The findings of this study show the allocation of China's health resource before and after new health system reform to be as below:(1) the quantity of health resource is increasing, and the growth rate after the reform is higher than before. (2) the disparities of health resource in different economic development level areas are declining, and the decrease is faster after the reform. (3) the disparity of beds in different regions is decreasing, but the disparity of licensed (assistant) doctors in different regions is enlarging. (4) The inequities of health resource al-location in China are reduced, and the improvement is greater after the reform than before. However, the health re-source allocation is still highly inequitable to geographical areas. Discussion:(1) the policies of health resource allo-cation implementation after the reform needs improvement. ( 2 ) The amount of health resource still needs to be in-creased in certain areas, especially need to strengthen the training of high-qualified health personnel. (3) When al-locating health resources, government should focus on the impact of both population and geographical size factors.

Objective:To analyze the correlated factors on the non-public hospitals efficiency performance and compare different types of them in order to provide reference for improving efficiency.Methods:Based on the result of 160 non-public hospitals total efficiency,questionnaire surveys were taken for collecting the information of region,quality,form of ownership,whether invested by the government,whether under the medical insurance,the total amount of employers,bed and service amount as the independent variables,while the total efficiency as the dependent variable to conduct the Tobit multi regression analysis.Results:Access policy,investment policy,nature of ownership,the number of beds,the proportion of physicians,the per capita services,assets and equipment had significant impact.Conclusion:The development of non-public hospital was related to the policy environment,operation mode and internal management.

Objective:To evaluate the technical efficiency and scale efficiency of non-public hospitals in China to provide references for improving efficiency of non-public hospitals with the comparison with the differences among different non-public hospitals with different types.Methods:Input and output data of 160 non-public hospitals in 2014 were collected;C2R and BC2 models were adopted to evaluate the annual total efficiency,technique efficiency and scale efficiency.Results:There were 16 total efficient hospitals(10.00％),41 technical efficiency hospitals(25.63％) and 20 scale efficiency(12.50％),43 at IRS stage,99 at DRS stage.Conclusion:The overall efficiency of non-public hospitals was low relatively and most of them were lower than public hospitals at same level.Scale was an important factor affecting the efficiency of non-public hospitals.

To discuss the influences of government health input on the efficiency of hospital operation. Methods:Taking 16 county-level hospitals in Ningxia as samples, using DEA and DEA-malmqutist indicator method to calculate the technical efficiency scores from 2000 to 2012, then analyze the compositions of technique efficiency(TE) , using Tobit regression to analyze the relationship between government budget health expenditure and medical institution efficiency. Results: The Ningxia governmental health budget expenditure is growing almost 3 times from 2000 to 2012 and the average TE is 0.82-0.94. In the 16 county-level hospitals, the TFP of 6 hospitals (37.5%) was less than 1, and the minimum was 0.82; while the TFP of 10 hospitals (62.5%) were more than 1, the max was 1.699. For the 6 hospitals of which TFP was less than 1, the reason for negative growth of TFP was contributed to the slow technique change, the pure efficiency or small scale. The regression result of TOBIT showed that the government health expenditure increases 1 000 units, the efficiency of medical institutions will increase 0.0031. Conclusion: The relationship between the governmental expenditure and medical institutions is positive, but the technical efficiency of medical institutions expenditure was the result of multiple factors.

Objective: According to ERG ( Existence Relatedness Growth) needs theory, analyze factors influencing the resignation probability in Township Health Centers (THC). Methods: Structural equation model was used based on ERG needs theory. The sample consists of 403 stuffs in the THC. Results: The result of model fitting goes well. The satisfaction levels of the needs to survive and the needs of relationship become the major influencing factors of resignation probability in the THC. Conclusion: To reduce the resignation probability in THC, it needs to guarantee their income and benefits, improve working condition and living convenience facilities.

Objective: To judge the return to scale of inefficient decision-making unit(DMU)on data envelopment analysis(DEA). Methods: On the basis of return to scale method of classical DEA decision-making unit. Through comparing the same input of efficient and inefficient DMU, increase the quantities of output of inefficient DMU(the inverse of efficiency value), taking this point as the area of inefficient technique unit return to scale. Results: Taking the county-level hospitals of Chinese Medicine as examples, it is found that there are no clear judgment on the return of scale of inefficient hospitals, after adjustment, there are 4 inefficient hospitals are classified into increasing return to scale stage and decreasing return to scale stage, which embody obvious characteristics of insufficient output. Conclusion: The return to scale is important information to evaluate the efficiency of medical institutions which is the reason leading to inefficiency medical institutions.