The essence of the market-oriented reforms is to promote competition rather than privatization. Competition does not only exist between public and private ownership forms, but also among public hospital them-selves. The promotion of the internal competition among public hospitals will play a positive role for the market mechanism to take effect. Due to the unique in various aspects of health care market, competition can have positive or negative influences on performance, thus the policy makers need to guide the competition policies carefully to make sure they work in the right direction. In regard to the status quo, we provide the following policy suggestions which emphasize on stronger regulation, higher degree of autonomy for lower-level medical institutions, and more information disclosure.

Objective: To analyze the trends of development and equity of health institutions in China during the period from 2002 to 2013 , and put forward references to optimize the decision-making on health resources alloca-tion. Methods:Statistical map, Gini coefficient and other methods were used to analyze the distribution and equity of health institutions in China for 12 years, during the period from 2002 to 2013. Results:(1) The overall development of health institutions is on the rise in China, and the distribution density of health resources with the population ad-justment is opposite to the adjustment of both population and geographic area at the same time. (2) In the past 12 years, the number of tertiary hospitals showed an increasing trend, and growth in the eastern region was the most sig-nificant. (3) From 2002 to 2013, the Gini coefficient of the number of health institutions and beds per 1,000 per-sons per square kilometer was maintained at 0. 40, and decreased from 0. 70 to 0. 60 in the eastern region of China, respectively. This same number was maintained at 0. 40 and 0. 20 in the central and western region. Conclusion: In China, the fairness trend of health resources allocation has improved during the period from 2002 to 2013, but the imbalance is more serious in the eastern region than in the central and western regions. It should be paid more atten-tion to optimizing the health resources allocation according to the local conditions of different regions, especially the influence of geographical distribution.

Since the China's new healthcare reform has launched , beneficial policies introduced by the central and local governments has promoted the rapid development of private hospitals .This paper taking Sichuan Province as an ex-ample analyzes the development of private hospitals from four points of view:hospital amount, scale, location and services package, using 2002—2014 hospital-level data, which provides decision support for formulating and improving relative pol-icies.As per the analysis of the data at hand , it has been confirmed that private sector has developed quickly during the 13 years, with the number of hospitals increasing by 19.2%annually.Private hospitals were mainly of small-scale.Although the proportion of services provided by privates sector has grown yearly , it was merely 14.5%in 2014.The hospital location that the private sector selected concentrated mainly in developed regions , but the proportion of private hospital in the un-derdeveloped region has risen steadily .In terms of types of service provided , there were certain differences between private and public sector.Compared to the public sector, the private sector provided a higher proportion of specialized medical services, concentrating on otolaryngology , cosmetic plastic surgery , cardiovascular services , etc.

Objective: To assess the private hospital development in China from 2005 to 2016 from a global perspective. Methods: We searched the English and Chinese literature in PubMed, CNKI and Google Scholar databases with the keywords including "private hospitals in China", "hospital ownership", "public and private hospital", "private hospital development". Descriptive statistical analysis was used to assess the trend of the private hospital development in China and worldwide. Both the change of private hospitals in supply capacity and health care delivery were studied in this paper. The number of hospitals, number of hospital beds and the average number of hospital beds per hospital were employed to measure the supply capacity. The visit number, inpatients number, and bed occupancy rate (BOR) were used to measure the healthcare delivery. The data was collected from the China Health Statistical Yearbook and the website of Organisation for Economic and Co-operation and Development (OECD) Statistics. Results: The private sector rapidly expanded in China's hospital market in recent years. The number of private hospitals exceeded the public sectors in 2015. There has also been a signifi cant rise for the indicators of both the supply capacity (including number of hospitals, number of hospital beds and the average number of hospital beds per hospital) and the health care delivery (inpatients number and BOR) of the private hospitals. However, the growth rates of them were relatively lower than the public. The expansion trend of China's private sector in the hospital market accorded with most the OECD countries around the world. In 2016, China was above the medium level of the share of the private hospitals' number with the OECD countries, but below the medium for the supply capacity, in terms of the hospital beds. Conclusion: As a result of the economic growth and supporting policy, the private sector has experienced a vast expansion in China's hospital market in the past decade. The rising gap in average size between private and publicly owned hospitals, and the inconsistent development between the private hospitals' supply capacity and their market share, have become the two main challenges. Meanwhile, the future policy in supporting the private sector should be carefully introduced to advance the whole healthcare delivery system development in China.