HCMG MIDTERM 2 EXAM QUESTIONS &
ANSWERS 100% LATEST UPDATE!
CHINA - ANSWERS
Background of China's System in comparison to US - ANSWERSHC Spend per capita:
$501
- China's pop 4.4x size, but GDP per capita is 15% of US
- Avg Chinese spends less of income on HC, but the number is increasing at 2x rate
1949-1984: Healthcare as a social good overview - ANSWERS- started with public
health network instead of a formal HC system
- lacked resources, physicians, modern medicine, health literacy, and proper hospitals
- followed former Soviet Union model
- 80% of population lived in the rural area
The role of barefoot doctors - ANSWERS- pt. outreach, practice, and health education
- Led to decrease in infant mortality, increased life expectancy
- Major gains in controlling ID
- Shift of mortality from ID to chronic conditions
HC in the Urban Area - ANSWERS- gov owned and operated all health care facilities
and employed the HC workforce
- no incentive to provide unnecessary services b/c hospitals and clinics running on
central budget
- No incentive for physicians to over prescribe drugs or tests b/c healthcare workforce
was salaried
How was care paid for? - ANSWERS- insurance similar to state-run HSA
- Payment was on prepaid capitated basis
- HC payments tied to the planned economy, no formal HI for the entire population
- misfunctioned when the economy structure underwent a systematic change
1984 - 1997: Healthcare as a commodity overview - ANSWERS- transformation from
planned economy to market economy
- Gov continued to own hospitals but reduced subsidies to hospitals, clinics, and
healthcare workforce
- Public hospitals functioned as for-profit entities, focusing heavily on the bottom line
, - Physicians tied closely to hospitals vs. In US
Patient pathways to seeing physicians vs in the US (No primary care physicians) -
ANSWERS- Patient goes to hospital and the NP directs pt to specialist vs in US PCP
gives referral for a specialist if needed
- Sees the specialist in the same day
- Get prescription through hospital's pharmacy and obtain same-day testing
- Follow up visit is optional but no scheduling needed
Differences in US and China - ANSWERS- China has longer hospital stays
- China has more hospital beds per 1,000 pop
- Low payment to physician
- Paid by salary vs FFS
- High integration of physicians and hospitals
- High concerns abt fairness and equity
1984 - 1997: "Privatization" of the HC sector overview - ANSWERS- Payment switched
to FFS
- To ensure access to basic care - gov regulated service prices of physician and nurses'
time, routine visits and services such as surgeries, standard dx tests, and routine
pharmaceuticals
- Facilities allowed to earn profits from new drugs and devices, new testing and
treatments, with profit margins of up to 15%
- Part of those revenues circle back to compensate physicians as bonuses
Hospital behaviors under FFS - ANSWERS- Gov subsidies mainly go to Class 2 and 3
hospitals, Class 1 operates like private hospitals
- Hospital manager incentivized to introduce high-tech services and expensive imported
drugs to boost revenues
What is the difference between classes of hospitals and how much financing they get -
ANSWERSClass 1: 13.92% - community clinics
Class 2: 9.86% - municipal level hospitals and some specialty hospitals
Class 3: 7.13% - provincial level hospitals and top medical school affiliated hospitals
Drug sales and hospital revenue - ANSWERS- Main source
- 54% Pharma sales mark-up, 34.9% service charges, and 7.8% Gov public finance
budget allocation
Chinas Total HC Spend breakdown in 1989 - ANSWERS- 45% drug spend
- 17% Hospital personnel
- 15% Supplies and maintenance
ANSWERS 100% LATEST UPDATE!
CHINA - ANSWERS
Background of China's System in comparison to US - ANSWERSHC Spend per capita:
$501
- China's pop 4.4x size, but GDP per capita is 15% of US
- Avg Chinese spends less of income on HC, but the number is increasing at 2x rate
1949-1984: Healthcare as a social good overview - ANSWERS- started with public
health network instead of a formal HC system
- lacked resources, physicians, modern medicine, health literacy, and proper hospitals
- followed former Soviet Union model
- 80% of population lived in the rural area
The role of barefoot doctors - ANSWERS- pt. outreach, practice, and health education
- Led to decrease in infant mortality, increased life expectancy
- Major gains in controlling ID
- Shift of mortality from ID to chronic conditions
HC in the Urban Area - ANSWERS- gov owned and operated all health care facilities
and employed the HC workforce
- no incentive to provide unnecessary services b/c hospitals and clinics running on
central budget
- No incentive for physicians to over prescribe drugs or tests b/c healthcare workforce
was salaried
How was care paid for? - ANSWERS- insurance similar to state-run HSA
- Payment was on prepaid capitated basis
- HC payments tied to the planned economy, no formal HI for the entire population
- misfunctioned when the economy structure underwent a systematic change
1984 - 1997: Healthcare as a commodity overview - ANSWERS- transformation from
planned economy to market economy
- Gov continued to own hospitals but reduced subsidies to hospitals, clinics, and
healthcare workforce
- Public hospitals functioned as for-profit entities, focusing heavily on the bottom line
, - Physicians tied closely to hospitals vs. In US
Patient pathways to seeing physicians vs in the US (No primary care physicians) -
ANSWERS- Patient goes to hospital and the NP directs pt to specialist vs in US PCP
gives referral for a specialist if needed
- Sees the specialist in the same day
- Get prescription through hospital's pharmacy and obtain same-day testing
- Follow up visit is optional but no scheduling needed
Differences in US and China - ANSWERS- China has longer hospital stays
- China has more hospital beds per 1,000 pop
- Low payment to physician
- Paid by salary vs FFS
- High integration of physicians and hospitals
- High concerns abt fairness and equity
1984 - 1997: "Privatization" of the HC sector overview - ANSWERS- Payment switched
to FFS
- To ensure access to basic care - gov regulated service prices of physician and nurses'
time, routine visits and services such as surgeries, standard dx tests, and routine
pharmaceuticals
- Facilities allowed to earn profits from new drugs and devices, new testing and
treatments, with profit margins of up to 15%
- Part of those revenues circle back to compensate physicians as bonuses
Hospital behaviors under FFS - ANSWERS- Gov subsidies mainly go to Class 2 and 3
hospitals, Class 1 operates like private hospitals
- Hospital manager incentivized to introduce high-tech services and expensive imported
drugs to boost revenues
What is the difference between classes of hospitals and how much financing they get -
ANSWERSClass 1: 13.92% - community clinics
Class 2: 9.86% - municipal level hospitals and some specialty hospitals
Class 3: 7.13% - provincial level hospitals and top medical school affiliated hospitals
Drug sales and hospital revenue - ANSWERS- Main source
- 54% Pharma sales mark-up, 34.9% service charges, and 7.8% Gov public finance
budget allocation
Chinas Total HC Spend breakdown in 1989 - ANSWERS- 45% drug spend
- 17% Hospital personnel
- 15% Supplies and maintenance
