Brief Introduction to Health Yearbook

The material mainly introduces health care of 31 provinces, autonomous regions and municipalities in China. The contents of the material involve:
The Number of Health Institutions

     It mainly involves the number of medical institutions of different grades and different varieties, the number of disease control institutions, the number of health supervision institutions, the condition of hospital grades, the number of hospitals grouped by the number of beds, the number of township hospitals and the number of community health service centers etc.

  1. Data come from annual report of health resources statistics
  2. The number of health institutions and the number of medical institution neither involves the number of village clinics. The number of village clinics is counted alone.
  3. The classification of health institutions:
  4. classified by levels of cities and towns; Cities involve municipalities, prefecture-level cities and county-level cities and towns involve autonomous counties and banner.

②by the kind of economy, health institutions can be classified into state-owned, collective, joint operation, private ones and others.

  1. by the host unit, health institutions can be classified into those being host by the government, those being host by the society and those being host by the individual. The government-hosted health institutions involve health institutions hosted by the health and other administrative department. The society-hosted health institutions involve health institution hosted by the health institutions hosted by enterprises, institutions, public organizations and other social organizations.

④by the sort management, they can be classified into non-profit and profit health institutions.

  1. The adjustment of statistical range
  2. The number of village clinics is involved into the total number of health institutions (not counted alone any longer).
  3. Since 2002, the number of health institutions is according to the number which is registered in the health, industry and commerce, civil administration department. From 1949 to 2002, the number of health institutions is according to the number which the health and other administrative departments gave permission to be founded.
  4. Since 2002, according to the principle of industry management, health institutions hasn’t involved Frontier health and quarantine office, higher and medium medical schools, institutions for drug control and family planning guidance centers which are permitted by the Family Planning Commission of various grades.
  5. Since 1996, according to the Administrative Regulations on Medical Institution, self-employed individuals are renamed as private clinics and are added to the health institutions. In 1996, the number of health institution increased very much (including 130000 private clinics).

The Number of Medical Workers
Medical workers mainly involve medical workers of different kinds and professional health workers, practicing (assistant) doctors classified by their gender, age, education background, job title and department and practice category and practice scope etc.

Ⅰ. The data come from annual report of health resources statistics and Brief Report of Statistics of Education Development from Education Department.
Ⅱ. The adjustment of statistical range:

  1. The total number of medical workers:
  2. Personnel working in village clinics (including rural doctors, health workers, practicing doctors, practicing assistant doctors, registered nurses) will be included in the total number of health workers.
  3. Since 2007, medical workers who have been being recruited after retirement for over half a year will be added to the total number of medical workers.
  4. Since 2002, according to the principle of industry management, medical workers hasn’t involved personnel in Frontier health and quarantine office, higher and medium medical schools, institutions for drug control and family planning guidance centers which are permitted by the Family Planning Commission of various grades.

2.Health Technicians
①Since 2007, health technicians don’t involve technicians such as pharmacists and inspectors.
②Since 2002, the number of practicing (assistant) doctors is the number of people who get a practicing certificate for a doctor(not including intern doctors without a certificate). Before 2002, the number of practicing (assistant) doctors was the number of on-job doctors. Practicing (assistant) doctors involve practicing (assistant) doctors in village clinics.
Before 2002, practicing (assistant) doctors involved chief physicians, associate chief physicians, attending doctors, resident doctors and assistant doctors.
③Since 2002, the number of registered nurses is the number of nurses who are registered. Before 2002, the number of registered nurses is the number of on-job nurses
3. Service and Technical Personnel
Before 2007, service and technical personnel referred to service personnel, not including technicians such as pharmacists and inspectors.
Ⅲ. The change of statistical range and the explanation of standard which refer to health institution are the same with the content in Chapter Health Institution.
Ⅳ. The classification of practicing (assistant) doctors’ department is according to Medical Subjects of Medical Institutions. The principle of classification of department of personnel in hospitals of TCM (traditional Chinese medicine) and specialized hospitals is as follows: hospitals of TCM belong to traditional Chinese medicine department; integrative medicine hospitals all belong to integrative traditional Chinese and western medicine department; national hospitals all belong to national medicine department; maternity and child care centers separately belong to maternity department and pediatric department; hospitals for sick children belong to pediatrics department; hospitals for infectious diseases and hospitals for leprosy all belong to infectious disease department; sanitariums and convalescent hospitals all belong to rehabilitation medicine department; tumor hospitals all belong to tumor department; other specialized hospitals belong to other relevant departments.
Ⅴ. In 2009, constitution of professional medical workers, department of practicing (assistant) doctors, practice category and practice scope which were classified by gender, age, education background and job title was the result of preliminary statistics.

Health Facilities
Health facilities mainly involve beds of health institution of different grades and different varieties, hospitals, maternity and child care centers, main medical equipment in Centers for Disease Control and Prevention, area of structure of buildings of health institution of different varieties and so on.
Ⅰ. Data come from annual report of health resources statistics.
Ⅱ. The department to which beds belong is determined by Medical Subjects of Medical InstitutionsThe principle of classification for hospitals of traditional Chinese medicine (TCM) and specialized hospitals is as follows: hospitals of TCM belong to traditional Chinese medicine department; integrative medicine hospitals all belong to integrative medicine department; national hospitals all belong to national medicine department; maternity and child care centers separately belong to maternity department and pediatric department; hospitals for sick children belong to pediatrics department; hospitals for infectious diseases and hospitals for leprosy all belong to infectious disease department; sanitariums and convalescent hospitals all belong to rehabilitation medicine department; tumor hospitals all belong to tumor department; other specialized hospitals belong to other relevant departments.
Ⅲ. Statistical range of area of buildings and explanations of standard are according to Standard for Constructing General Hospitals Standard for Constructing Maternity and Child Care Centers, Standard for Constructing Village Clinics and Standard for Constructing Epidemic Prevention Stations.
Ⅳ. Adjustment of statistical range: Since 2002, the number of beds of health institutions is the same with the number of beds of medical institutions.

Health Care Spending
Health care spending involves total expenditure on health, health operating expenses, investment in health capital construction, annual income and expenses of health institutions, medical expenses of per outpatients and per inpatients.
Ⅰ. Total expenditure on health is business accounting amount. Data of other health spending mainly come from report of health resources statistics. Urban and rural residents’ expenditure of medical security comes from China Statistical Yearbook.
Ⅱ. Both statistical range of all standards and explanation of non-profit hospitals are according to Accounting Regulations for Hospitals; both statistical range of all standards and explanation of profit-making hospitals are according to Accounting System for Enterprises; both statistical range of all standards and explanation of other health institutions are according to Accounting Regulations for Institutions.
Ⅲ. Adjustment of statistical range

  1. Since 2007, total expenditure on health is counted according to a new statistical range.
  2. The change of statistical range and the explanation of standard which refer to health institution are the same with the content in Chapter Health Institution.

Medical Service
The indicators of medical service include the number of clinic visits, the number of inpatients, bed occupancy rates, the length of stay in hospital, average amount of work per doctor, classification of inpatients’ diseases, residents’ rate of seeking medical care per two weeks, residents’ hospital admission rate etc.

  1. Data of the number of clinic visits, number of inpatients, bed occupancy rates, average length of stay in hospital, average amount of work per doctor and inpatients’ prognosis of diseases come from annual report of medical service statistics. Data of residents’ rate of seeking medical care, hospital admission rate, regularly-going hospitals, ways of medical security and so on come from China health service survey in 1993, 1998, 2003.
  2. The change of statistical range and the explanation of standard which refer to health institution are the same with the content in Chapter Health Institution.
  3. The adjustment of statistical range: number people who seek medical care in village clinics are added to total number of people who seek medical care. Data of every year is adjusted according to this principle.
  4. Inpatients’ situation of prognosis of diseases is collected by hospitals which are subordinate to health department of different grades according to ICD-10 International Standard for Classification of Disease.
  5. Stratified-cluster random sampling method is applied in China health service survey in 1993, 1998, 2003 and 2008. In the survey in 1993, 215163 people from 54 thousand families from 92 sample counties and cities (27 cities and 65 counties) were chosen randomly. In the survey in 1998, 216101 people from 56994 families from 95 sample counties and cities (28 cities and 67 counties) were chosen randomly. In the survey in 2003, 210 thousand people from 57 thousand families from 95 sample counties and cities (28 cities and 67 counties) were chosen randomly. In the survey in 2008, 180 thousand people from 58 thousand families from 94 sample counties and cities (28 cities and 66 counties) were chosen randomly. All the 4 surveys are classified by cities and counties. Cities are classified into 3 groups according to their population: large cities (over 1 million residents), medium cities and small cities (less than 300 thousand residents). Counties are classified into 4 groups according to many indexes including social economy: A-level counties (wealthy counties), B-level counties (comparatively well-off counties), C-level counties (counties simply having enough food and clothing), D-level counties (poverty-stricken counties)

Rural and community health
The indicators of rural and community health involve the number of clinic visits, the number of inpatients, the rate of utilization of beds, the length of stay in hospital, the average amount of work per doctor and so on

  1. Data in this chapter come from annual report of statistics of health resources and medical service.
  2. Data in this chapter and data from other related community health service centers (stations) refer to registered institutions not including unregistered community health service centers (stations) which are subordinate to health institutions.

 

Maternity and Child Care
Maternity and Child Care mainly involves death rate of children under 5 years old, death rate of puerperal and pregnant women, prenatal examination rate, postpartum visit rate, rate of new delivery, hospitalized delivering rate, management rate of children care system, gynecological diseases which are checked out and treatment situation of gynecological diseases, pre-marital examination and the diseases which are found (male and female), artificial abortion, ligature and so on.
1.Death rate of newly-born babies, death rate of infants and death rate of children under 5, death rate of puerperal and pregnant women come from maternity and child health monitoring are. Other data except these come from annual report of maternity and child health statistics.
2. Monitoring net for maternity and child health: in 1990 to 1995, Health Department set 2 monitoring nets of maternity and child health in 30 provinces, autonomous regions and municipalities (monitoring net for puerperal and pregnant women’s death had 247 monitoring points and monitoring net for death of children under 5 had 81 monitoring points), which dynamically monitored death situation of puerperal and pregnant women and children under 5. Since 1996, monitoring net for puerperal and pregnant women’s death, monitoring net for death of children under 5 and monitoring net for birth defects have been an incorporated part, and it has chosen randomly 166 monitoring points to set China maternity and child health monitoring net. Since 2007, the number of China maternity and children health monitoring points is increased to 336.
3. Because of lacking data in some individual regions, numbers of surgery for family plan of some years may change a lot.
The general level of the people’s health
The general level of the people’s health mainly introduces general level of the Chinese health and nutrition situation. It involves people’s birth rate, date rate, life expectancy, morbidity, residents’ long-term dysfunction and disability situation, teenagers and children’s physical development situation in cities and counties, residents’ nutrition situation and so on.
Data of birth rate, death rate and life expectancy all come from China Statistics Yearbook. Date of residents’ morbidity, residents’ long-term dysfunction and disability situation all come from China health service survey in 1993,1998,2003,2008 (the introduction of survey can be read in Chapter Five Medical Service). Data of average height and average weight of different gender and age in cities and counties come from 2002 residents’ nutrition and health condition survey. Data of residents’ nutrition situation come from China nutrition survey in 1982, 1992 and 2002.

Disease Control and Public health
Disease control and public health involves morbidity and death rate of statutory reports of infectious diseases, children’s coverage rate of vaccine, morbidity of hypertension, situation of prevention of schistosomiasis, parasitosis, situation of improved water and improved lavatories in rural regions, residents’ smoking and smoking cessation situation and so on.
1. Data of morbidity, death rate and fatality rate of infectious diseases come from statutory reports of infectious disease statistics annual report. The prevention of schistosomiasis, parasitosis and endemic diseases come from annual report of parasitosis and endemic diseases statistics. One-year-old children’s coverage rate of vaccines which are on the list of China Immunity Plan comes from annual statistics report of China immunity plan. The data of situation of improved water and improved lavatories in rural regions come from annual report of improved water and improved lavatories statistics from Committees of Patriotic Public health Campaign. The morbidity of hypertension comes from the National Sampling Investigation of Hypertension in 1979, 1980 and 1991.Data of residents’ smoking and smoking cessation situation come from National Residents’ Smoking Survey Report in 1996.
2. With new infectious diseases appearing and spreading, A and B kind of infectious diseases of Statutory Reporting are adjusted. Infectious diseases of statutory report before 1989 involve 19 diseases. They are plague, cholera, diphtheria, meningitis, pertussis, scarlet fever, measles, influenza, dysentery, typhoid and paratyphoid, viral hepatitis, poliomyelitis, encephalitis B, malaria, kala-azar, forest encephalitis, cade worm disease, epidemic hemorrhagic fever, leptospirosis. According to People's Republic of China Disease Prevention Act issued in 1989, from 1990 to 1995, A and B kind of infectious diseases of Statutory Reporting involves 25 diseases. They are plague, cholera, viral hepatitis, dysentery, typhoid and paratyphoid, AIDS, gonorrhea, syphilis, poliomyelitis, measles, pertussis, diphtheria, meningitis, scarlet fever, epidemic hemorrhagic fever, rabies, leptospirosis, brucellosis, anthrax, epidemic and endemic typhus, encephalitis B, kala-azar, malaria and Dengue Fever. Tetanus neonatorum and phthisis were added into B kind of infectious diseases in 1996. HIV infectors were added in 2002. SARS was added in 2003. Bilharzias and bird flu were added in 2005. Influenza A (H1N1) was added in 2009.
3. Epidemic situation report was not complete enough in the early days of new China and from the end of 1960s to the beginning of 1970s. Situation of missed reports of death and morbidity of infectious diseases were comparatively serious.
4. The total number of families in rural areas in this Chapter is only used to count popularity rate of lavatories in rural areas.