——基本公共卫生服务均等化水平明显提高。国家免费向全体居民提供国家基本公共卫生服务包，包括建立居民健康档案、健康教育、预防接种、0—6岁儿童健康管理、孕产妇健康管理、老年人健康管理、高血压和II型糖尿病患者健康管理、重性精神疾病患者管理、传染病及突发公共卫生事件报告和处理、卫生监督协管等10类41项服务。针对特殊疾病、重点人群和特殊地区，国家实施重大公共卫生服务项目，对农村孕产妇住院分娩补助、15岁以下人群补种乙肝疫苗、消除燃煤型氟中毒危害、农村妇女孕前和孕早期补服叶酸、无害化卫生厕所建设、贫困白内障患者复明、农村适龄妇女宫颈癌和乳腺癌检查、预防艾滋病母婴传播等，由政府组织进行直接干预。2011年，国家免疫规划疫苗接种率总体达到90%以上，全国住院分娩率达到98.7%，其中农村住院分娩率达到98.1%，农村孕产妇死亡率呈逐步下降趋势。农村自来水普及率和卫生厕所普及率分别达到72.1%和69.2%。2009年启动“百万贫困白内障患者复明工程”，截至2011年，由政府提供补助为109万多名贫困白内障患者实施了复明手术。

图71990—2011年全国农村住院分娩率(%)与孕产妇死亡率(1/10万)变化趋势

Access to basic public health services has become more equitable. The state provides all residents with a free package of 41 basic public health services in ten categories, including health record, health education, preventive inoculation, healthcare for children under six, healthcare for pregnant and lying-in women, healthcare for elderly people, treatment for hypertension and type II diabetes patients, healthcare for severe psychosis patients, reporting and handling of infectious diseases and public health emergencies, and healthcare supervision and coordination. Targeting special diseases, key groups and special areas, the state has launched key public health service programs, including subsidizing rural pregnant women for hospitalized childbirth, re-vaccinating people under 15 against hepatitis B, eliminating fluorosis caused by coal burning, supplementary taking of folic acid by rural women before pregnancy and in the early stage of pregnancy, building sanitary toilets, cataract removal for poor patients, cervical and breast cancer tests for rural women within eligible age, and preventing mother-to-child transmission of AIDS. In 2011, the inoculation rate of the National Immunization Program (NIP) exceeded 90%; the rate of hospitalized childbirth nationwide reached 98.7% (98.1% in rural areas); and the maternity mortality rate in rural areas kept going down. In the rural areas, 72.1% of the population had access to tap water and 69.2% had access to sanitary toilets. In 2009, the government launched a program to provide cataract operations for a million poor patients, and by 2011 more than 1.09 million such people had had such operations with government subsidies.

　　Medical and Health Services in China-Figure 7: Rural hospitalized childbirth rate (%) and rural maternal mortality rate (one in 100,000) from 1990 to 2011, according to a white paper released by the Information Office of the State Council on Dec. 26, 2012. (Xinhua)

    ——公立医院改革有序推进。从2010年起，在17个国家联系试点城市和37个省级试点地区开展公立医院改革试点，在完善服务体系、创新体制机制、加强内部管理、加快形成多元化办医格局等方面取得积极进展。2012年，全面启动县级公立医院综合改革试点工作，以县级医院为龙头，带动农村医疗卫生服务体系能力提升，力争使县域内就诊率提高到90%左右，目前已有18个省(自治区、直辖市)的600多个县参与试点。完善医疗服务体系，优化资源配置，加强薄弱区域和薄弱领域能力建设。区域医学中心临床重点专科和县级医院服务能力提升，公立医院与基层医疗卫生机构之间的分工协作机制正在探索形成。多元化办医格局加快推进，鼓励和引导社会资本举办营利性和非营利医疗机构。截至2011年，全国社会资本共举办医疗机构16.5万个，其中民营医院8437个，占全国医院总数的38%。在全国普遍推行预约诊疗、分时段就诊、优质护理等便民惠民措施。医药费用过快上涨的势头得到控制，按可比价格计算，在过去三年间，公立医院门诊次均医药费用和住院人均医药费用增长率逐年下降，2011年比2009年均下降了8个百分点，公立医院费用控制初见成效。

    新一轮医改给中国城乡居民带来了很大实惠。基本公共卫生服务的公平性显著提高，城乡和地区间卫生发展差距逐步缩小，农村和偏远地区医疗服务设施落后、服务能力薄弱的状况明显改善，公众反映较为强烈的“看病难”、“看病贵”的问题得到缓解，“因病致贫”、“因病返贫”的现象逐步减少。

The reform of public hospitals has been carried on in an orderly way. In 2010, the Chinese government started pilot reforms of public hospitals in 17 state-designated cities and 37 province-level districts; and positive progress has been witnessed in improving services, innovating institutions and mechanisms, strengthening internal management and speeding up the creation of a situation in which hospitals are established and run in diversified forms. In 2012, the government launched a pilot comprehensive reform of county-level public hospitals, aiming to improve rural system of medical services with the county hospitals playing the leading role, and enabling 90% of the population in a county to see doctors. So far, over 600 counties in 18 provinces, autonomous regions and municipalities directly under the central government have been included in this reform. The government has worked hard to improve medical services, optimize the allocation of medical resources, and enhance the medical capabilities of weak areas and weak fields. The capabilities of key clinical specialties in regional medical centers and county-level hospitals to deliver medical services have been enhanced, and the mechanism of division of responsibilities and cooperation between public hospitals and community-level medical institutions is being studied and formed. The government has intensified efforts in the creation of a situation of establishing and running hospitals in diversified forms, encouraging and guiding non-governmental funds to establish both for-profit and non-profit medical institutions. By 2011, there were 165,000 medical institutions established with non-governmental investment, including 8,437 private hospitals, accounting for 38% of the national total. Doctor-appointment service, time-phased outpatient service and high-quality nursing service that bring benefits and convenience to the people have been introduced nationwide. The fast price growth of medicine has been contained. In comparable prices, the growth rates of average outpatient and inpatient costs in public hospitals has decreased year by year in the past three years, and that of 2011 went down by eight percentage points from that of 2009, reaping initial results in expense control for public hospitals.

The new round of medical reform has brought substantial benefits to both urban and rural residents. Access to basic public health services has become much more equitable; the gap between urban and rural areas and between regions has been narrowed in medical development; medical services in rural and remote areas with backward facilities and weak capabilities have been remarkably improved; medical services have become more affordable and accessible; and fewer and fewer people are becoming poor or return to poverty because of illness.