Promoting Sustainable Strategies to Improve Access to Health Care in the Asian and Pacific Region Acronyms and Abbreviations CMS Cooperative Medical Scheme

The Chinese economy has grown rapidly during the past 30 years. Annual disposable per capita income in urban areas increased from RMB 343 (USD 1 = 6.8 RMB, 2008) in 1978 to RMB 10,493 in 2005 and, in rural areas, from RMB 134 to RMB 3,255.1 Annual per capita health-care expenditure increased from RMB 11 in 1978 to RMB 749 in 2005.2 Despite the predominantly agricultural character of China, the rural population decreased from 82 per cent of total population in 1980 to 57 per cent in 2005.3 Health-care utilization, however, declined during this period of economic growth. Between 1993 and 2003, the percentage of individuals who reported out-patient visits in the previous two weeks dropped from 19.9 to 11.8 per cent in urban areas and from 16.0 to 13.9 per cent in rural areas.4 About 57.0 per cent of urban residents and 45.8 per cent of rural residents who reported being unhealthy did not see a doctor in 2003; while in 1993, those rates were 42.4 and 33.7 per cent, respectively. People who had not been hospitalized, but who should have been, accounted for 29.6 per cent of all whom doctors had diagnosed as needing hospitalization (27.8 per cent in urban and 30.3 per cent in rural areas)