REVIEW article
Front. Public Health
Sec. Public Health Policy
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health WelfareView all 107 articles
The Evolution and Future Trajectory of Public Hospital Reforms with a Public-Welfare Orientation in China
Provisionally accepted
- 1Guilin Medical University, Guilin, China
- 2Tibet University, Lhasa, China
- 3North Sichuan Medical College, Nanchong, China
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As a cornerstone of the healthcare system, public hospital reforms in China represent a complex and critical endeavor, shaped by the nation's evolving socioeconomic landscape. This paper employs a methodological framework of historical and policy analysis to examine the evolution of public hospital reforms in China. It traces the trajectory of these reforms against the backdrop of the country's socioeconomic development across different periods and identifies four distinct stages: 1)the government-led system foundation stage (1949–1978), 2) the market-oriented phase marked by a gradual weakening of public-welfare nature (1979–2004), 3)the period of reflection and readjustment toward restoring public-welfare orientation (2005–2020), 4)the ongoing stage of deepening reform centered on reinforcing public-welfare nature (2021–present). A key contribution of this study lies in its integration of historical and policy perspectives, addressing a significant gap in the comparative literature on health system reforms. The analysis concludes that upholding public-welfare nature as the core principle is essential for evaluating the success of future reforms. To address existing policy barriers, the study proposes establishing a collaborative governance mechanism and strengthening the "tripartite linkage" among medical services, health insurance, and pharmaceuticals, coupled with a reconstruction of incentive systems to better align with public-welfare objectives. These insights offer valuable lessons for other developing countries pursuing similar health system transformations under complex socioeconomic conditions.
Keywords: collaborative governance, Development trajectory, Public hospitals, public-welfare, Reform process
Received: 12 Oct 2025; Accepted: 11 Dec 2025.
Copyright: © 2025 deng, lacuo and Qiuyu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Pan Qiuyu
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