Dual Practice by Public Health Providers in Shandong and Sichuan Provinces, China

There are four types of health providers at present in China. These are defined in terms of differences in ownership. Private practice in the health sector was reintroduced from 1980, when China began its economic reform from a planned economy to a market economy. Dual practice (DP) is quite common and a major concern from the point of view of health policy-making as little is known about it. The aim of this study was to describe policies and regulations of DP, the current situation, its impact on access to services and physician behaviour, and to provide evidence for future policy decisions. This study was conducted in two provinces, Shandong and Sichuan. Currently, due to the limited financial capacity of government and low salaries in public hospitals, most public hospital doctors undertake DP (usually in a lower level public hospital). The findings suggest that this is an effective means of supplementing their income, and that it is seen as acceptable in public hospitals. This is because few doctors are aware of the relevant regulations, thus better hospital information dissemination is required. The results also indicate that different specialties have different opportunities to undertake DP: surgeons have more scope for DP than physicians. [From executive summary]