The health of the population continues to improve. In terms of important indicators reflecting the nation's health status, the health of China's residents is among the highest in the developing world. per capita life expectancy reached 74.8 years in 2010, with 72.4 years for men and 77.4 years for women (see Fig. 1). The maternal mortality rate fell from 51.3 per 100,000 live births in 2002 to 26.1 per 100,000 live births in 2011 (see figure 2). The infant mortality rate and the mortality rate of children under 5 years of age have continued to decline, with the infant mortality rate falling from 29.2 per 100,000 in 2002 to 12.1 per 100,000 in 2011 (see Fig. 3), and the mortality rate of children under 5 years of age dropping from 34.9 per 100,000 in 2002 to 15.6 per 100,000 in 2011 (see Fig. 4), thus realizing the United Nations Millennium Development Goals ahead of schedule.
A medical and healthcare system covering both urban and rural areas has been established. First, the public **** health service system. It includes specialized public **** health service networks for disease prevention and control, health education, maternal and child health care, mental health, health emergencies, blood collection and supply, health supervision, and family planning, as well as a medical and health service system based on the primary medical and health service network, which undertakes the function of public **** health services. Second, the medical service system. In rural areas, a three-tier rural medical and health service network has been established with county-level hospitals as the leader and township health centers and village health offices as the foundation, and in urban areas, a new type of urban medical and health service system has been established with a division of labor between hospitals of all levels and types and community health service organizations. Third is the medical security system. This system takes basic medical security as its mainstay, supplemented by various other forms of supplementary medical insurance and commercial health insurance. The basic medical security system includes basic medical insurance for urban workers, basic medical insurance for urban residents, a new type of rural cooperative medical care, and urban and rural medical assistance, covering the urban employed population, the urban non-employed population, the rural population, and the urban and rural population in difficulty, respectively. Fourth is the drug supply guarantee system. This includes the production, circulation, price management, procurement, distribution and use of medicines. In the near future, the focus is on the establishment of a national basic drug system.
The structure of health financing is constantly being optimized. The sources of health financing include general government taxes, social medical insurance, commercial health insurance, and residents' out-of-pocket expenses, etc. In 2011, China's total health expenditure amounted to RMB 24,345,591,000,000, with per capita total health expenditure amounting to RMB 1,806.95 over the same period, and with total health expenditure accounting for 5.1% of the gross domestic product (see Figure 5). Calculated on the basis of comparable prices, from 1978 to 2011, China's total health expenditure grew at an average annual rate of 11.32%. Individual cash health expenditures declined from 57.7 percent in 2002 to 34.8 percent in 2011 (see Figure 6), and the level of risk protection and redistributive role of the health financing system has continued to improve.In 2011, hospitals and outpatient institutions spent RMB 1808.94 billion, and public **** health institutions spent RMB 204.067 billion, accounting for, respectively, 71.74 percent and 809.9 percent of the total health costs. 71.74% and 8.09% respectively. Among the hospital costs, the costs of urban hospitals, county hospitals, community health service centers and township health centers accounted for 64.13%, 21.28%, 5.17% and 9.3% respectively.
Health resources continue to develop. By the end of 2011, there were 954,000 medical and health institutions nationwide, an increase of 148,000 medical and health institutions compared with 2003. There were 2.466 million practising physicians, with the number of practising physicians per 1,000 population increasing from 1.5 in 2002 to 1.8. Registered nurses numbered 2.244 million, with the number of registered nurses per 1,000 population increasing from 1 in 2002 to 1.7. The number of beds in medical and health institutions was 5.16 million, with the number of beds in medical and health institutions per 1,000 population increasing from 2.5 in 2002 to 3.8.
The utilization of medical and health services has improved significantly; in 2011, the number of consultations at medical institutions nationwide increased from 2.15 billion in 2002 to 6.27 billion, and the number of hospitalizations increased from 59.91 million in 2002 to 150 million. The average annual number of visits by Chinese residents to medical and health-care institutions was 4.6; the number of hospitalizations per 100 residents was 11.3; the utilization rate of hospital beds was 88.5 per cent; and the average length of stay for those discharged from hospitals was 10.3 days. It has become more convenient for residents to seek medical care, and accessibility has improved significantly; the proportion of households within 15 minutes of a medical institution rose from 80.7 per cent in 2003 to 83.3 per cent in 2011, with 80.8 per cent in rural areas. The medical quality management and control system has been continuously improved. A system of gratuitous blood donation has been established, and blood safety has been guaranteed.