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Sanming: The real story of grass-roots healthcare transformation in China

Sanming: The grass-roots healthcare transformation

China’s recent healthcare reform journey has been a remarkable success story, and one that has gained international attention.


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While the nation has made significant progress towards universal health coverage, many challenges remain – including the quality, efficiency and affordability of hospital care. The health systems in many emerging economies face similar problems. Across Africa, Latin America, Asia and the Middle East, a familiar pattern of long waits, inequity, poorly designed incentives, lack of transparency and under-motivated staff are evident.

KPMG was recently given privileged access to study one of the most successful (and controversial) city-wide hospital system transformations in China. We spent three weeks in Sanming city conducting in-depth research with politicians, health service leaders, managers from local drug distributors, clients and patients to highlight what others from around the world can learn from this case study.

In our report, Sanming: The real story of grass-roots healthcare transformation in China, we take an in-depth look at the city’s four-in-one reform to governance, drug procurement, medical insurance and service providers. While the Sanming story of reform has become one of the most widely discussed in China’s healthcare debate, it is a model that many cities and provinces have decided to follow.

Above all, this report shows that healthcare transformation is possible. Even if all problems can’t be solved in a single phase, it is possible to simultaneously enhance coverage, quality, affordability and satisfaction on a large scale.

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