Social Experiment on Integrated Delivery System in Yanchi, Ningxia


It is critical to select the correct policy instruments, including financing, payment, organization, regulation, and persuasion, to solve the fundamental problems facing China’s health care delivery system and achieve the ultimate goals of health improvement, financial risk protection, and public satisfaction. We have identified a number of issues in the health care delivery system of Yanchi county in China’s Ningxia province that make it a good candidate for a policy pilot project:

  1. Healthcare Expenditures: Health care expenditures in Yanchi county have outpaced its GDP growth by almost twofold, with both social insurance and patients bearing the burden of increasing costs;
  2. Resource Allocation: Resources concentrate on tertiary hospitals even though a substantial portion of out-of-county visits, which account for one-third of out-of-county expenditures, could have been treated within the county;
  3. Treatment-based Delivery: Health care facilities lack incentives to provide sufficient preventive care and promote population health, which is more crucial than ever given an aging population and an increased burden of chronic diseases.


The primary objective of this project is to design policy instruments to correct misaligned incentives and promote an efficient and integrated delivery system in Yanchi, Ningxia, with the ultimate aim of devising effective policy solutions that can be applied more broadly across China.

A research team based in China will conduct monitoring and evaluation on a regular basis to ensure that the intervention design is implemented with fidelity and will assist in data collection and analysis.


This project is a collaborative partnership between the Harvard T.H. Chan School of Public Health, Fudan University, Peking University and the Ningxia Medical University with support from local and provincial government offices.