Health systems reform is currently one of the most significant and debated issues in China. In October 2008, the government recently drafted a health care reform made available for public feedback. While China's economy has consistently performed well for the past few decades, China is increasing its efforts to strengthen its health system and become a leader in global health.

Health system performance can be measured by three basic dimensions: equity in health care financing, patient responsiveness or satisfaction with the health system, and improvement of health status (or coverage of health interventions). Using the China National Health Services Survey, which is a national household interview survey conducted every five years since 1993 that collects data from over 50,000 households, we establish benchmarks and discuss measurement issues for China. In addition to demographic and socioeconomic information, the interviewers, who are trained medical professionals, also collected comprehensive information on health status, health care utilization, and behavioral factors.

Each abstract outlines the measurement on each of the three goals of health system performance and how each has performed over time. Our analysis is not only conducted at the national level, but also at the provincial level. Our main results show that: (1) inequities in health care financing increased from 1998-2008; (2) patient satisfaction decreased over time, with a more significant decline seen with rural residents than with urban; (3) financial constraints are one of the major reasons for dissatisfaction among patients; and (4) health intervention coverage improved since 1993. These studies assess the performance of a health system based on the three final goals and draw evidence-based information to better inform policy-makers. Establishing a measurement of China's health system reform is not simply important in measuring the health system itself, but also has major global health implications.