Chinese community health centers are losing their public appeal

As the number of hospital visits increases in China, the country’s basic medical institutions are seeing relatively fewer patients in comparison despite the government’s efforts to promote such services.

Only 50.2% of the 8.47 billion hospital visits in 2021 were made to basic medical services, such as easily accessible community health service centers, according to Data published Tuesday by the National Health Commission. The percentage of visits has been steadily declining since escalation to 61.8% in 2010.

China’s community health service system was established in 1999, aimed at meeting the basic health needs of residents in their own neighborhood. These facilities do not charge doctor’s appointment fees and help connect critically ill patients to major hospitals.

In 2015, the Chinese authorities offers a hierarchical medical care system to make more reasonable use of the country’s health resources. According to the plan, the country’s basic medical facilities are expected to constitute 65% of all hospital visits by 2017, although the target was not met that year as well.

“If the situation continues, it won’t be long before we see basic medical facilities serving fewer patients than major hospitals,” a healthcare industry insider said. Told financial outlet Caixin. “That means we’re only moving away from our original goal.”

While community health care centers initially served as the first point of contact for those seeking medical services, a growing number of hospitals offering advanced services have attracted more patients in recent times. As of last year, China had 3,275 third-tier public and private hospitals — the top and largest medical institutions offering both comprehensive and specialized services — growing nearly 10% year on year. on the other, according to government data.

Visits to top hospitals increased nearly 24%, from 1.8 billion in 2020 to 2.23 billion visits last year, according to the National Health Commission. Meanwhile, the percentage of visits to community health services has declined over the past decade, although the number of visits is gradually increasing.

Patients like Shanghai-based Xi Lijuan, who is over 70 and suffers from chronic heart disease, said they mostly avoid community health service centers because of the lack of experienced doctors and the drugs they need. they need. She usually spends at least half a day traveling to a top hospital in Huangpu District to get two weeks of medicine.

“They don’t have the medicine I need,” she said, referring to local community health care facilities. “The cost of visiting a major hospital is high – it’s a much longer journey and it means waiting for hours in hospital, but there’s no other choice.”

A medical staff member at a community health service center in suburban Shanghai confirmed that few people had come to see a doctor lately. She said most of them come just to refill their prescription drugs every three months, as government regulations allow.

“Even if people develop symptoms of a common illness, they won’t think of us for treatment because they don’t trust our doctors,” said the staff member, who declined to be named due confidentiality issues. “Because of this common perception of community health service centers, it has been difficult for us to hire or train good doctors.”

Publisher: Bibek Bhandari.

(Header image: Patients waiting at a rural hospital in Minhou County, Fujian Province, 2014. Chen Hao/VCG)

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