Worldwide Healthcare
Awareness Team
全球卫生行动小组
Team Written Articles on Trisector Engagement
Tri-sector Engagement: China's Support for the Medical Technology Industry
By: Eric Best
The involvement of government in Chinese healthcare has created a whole new economic boom in the technology field. China has become the largest drug developer in the east with 147 pharmaceutical companies (Pharmaprojects) that since working with China’s new healthcare interest have created all sorts of outlets for new medical technology. This sector of the Chinese market is important because it shows that the span of recent influence in healthcare has also expanded potential options for other markets as well. Part of China’s initiative to be more friendly to the environment has incorporated renewable technology into the healthcare field through the widespread use of electronic health records, online prescription refills or scheduling, and tele-health check-ins which has almost entirely removed paper from the waiting room transition. This not only opens up a variety of new investments for China to accumulate under their healthcare plan but it also gives the existing institutions cutting-edge efficiency in regards to timely service and quality of care. China is using medical technology to leapfrog the healthcare turmoil that we experience here in the United States and through this are building a firm foundation to base their new expansions to the system they already have.
Tri-sector Engagement: How Can Private Hospitals Aid in Evenly Treating the Population
By: Bianna Koutsenko
In China, it is very common for multiple generations from a family to live in the same home. However, as time has been going on the elderly population has been consistently rapidly increasing. The down side to that is “retirement and nursing homes are still relatively uncommon and especially in rural areas the healthcare infrastructure is unable to provide optimal care for the elderly.” By not being able to provide the healthcare the elderly population needs, the population is suffering severely. China’s geography, and their market causes some of the more common diseases. For instance, “the elderly are more likely to suffer from chronic non-communicable diseases such as cancer and cardiovascular disease, which have become more prevalent due to China’s rapid industrialization and urbanization”.
Many leaders in the private sector of health care are working on expanding private hospitals. By “involving the private sector, for example by inviting them to build private hospitals or collaborating on innovation. Philips, for example, is working with the Chinese Society of Cardiology to build the China National Cardiovascular Data Repository, which will help doctors conduct more clinical research, work more productively and provide better healthcare to China’s 270 million heart patients”. China needs to combine their health care for the most efficient and successful health outcomes so they can provide for their elderly population.
In China the private health cate system is far more successful than the public because “as health care expenditures increase, current public health care systems are becoming inadequate to cover the costs incurred.” Private health care can not be provided to everyone because some people are financially inept to pay the fees. If China cares about the well-being of every individual, and not just the rich ones when it comes to health care, their system would be a lot less flawed.
Works Referenced
Kung, P. (2015, September 10). How can China care for its ageing population? Retrieved July
20, 2017, from https://www.weforum.org/agenda/2015/09/how-can- china-care- for-its- ageing-
population/
Private health insurance coverage. (2009). 1-5. doi:10.1787/health_glance-2009- graph6_2_2-en
Tri-sector Engagement: Solving the Issue of Burdened Public Hospitals in China
By: Meghan Paulus
Public Hospitals in China are the most used health care facilities in the nation, because of this many public hospitals are overrun and overburdened with patients. Not only do many public hospitals have patients from urban centers, they also have patients from rural centers due to the disparity in There are three types of hospitals in the Chinese health care system. First there is the public sector of hospitals which are run and funded by the government. Second, there are for profit private hospitals that are run by private organizations and a board of directors. Third there are not for profit private hospitals and clinics that are usually run by nonprofit organizations. Since there is a general distrust in many lower tier clinics and other hospitals many citizen’s in China opt to public hospitals for treatment. The problem is not going to be solved by building more hospitals alone. (Eggleston, K.) In fact, that would most likely cause a greater disproportion of services throughout the nation.
Through Tri-sector engagement the issue of overburdened hospitals can be approached by seeking to work as a team between sectors. Simply passing the weight from public to private hospitals will not be enough. Instead the government should advocate to the citizens of China to put their trust not only in public hospitals but private ones as well. (He, L.) Especially since chronic disease is on the rise in china and the ageing population that accounts for almost 12 percent of the total population needs more care than ever. (Kyung, P.) In addition, these hospitals need to as a team, whether public, private, or nonprofit to be able to provide excellent health care to the people who aren’t getting the most out of the current health care system. Another issue between public and private hospitals includes the lack of physicians practicing in the country. Many physicians who are working in hospitals find it hard to serve the entire population of patients that find their way to the hospital every day. Since there are only about 1-2 practicing physicians per 1000 citizens many are overworked. There is also the fact that working in two different hospitals is generally frowned upon by hospital management. This is because many public hospitals have some of the best doctors practicing in China and since there is a lack in the pool of practicing physicians, it is hard for those who want to work in public and private hospitals to do so. However, this is changing because in 2009 physicians were able to start practicing at multiple hospitals in order to help relieve over-crowding at public hospitals. (The State Council.) What has been done and is being done now has helped to bring the burden on public hospitals down but more needs to be done to create an infrastructure that is efficient for the large population that China has.
Overall, teamwork should be stressed the most between public, nonprofit, and private hospitals. If this can be done along with more reforms to the ways hospitals are run, such as offering government subsidies and rewards to hospitals who turn out better health outcomes rather than hospitals who make the most money, then China will be able to drastically turn around their current infrastructure and create the universal health access they have promised their citizens at every level. Leaders in every sector are ambitiously working towards a healthier China at the governments lead. Furthermore, it should be the government’s responsibility to work with private and nonprofit sectors to complete these goals. The importance of tri-sector engagement spans more than just the health care system in China. In fact, this team work between facilities is what will bring new and efficient innovations to public, private, and non-profit systems throughout the world. Moreover, by creating an efficient hospital system with trust in every sector than lower tier clinic in rural settings will receive more demand and supply that demand and bring equity to China’s healthcare system. Therefore, this initiative could ease the burden of overcrowded public hospitals, budgeting health insurance, running facilities, and providing for the nation’s health.
Works Referenced
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Eggleston, K. (2009). Comparing Public and Private Hospitals in China: Evidence from Guangdong. Retrieved July 21, 2017, from http://aparc.fsi.stanford.edu/publications/comparing_public_and_private_hospitals_in_china_evidence_from_guangdong
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The State Council of The Peoples Republic of China. (2017, May 5). China details major tasks in healthcare reform. Retrieved July 21, 2017, from http://english.gov.cn/policies/latest_releases/2017/05/05/content_281475646380958.htm
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He, L. (2017, March 05). China's health care reform offers opportunity for private hospitals. Retrieved July 21, 2017, from http://www.scmp.com/business/companies/article/2076196/chinas-dire-need-reform-health-care-sector-seen-opportunity
4. Kung, P. (2015, September 10). How can China care for its ageing population? Retrieved July 20, 2017, from
https://www.weforum.org/agenda/2015/09/how-can- china-care- for-its- ageing-population/
Tri-sector Engagement: Corruption in Healthcare Providers and the Importance of
Non-Profit Medical Organizations
By: Erin McGrane
Not only is China’s healthcare system overburdened and the quality limited, but there is also an alarming amount of corruption occurring among China’s hospital staff. Such unethical practices include doctors ordering excess tests and treatments which are not medically necessary, over-prescribing drugs, and accepting bribes from pharmaceutical companies to sell their products as well as patients for drug prescriptions. This is occurring for a number of reasons; the first being hospitals are underfunded from the government and receive 90 percent of their income from drug and service sales. Therefore the hospital relies on selling a lot of products and services to keep the hospital running. This unfortunately puts business above ethics. Another reason is the salary of the doctors themselves are low, leading them to seek extra payment from successful hospital revenue and to be tempted by bribes from pharmaceutical companies and patients.
The alarming effect of this reality is that these unethical practices and low quality medical services lead to extreme tension between patient and doctor which has frequently caused violence against the healthcare providers. Stated by Business Insider, approximately 67 percent of hospitals in 2012 reported cases of violence against hospital staff, some of which was deadly. It has become common place knowledge among the population that healthcare providers are corrupt, with 72 percent of survey participants indicating that they expect some form of unethical behavior during hospital visits according to a study done by China Policy Institute.
There are a number of factors that need to be addressed in order to put an end to this unfortunate reality of unethical hospital practices and violence against medical staff. A number of these are being worked on through China’s continuous healthcare reform goals, however it is not enough to rely on privatized government solutions. It is important in these cases to examine all angles of the tri-sector. In this case non-profit organizations can offer an important balance to the equation. The underlying problem with corruption in hospital services is due to the emphasis placed on hospitals and medical care as a business. Therefore it is an important factor to have organizations in which profit and business revenue is not a factor so that improvement and innovation are the only goals.
One such organization that is making a difference in China’s healthcare field is the Chinese Medical Association (CMA). The CMA is the largest and oldest non-profit organization working in the medical field in China. The organization works to improve medical technology and services as well as to educate and cultivate medical professionals. Perhaps most importantly, the CMA serves as a link between the government and healthcare professionals to communicate needs and requests straight from the people involved in the field. This is an important piece in keeping healthcare reforms headed in the right direction so that problems in the field can be more effectively addressed.
While the CMA is making strides in aiding the healthcare industry, it would be even better to see an increase in the amount of non-profit organizations working in the medical field. If non-profit grassroots level clinics were created and made accessible to patients, it would create an alternative to corrupt and pricey hospitals for patients to receive medical attention. In addition it could create competition for hospitals in a healthy way such that could hopefully put pressure on them to change their unethical ways in order to maintain business.
References
Huang, C. (2014, May 23). Healthcare Is So Corrupt In China That Patients Have To Bribe Doctors For Proper Care. Retrieved July 19, 2017, from http://www.businessinsider.com/healthcare-is-so-corrupt-in-china-that-patients-have-to-bribe-doctors-2014-5
CPIAnalysis. (2015, August 12). Medical corruption in China: the views of the general public. Retrieved July 19, 2017, from https://cpianalysis.org/2015/08/12/medical-corruption-in-china-the-views-of-the-general-public/
UICC. (2017, March 31). Chinese Medical Association . Retrieved July 20, 2017, from http://www.uicc.org/membership/chinese-medical-association
Tri-sector Engagement: Third Tier Clinics; Providing Better Healthcare Access in Rural China
By: John Neyman
There are a few different ways in which third tier hospitals and clinics can go about bringing better healthcare to first and second tier rural hospitals. Though first I want to explain the difference between the three tiers. The first tier which is the lowest quality of healthcare is usually only found in small communities and rural areas, that being said there is not enough experience, equipment, and space that is needed to run a proper hospital. Second tier hospitals are slightly nicer in the way that they can provide more medical services over a broader community of people, they also have better medical training, equipment and space. Finally third tier hospitals are often found in the cities, these hospitals are the best of quality and provide specialty medical services as well as professional training for their staff and other medical personnel that’s employed by the lower tier hospitals. There are also different sublevels inside these tiers, there are very minor differences between them but nonetheless they have different qualities of care.
Now that you know about the different tiers, the question of how can third tier clinics provide better healthcare access to rural china, can be better understood. These third tier clinics can provide better healthcare by providing mandatory training to the lower tier clinics of the rural areas. This will make it so that the level of care provided depending on location would stay somewhat constant. Third tier clinics can also help the lower tiers by giving staff incentive to work at the lower tier clinics for a period of time in order to train as well as provide patients with the better care that is needed for their area, and eventually welcome back these employees to the major cities and hospitals no questions asked. A final option would just be to develop better hospitals in the rural areas designed around the success of the third tier clinics, in the hopes that eventually over time all health care will be equal in whatever region you are in. All of these options are currently in the works and China does plan on equalizing the playing field for healthcare in every region, it is just a matter of time and resources, which china has plenty of at this point in time.
References
Ziqian WANG, Export Marketing Manager at Kempf Follow. (2015, November 01). An Introduction of Healthcare Market in China. Retrieved July 20, 2017, from https://www.slideshare.net/cynthia627/healthcare-market-research-china-v6