Public hospitals are the major providers of medical services in China, with the latest official statistics showing that public hospitals perform over 85% of diagnosis and treatment services, and take in 82% of inpatients in the China. To give a sense of the scale of a major Chinese public hospital, the Beijing-based Guang’anmen Hospital (GAMH) recorded over three million outpatient visits in 2019 alone. The tertiary facility, with a specialty in Traditional Chinese Medicine (TCM), boasts a capacity of 650 inpatient beds.
As such, they were heavily relied on during the pandemic, undertaking critical and difficult life-saving work. “Public hospitals enjoy strong capital investment, with advantages in technology, talent, scientific research and management,” said Ms Wang Xiaopin, Party Secretary of GAMH.
“They play an important role in responding to various public emergencies and the demand for medical services, safeguarding the safety and health of the public.”
Restrictions faced by public hospitals
However, she pointed out that public hospitals face unbalanced and insufficient development of medical resources.
“With medical service capacity limited by the scale of hospital area, less than ideal layout of hospital functions and insufficient clinical development, medical care capability and quality levels are impacted,” said Ms Wang.
The Chinese authorities have placed public hospital development as one of its top priorities. China’s 14th Five-Year Plan, which announced a framework for the country’s development pathway from 2021 to 2026, outlined recommendations to improve affordability and accessibility in healthcare, focusing on health promotion rather than treatment. The State Council later issued a circular outlining key tasks, which revolved around the development of public hospitals from scale expansion to improvement of quality and efficiency; shifting operations to a more refined and detailed approach; and relooking resource allocation from material resources to human resource development.
“This (goal of achieving quality development) is a heavy task with a tight timeline – the challenge for us is how we can combine actual hospital development realities to form a scientific hospital management model,” Ms Wang noted.
Development blueprint in the near term
On GAMH’s end, there are plans in place to push through development on multiple fronts. This is driven by the top-line goal – to support the country’s overall strategic needs and the vision to promote and advance TCM use.
GAMH aims to leverage on its status as a national and regional designated medical hub and national clinical medicine research centre, to further its capabilities in TCM to prevent and treat major diseases such as cancer and cardiovascular disorders.
In the area of hospital management, it will be looking at enhancing its quality management and control system. “We will build a modern management system which is standardised and streamlined, and will penetrate into every department,” said Ms Wang.
A well-trained and motivated workforce will be the key driver behind these plans. “We will be strengthening talent management, by establishing a selection, appointment, training, and evaluation mechanism,” she added. “A practical performance appraisal system will be formulated based on individual characteristics, ensuring it fully realises the purpose of appraisals in improving quality.” Specifically, for GAMH as a TCM specialty hospital, a priority would be in the training of quality TCM professionals and TCM research and innovation.
In response to the guidelines in the Five-Year Plan and State Council circular, the hospital will be enhancing the development across the its two campuses / zones, keeping in mind the need to not just scale up service capacity, but also to also ensure the quality of those services.
To overcome the limitations in physical capacity, the hospital has also expanded into telehealth. “We are the first TCM hospital in Beijing to be approved as an “internet hospital”, and allow users to tap on their medical insurance to pay for telehealth services,” Ms Wang explained. “It avoids congregation of crowds in physical facilities, and resolves the issue faced by patients that it is hard for them to get appointments.”
The pandemic has proved to be a learning opportunity for Chinese hospitals, with many now putting in place risk frameworks, making sure medical supplies stocks, emergency stockpiles and supply chains are reinforced. Ms Wang noted that GAMH is looking for new opportunities amidst crisis and uncertainty. “While implementing strict pandemic control measures, we will take this chance to emphasise three transformation areas: clinical quality, operational efficiency, and sustainable development levels. From acting immediately when we get a request, we will strive to act even before those requests are raised, to increase service satisfaction.”