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China Eyes Community Health Service in Deepening Medical Reform

"Using a same bottle of ofloxacin injection, I have to pay 9.3 yuan in the hospital, but only 1.05 yuan here. Who will go to hospital for minor diseases then?" 65-year-old Liu Xianglian said while receiving a medical checkup at a community health service center.

"Thanks to zero-profit drug purchasing by the government, people are paying less for medical service at community health service centers," said Ma Rulin, deputy director of Yinchuan Health Department, Ningxia Hui Autonomous Region in northwest China.

In 2005, the average cost of a prescription at a community health service center paid by low-income people in Yinchuan was 14.5 yuan (US$1.8), while in 2003, the cost was 112 yuan (US$13.7), according to Ma.

Apart from low cost to see a doctor, Shanghai resident Cao Miaoxing has been enjoying the "home sickbed" which was set-up by the health service center in his community. Every week, Doctor Zeng Weihua visits him for physical examinations and diet suggestions.

"Not only me, the doctor also guides my wife in eating and taking medicine, as she has had frequent heart attacks recently," said Cao, who has suffered from several cerebral hemorrhages.

"Community health service provides people a more convenient, quicker medical service and eases pressure of large hospitals," said Mao Qun'an, spokesman of the Ministry of Health, "that's why it will be improved as a priority in Chinese medical reforms."

It is unreasonable to see a doctor in large hospitals for minor illnesses.

Improving community health service is a wise shift of the government to change the unusual phenomenon, said He Wenjie, deputy to the National People's Congress  (NPC), China's legislature, who is in Beijing attending the annual session.

According to statistics from the Ministry of Health, China currently has more than 3,400 community health service centers nationwide. Over 95 percent of cities have community health service.

Most community health service centers are short of funds and qualified health staff, resulting in poor confidence and reliability from the public. The country has less than 10,000 in-service community doctors, far less than the 100,000 it really needs.

"Only by improving community health service can we divert patients cramming in large hospitals and lower their medical cost, " said Health Minister Gao Qiang.

At the ongoing session of NPC, Chinese Premier Wen Jiabao said in the government work report that China will exert efforts in developing community health service.

A new community-based urban medical service system is set to be established in the next five years by re-allocating resources, raising funds and enhancing the training of staff, according to the report.

This year, the Ministry of Health will take measures to encourage community health service providers to shoulder the "first treatment" of patients, so that minor diseases will be stopped at the community level but major ones will be introduced to hospitals, said Mao.

Chronic diseases diagnosed by hospitals and recovery periods after operations will be shifted to community health centers, he added.

Qualified community centers will be enrolled into the urban medicare insurance lists, so that patients can get more reimbursement for their treatment, according to the government report.

Some policies have been carried out which raise the proportion of the reimbursement as a way to encourage people to go to community health service centers, Vice Premier Wu Yi told the media.

"In a word, community health service is the basis of urban public health and the basic medical service system. We will try to make a breakthrough from community health in the reform of providing the people easier and cheaper access to medical service, " said Mao.
 
(Xinhua News Agency March 13, 2006)

Public Health Reform and the Government
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