对2019年中国县级医院能力建设进展报告的思考

波士顿大发888在线娱乐集团(888棋牌在线)中国团队一直在撰写一系列时事通讯,强调中国政府在降低药品和大发888在线娱乐设备价格方面的努力. 重要的是要明白,这一举措是在2009年开始的中国大发888在线娱乐改革的大背景下进行的, 其实质是通过将公共大发888在线娱乐覆盖范围扩大到出生和生活在城市以外的约10亿人,解决贫富差距问题.

了解更多关于中国公共大发888在线娱乐保险计划及其演变的背景, please refer to our previous article here.

Currently, there are approximately 2800+ county-level administrative regions in China, and over 70% of the total Chinese population resides in these counties, more commonly referred to as “the rural areas of China”. 这些县的保健设施通常包括一个县总医院和几家妇女和儿童专科医院, for cancer care, orthopedics, Chinese traditional medicine, etc.

认识到与现代城市的同行相比,这些县级大发888在线娱乐保健提供者在能力和基础设施方面存在巨大差距, 中国政府在2015-2016年制定了一项计划,作为大发888在线娱乐改革的重点之一, 提高目前为农村居民服务的县医院的服务能力.

In response, 888棋牌在线的一些客户已经在他们的战略市场发展计划中确定了县医院作为一个新兴的客户细分. 888棋牌在线分析了国家卫生888棋牌在线委员会最近发布的一份报告,该报告回顾了能力建设项目在其前三年的进展,并希望分享一些有趣的和相关的发现.

  • The scope of the assessment covered 1,837 County General Hospitals which, and according to the National Health Commission, accounted for 97.8% of all county-level general hospitals.
  • 早期指标表明,在当地提供更多护理方面,县医院的能力建设工作取得了成功.
    • The number of diseases that can be treated by the county hospitals had increased from 1,062 (2017) to 1,412 (2018), as well as the number of types of surgical procedures performed, 343 (2017) to 434 (2018), which are 33% and 26.5% increases compared to 2017, respectively.
    • Average annual patient visits: 312,000 per hospital, 20% increase from 2017
    • Average annual hospital admissions: 24,000 per hospital, 36% increase from 2017*; average inpatient stay is 7.4 days and utilization of hospital bed is 88.3%
    • 平均每年手术次数:8526次,增长39%(*2017年数据作为对比)

这些数据还被用于监测县级医院在分级保健提供系统中的作用.

  • County hospitals and higher-level hospitals: 194,800例患者从上级医院转移到县医院,580,500 patients were referred to higher-level hospitals in 2018.
  • County hospitals and lower-level care facilities: 2,021,300 and 799,700 patients were respectively transferred from and to lower-level facilities.

该报告还揭示了最大的能力差距所在——诸如精神病学等专业, Rehabilitation and Physiotherapy, Intensive Care, and Infectious Diseases are rarely established. For example, only 42.5% of the 1,837 County General Hospitals reported having a department of Psychiatry.

And even when there is a dedicated department, 这并不一定意味着工作人员具备或受过培训,能够提供最基本的诊断或治疗服务之外的服务. For example, although 86% of the county hospitals have Pathology departments in their hospitals, only 40% of those are capable of performing special staining, immunohistochemistry, or molecular diagnostics in their histopathology labs.

When it comes to surgical procedures, examples of low adoption are:

  • 在1837家医院中,只有429家(23家)实施了超声引导的射频消融术.35%)
  • Video-assisted arthroscopy is performed in 1,088 hospitals (59.23%)
  • Surgical removal of tuberculosis in the spine is performed in 1,018 hospitals (55.42%)
  • Pulmonary lobectomy is performed in 925 hospitals (50.35%)
  • 923家医院(50家)对肺大疱性疾病实施了胸腔镜手术.24%)

Undoubtedly, 随着县医院继续改善其基础设施和服务能力, they represent an emerging market segment for our clients, pharmaceutical and medical device companies, who typically supply to the 2,000 ~3,000 mega hospitals in big cities in China. While staff skills take time to build, it is not difficult to see the short-term equipment needs driven by the 2,000 or so county hospitals’ rush to improve their infrastructure, particularly the capital equipment. As the report revealed, the total asset value of hospital-based capital equipment has grown significantly by almost 30% from 2017 to an average value of 95 million yuan in 2018 (approximately $15million; exchange rate 6.5)每个医院的主要驱动因素是磁共振成像和CT扫描仪等成像设备的获取.

但该行业也认识到,县级医院与目前大城市-大医院类型的客户有很大的不同. To begin with, 医院的负担能力和在县医院治疗的病人的负担能力. 这让888棋牌在线回到了这篇文章的开头,政府支付者在资助农村大发888在线娱乐保健服务的扩张时是如何应对的——政府通过国家报销流程和国家/省级招标制定了积极的价格削减.  So, 这里的困境是,在业内对这2000家县医院带来的短期业务上行机会持谨慎态度的同时, the government payer has already used that theoretical volume in price negotiations.

波士顿大发888在线娱乐保健协会与大型跨国公司和专门从事创新大发888在线娱乐技术的中小型企业合作. 然而,对于中小企业来说,这可能是一个不太相关的讨论,因为888棋牌在线必须关注中国领先的医院和国家级别的kol,以推动早期采用, 对于在中国的老牌国际公司来说,这是一个挑战,要讨论并确定现在是不是重新审视市场潜力的时候,以及基于传统客户细分而制定的各种战略和模式. 随着中国政府的谈判机制成为覆盖决策和采购过程的规范,定价可能成为最紧迫的问题. Please contact us to see how we can help.