China boosts community health service

Updated: 2011-03-12 11:57
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GUIZHOU -- What is 72-year-old Chen Shiying's solution to the problem of how to live a longer life? Daily health care.

"Whenever I feel uncomfortable, I drop in to the community clinic, where doctors remind me to keep a healthy diet," said the old lady from Guiyang, capital of Southwest China's Guizhou province. "In case of emergency, I call the clinic and the doctors come to my home immediately."

The consultation was free of charge, except for the cost of medicine.

Chinese Premier Wen Jiabao vowed in his government work report on March 5 to prolong the average life expectancy of Chinese people by one year during the next five years.

Some experts believe improving daily health care is effective in helping people live longer.

"Daily health care could help people reduce the chances of getting major diseases," said Li Shijian, vice-president of the No 6 People's Hospital in Guiyang.

Chen Shiying suffers from high blood pressure, cholecystitis and pancreatitis, but a trip to the nearest hospital could take two or three hours.

"My four children all have to work," she said. "I don't want to trouble them. The community clinic made medical service convenient. "

Expensive medical treatment at a hospital was another burden.

Without a retirement pension of her own, Chen lives on a 300 yuan ($46) per month widow's pension.

An operation to cure her cholecystitis in 2009 cost 5,000 yuan. In the clinic, however, basic treatments cost much less. An intravenous drip, for example, only costs 50 yuan at the clinic.

Huang Can, vice director of the Xiaohe district health bureau in Guiyang city, said medical treatment for common diseases in community clinics generally costs 30 to 50 percent less than the same treatment in big hospitals.

In Chen's community, about 25,000 residents benefited from the community clinic.

Basic health care was stressed after the founding of the People's Republic of China in 1949. Then, people had access to subsidized health clinics run by "barefoot doctors," usually middle-school students trained in first aid.

The primitive service, free of charge, played an important role in doubling the country's average life expectancy from 35 in 1949 to 68 in 1978.

After China's economic reforms, the system was dismantled as China attempted to switch to a market-oriented healthcare system.

In 2005, China admitted that these health reforms had not ben successful.

In 2008, a new round of medical reforms was unveiled. These reforms aimed to establish a basic health care system that would eventually cover all urban and rural residents.

Statistics announced at a conference on basic medical service last November showed that, by the end of 2009, China had set up 8,859 community clinics in 36 big cities.

Despite the convenience, these clinics offer by being closer to patients and less expensive than hospitals, people tend to choose big hospitals boasting more medical resources.

In an example given by Huang Can, the No 44 Hospital in Guiyang had a 110 percent bed occupancy rate, compared to a bed occupancy rate of 48 percent in community clinics.

This led to decreases in funding for local clinics.

A regulation announced in 2009 by the Health Ministry and the National Development and Reform Commission stipulated that community clinics should cover at least 1,400 square meters.

A survey by Guiyang's Bureau of Health showed that only 10 out of the city's 41 clinics reached these national size standards.

"Without enough space, services offered by the clinics are limited," said Huang.

Another problem facing clinics is a shortage of qualified doctors, according to Long Weimin, director of the health service center of the Youzha community in Guiyang.

"Due to profit and future development concerns, only a few doctors want to go to the community clinics," said Sun Chengyi, a deputy to the National People's Congress.

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"Among those willing to go, only a small number are general practitioners," he added.

Li Ling, a professor with the China Center for Economic Research at Beijing University and a senior advisor to the Health Ministry, suggested public hospitals join hands with community clinics to aid the clinics' development.

"Public hospitals are like the eldest son of a family," she said. "He gets more attention from the family. He shouldn't compete with his brothers and sisters for food, instead, he should help his siblings."

On Monday, the Chinese government issued a circular pledging to "establish a cooperative system between public hospitals and basic health service centers."

Chen Zhu, head of the Health Ministry, promised to raise the fund of basic health service centers to 25 yuan per capita in 2011. The per capita fund in 2009 was less than 15 yuan.

Li Ling felt nostalgia for the "barefoot doctor" system, noting that doctors close to the people are still needed.

"Policies should be made to encourage doctors to go to clinics, " she said. "For example, a favorable housing policy could help them live near their potential patients. They could build up good relationships and doctors could know their patients' situations better," she said.