Rising healthcare expenditures and continued “brain drain” of rural clinics underscore the urgent need for healthcare reform in China.
Liu Jingjing, Caijing 18 February 2009
The Ministry of Health published a report on February 16 on China’s healthcare development and reform in 2008 that showed a rise in total healthcare expenditures and “brain drain” in rural clinics, increasing the urgency around the need for reform.
In the report, national healthcare expenditures in 2007 totalled 1,129 billion yuan, accounting for 4.52 percent of GDP. The report estimated that total healthcare expenditures will reach 1,222 billion yuan in 2008.
Individual medical expenditures accounted for 45.2 percent of total expenses, a 4.1 percent decrease compared with 2006, while government and social medical expenditures increased by 2.2 percent and 1.9 percent respectively.
“The increase in healthcare expenditures reflects the public demand for medical services,” said Rao Keqin, director of the Health Statistical Information Center under the Ministry of Health. “It will continue to grow as our population ages and chronic diseases become more common.”
Another professor, who asked to remain anonymous, said, “The increase is not necessarily bad.” Given China’s increasing incomes, the public is willing to spend more on healthcare. As a result, the government does not need to be as concerned with controlling costs, and should focus instead on developing an effective system to increase the supply of healthcare services, he said.
The statistics estimate that there were 300,000 public healthcare institutions in China at the end of 2008, including 13,111 public hospitals and 6,590 private hospitals. These figures show an increase of 2,000 institutions from 2007.
Highly troubling, however, is that only 900,000 healthcare professionals – out of an estimated total of 6,980,000 – worked in rural clinics. Rural clinics in 2008 lost 20,000 workers from the previous year to “brain drain.”
And this was not the first decrease. The total number of rural healthcare workers was 914,000 in 2007, down 46,000 compared to 2006.
Rao told Caijing that some of the workers lost their jobs because county and village hospitals merged into medical centers.
But Rao said that the brain drain did not affect rural medical services. Statistics show that the number of medical treatments totalled 760 million in 2008, comparable to 2007 figures, while hospital admissions increased by nearly 3.9 million.
“A sound traffic system makes it convenient to receive medical treatment,” Rao said.
Attracting rural healthcare workers has also been a major problem. Students from formal medical schools are often not willing to work in rural regions due to the less modern circumstances. However, some experts point out that the problem should also be attributed to the medical education system, as rural healthcare needs generalists, but medical students are trained to specialize in specific diseases.
According to health statistics from the first three quarters of 2008, individual expenditures increased 7.6 percent to 146.5 yuan per patient, and hospital inpatient expenses increased 9.5 percent to 5,446.5 yuan per patient. The increases in 2007 from 2006 for outpatient and inpatient expenditures were 5.5 percent and 6.3 percent respectively. The government report attributed these increases to price increases.
Medicine expenditures also increased. Outpatients accounted for 50.0 percent of medicine expenditures in the first three quarters of 2008, the same as 2007, while inpatients accounted for 44.2 percent, increasing one percent from 2007.
“Malignant neoplasm, diabetes, high blood pressure and other chronic diseases need long-term treatment,” Rao said, “Meanwhile, with the continued development of pharmaceutical technology, the quality and price of medicine are inevitably increasing. All of this accounts for the increase in medicine expenses.”
Also contributing to the medicinal expense increase is that hospitals earn profit from selling medicine. Separating the pharmacy from the hospital is an important reform that may be included in the new healthcare framework.
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Healthcare Reform is on the Way
Rising healthcare expenditures and continued “brain drain” of rural clinics underscore the urgent need for healthcare reform in China.
Liu Jingjing, Caijing
18 February 2009
The Ministry of Health published a report on February 16 on China’s healthcare development and reform in 2008 that showed a rise in total healthcare expenditures and “brain drain” in rural clinics, increasing the urgency around the need for reform.
In the report, national healthcare expenditures in 2007 totalled 1,129 billion yuan, accounting for 4.52 percent of GDP. The report estimated that total healthcare expenditures will reach 1,222 billion yuan in 2008.
Individual medical expenditures accounted for 45.2 percent of total expenses, a 4.1 percent decrease compared with 2006, while government and social medical expenditures increased by 2.2 percent and 1.9 percent respectively.
“The increase in healthcare expenditures reflects the public demand for medical services,” said Rao Keqin, director of the Health Statistical Information Center under the Ministry of Health. “It will continue to grow as our population ages and chronic diseases become more common.”
Another professor, who asked to remain anonymous, said, “The increase is not necessarily bad.” Given China’s increasing incomes, the public is willing to spend more on healthcare. As a result, the government does not need to be as concerned with controlling costs, and should focus instead on developing an effective system to increase the supply of healthcare services, he said.
The statistics estimate that there were 300,000 public healthcare institutions in China at the end of 2008, including 13,111 public hospitals and 6,590 private hospitals. These figures show an increase of 2,000 institutions from 2007.
Highly troubling, however, is that only 900,000 healthcare professionals – out of an estimated total of 6,980,000 – worked in rural clinics. Rural clinics in 2008 lost 20,000 workers from the previous year to “brain drain.”
And this was not the first decrease. The total number of rural healthcare workers was 914,000 in 2007, down 46,000 compared to 2006.
Rao told Caijing that some of the workers lost their jobs because county and village hospitals merged into medical centers.
But Rao said that the brain drain did not affect rural medical services. Statistics show that the number of medical treatments totalled 760 million in 2008, comparable to 2007 figures, while hospital admissions increased by nearly 3.9 million.
“A sound traffic system makes it convenient to receive medical treatment,” Rao said.
Attracting rural healthcare workers has also been a major problem. Students from formal medical schools are often not willing to work in rural regions due to the less modern circumstances. However, some experts point out that the problem should also be attributed to the medical education system, as rural healthcare needs generalists, but medical students are trained to specialize in specific diseases.
According to health statistics from the first three quarters of 2008, individual expenditures increased 7.6 percent to 146.5 yuan per patient, and hospital inpatient expenses increased 9.5 percent to 5,446.5 yuan per patient. The increases in 2007 from 2006 for outpatient and inpatient expenditures were 5.5 percent and 6.3 percent respectively. The government report attributed these increases to price increases.
Medicine expenditures also increased. Outpatients accounted for 50.0 percent of medicine expenditures in the first three quarters of 2008, the same as 2007, while inpatients accounted for 44.2 percent, increasing one percent from 2007.
“Malignant neoplasm, diabetes, high blood pressure and other chronic diseases need long-term treatment,” Rao said, “Meanwhile, with the continued development of pharmaceutical technology, the quality and price of medicine are inevitably increasing. All of this accounts for the increase in medicine expenses.”
Also contributing to the medicinal expense increase is that hospitals earn profit from selling medicine. Separating the pharmacy from the hospital is an important reform that may be included in the new healthcare framework.
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