Assistance improves healthcare imbalance

Rural doctor Zhao Jianhua (center) and Zhao Gang (left) check the blood pressure of a villager on her doorstep in Napo county, Guangxi Zhuang autonomous region, in March 2021. [Zeng Yiming/Xinhua]

Sending experts to less well-off areas ensures better medical outcomes

When neurologist Luo Bin was sent from his Beijing hospital to a county-level hospital in Inner Mongolia in 2020, he was saddened to see the scale of the patients' unmet medical needs.

During his seven-month stint in the autonomous region, his name was added to the list of the hundreds of medical specialists and other experts that have been sent to Inner Mongolia since 1998 to pass on their skills and help balance the nation's disparities in expertise.

Luo, from the capital's Aerospace Center Hospital, specializes in thrombolysis, a minimally invasive procedure to dissolve blood clots and restore the flow of cerebral blood in patients with ischemic stroke. The doctor is so skilled at the technique that he performs 500 of them annually in Beijing.

"At that time, at the People's Hospital of Horqin Right Wing Front Banner, the most common treatment for acute stroke was clot-busting medications, which often cannot resolve the underlying issue of the narrowing of blood vessels nor greatly improve these patients' quality of life," he said.

Luo's arrival and that of several other medical aid workers were aimed at changing the status quo. Through the aid program, they carried out 150 thrombolysis procedures and trained three local doctors in the practice.

"By the time we left, the local demand for the procedure could be met and patients no longer need to travel to larger cities for the therapy," he said.

Luo is part of the broader drive in China to narrow the urban-rural gap in healthcare services. This drive has played an irreplaceable role in elevating the nation's average life expectancy over the past 75 years.

Lei Haichao, head of the National Health Commission, said at a news conference in September that the average life expectancy — one of the three key indicators of a nation's health level — rose to 78.6 years last year in China, compared to 35 years around 1949 and 73.5 years in 2012.

The global average life expectancy was 73.2 years last year and 72.6 years in 2022, according to the World Health Organization.

The two other health benchmarks — the mortality rates for children under five years old and pregnant women — have also fallen significantly in the past 75 years. Data shows that the nation's mortality rate of for those under 5 years old decreased from 200 to 6.2 per 1,000 births during the period, and the maternal mortality rate dropped from 1,500 to 15.1 per 100,000 births.

"Such levels are the best in our history and are also parallel with levels in middle- and high-income countries across the globe," Lei said.

Lei noted that a shortage of high-quality medical resources and their uneven distribution have been a global issue, and that China has taken a three-pronged approach to tackle it.

Those approaches are to expand access to quality healthcare services, to increase the overall capacity and quality of medical resources through establishing regional and national medical centers, and to make use of 5G and other advanced technologies to improve medical outcomes.

A system enabling remote medical examination is demonstrated at the 2024 World Health Expo in Wuhan, Hubei province, in April last year. [Photo provided to China Daily]

A series of programs have been launched to this end, such as establishing paired assistance between top-tier, urban hospitals and county-level medical institutions, and dispatching experienced medical professionals to the countryside and less developed areas through various channels.

"Some 40 percent of clinical departments designated as having national key specialties are located in cities that are not provincial capitals, signifying that the current policies are oriented toward evening out healthcare services across regions," Lei said.

Luo, the neurologist from Beijing, said that the monthslong medical aid program he took part in yielded fast and long-term improvements.

"I received a patient who had been waiting for a local doctor capable of carrying out carotid stenting for a long time. Without our arrival, he would have had to travel to Changchun in Jilin province to receive the surgery and leave his small farm behind for months," he said.

Luo said that most patients rendered bed-bound by this type of stroke would be able to stand up and walk one to two days after surgery and check out from the hospital a week later.

During his stay, Luo completed about 150 thrombolysis therapies at the banner hospital. More importantly, he trained three doctors to be capable of performing the operation independently.

"Hands-on guidance is significant. Because I was by their side all the time, we were able to sort out various questions together, such as how to devise treatment plans tailored to a patient's blood vessel size and time of disease onset," he said.

Besides giving lectures to his local proteges, Luo also asked them to make morning rounds with him and lead discussions of updates on patients' clinical conditions and laboratory results during seminars.

"This approach helped them better absorb knowledge," said Luo.

In addition to offering convenient and affordable access to quality medical services, China has also been striving to ramp up total medical service capacities in recent years, according to Lei.

Since 2017, Lei said that China has established 13 national medical centers specializing in different fields, as well as 125 regional medical centers.

National medical centers are aimed at carrying out the diagnosis and treatment of rare and severe cases of specific disease categories. They also play a leading role in researching and promoting advanced therapies.

Regional medical centers aim to provide patients with quality medical treatment closer to their homes.

Lei added that 114 provincial-level medical centers have also been established.

"Through the construction of these projects, China's overall medical resources and medical service capacities have leaped forward and their distribution is more balanced across the nation," he added.

In Jinjiang, a county-level city in the eastern province of Fujian, a regional medical center was set up in partnership with the Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University in June 2021. The center is based at the Jinjiang Municipal Hospital.

As of recently, the hospital in Shanghai has sent 46 experts and its management team to the hospital and six of its well-known experts have set up their own offices there.

One of the beneficiaries of the collaboration mechanism is a 17-year-old boy who four years ago was diagnosed with idiopathic scoliosis, a type of scoliosis that causes the spine to develop an abnormal curve.

Progression of the disease in recent months prompted his parents to consider taking him to Shanghai to undertake an extremely complicated, invasive spinal surgery. "Upon hearing that Shanghai experts were coming here, we decided to have the operation in our hometown," said his father.

Zheng Yongqiang, a local orthopedic surgeon, said that the family has so far paid about 50,000 yuan ($7,000) out of pocket. "If they went to Beijing or Shanghai, it would probably cost them several hundred thousand yuan, adding medical expenditures, travel and accommodation expenses together," he said.

Zheng said he also valued the opportunity to personally observe the surgery. "For us, watching highly experienced surgeons performing and explaining procedures is an important addition to reading textbooks or research papers," he said.

Qin Wei, Party chief of the Jinjiang Municipal Hospital, said that the partnership has introduced 159 novel technologies locally, and the number of outpatient visits, hospitalizations and surgeries have doubled compared to the past.

To further bridge the gap between urban and rural medical institutions, Lei said that 5G technologies and other advanced information technology tools have been used to facilitate remote diagnosis and treatment.

China has set up 3,340 online hospitals that together provide over 100 million consultations online each year.

"We will also guide and regulate the development of private hospitals so that they can complement the network of public hospitals," he said.

As the nation is aiming to make its medical services more diversified to meet the varying demands of residents, Lei said that authorities have announced recently to allow the establishment of wholly foreign-owned hospitals in Beijing, Shanghai and seven other areas.

Deng Jiahui contributed to the story.