China approves guideline to nearly double its number of doctors by 2020

China’s State Council has approved a guideline aimed at improving the country’s medical services by increasing its number of hospitals and general practitioners by 2020, the council announced in a press release.

Under the guideline, China will seek to establish six hospitals per 1,000 people and two general practitioners for every 10,000 residents of China.

As of 2013, China had an average of 4.55 hospital beds for every 1,000 residents, 1.07 general practitioners for every 10,000 residents, and 2.05 nurses for every 1,000 members of the population. The new guideline is aimed at increasing the number of nurses to 3.14 per 1,000 people by 2020, and increasing the doctor/nurse ratio from 1:1 to 1:1.25.

The quality of current medical services in China is low, according to the press release. The guideline will seek to address the problem by revamping medical institutions across the country.

China’s community-level hospitals will be designed based on demographic data, and planning will be focused on accessibility, efficiency and cost reduction. The guideline will seek to control the number and size of public hospitals, which currently comprise nearly 90% of China’s hospitals. The guideline will promote the establishment of nonpublic hospitals, with a goal of at least 1.5 hospital beds per 1,000 residents provided by private hospitals by 2020. This would equal a public/private hospital beds ratio of 3:1.

According to a report released by McKinsey & Company, public hospital reform is one of China’s biggest healthcare challenges. According to this document, the components of public hospital reform include the following:

increasing government subsidies and medical service charges as main funding sources;
decreasing dependence on drug sales as a source of hospital revenue;
promoting clear relationships between payers and providers, and implementing effective cost-control mechanisms;
improving the management of public hospitals by establishing key performance indicators of quality and operating efficiency; and
reallocating resources to community health centers rather than large urban hospitals.

According to the McKinsey report, China aims to establish balance between large urban hospitals and grassroots institutions.

“The chronic imbalance of resources has long been a problem in China’s healthcare system. The largest Class 3 hospitals in big cities tend to have the highest quality physicians and equipment, and capture the lion’s share of patient flows,” the report stated. “By contrast, grassroots facilities such as urban community health centers (CHCs) and county hospitals tend to be underdeveloped, poorly funded and disconnected from larger hospitals.”

To address this, China aims to establish a primary care infrastructure that includes development of CHCs and community health stations, along with a three-tier medical network consisting of county hospitals, township health centers and village clinics. The government has also taken measures to improve physician quality and training at primary care institutions. The Central Government Healthcare Reform Office has facilitated on-the-job training of urban community health physicians across the country.

The guideline will also use technology to improve the delivery of its healthcare services. Through the guideline, China plans to introduce “smart” medical projects which will combine the mobile Internet, the Internet of Things, cloud computing and wearable devices to harness and optimize big data, the state council said in the press release.