Primary healthcare development during the healthcare reform in China and future direction - with experience inspiration from UK

• Thesis title in Czech: Vývoj primární péče v průběhu zdravotní reformy v Číně a její budoucnost - na základě zkušeností z UK
• Thesis title in English: Primary healthcare development during the healthcare reform in China and future direction - with experience inspiration from UK
• Key words: Primary health care; China; health care reform; UK primary health care
• English key words: Primary health care; China; health care reform; UK primary health care
• Academic year of topic announcement: 2017/2018
• Thesis type: diploma thesis
• Thesis language: angličtina
• Department: Department of Public and Social Policy (23-KVSP)
• Supervisor: Ing. Zuzana Kotherová, Ph.D.
• Author: hidden - assigned by the advisor
• Date of registration: 18.06.2018
• Date of assignment: 18.06.2018
• Date and time of defence: 10.02.2021 09:00
• Venue of defence: Pekařská 16, JPEK405, 405, Zasedací místnost
• Date of electronic submission: 04.01.2021
• Date of proceeded defence: 10.02.2021
• Opponents: Mgr. Ing. Olga Angelovská, Ph.D.

References

[1] WHO, “Primary Health Care: A Framework for Future Strategic Directions,” pp. 1–40, 2003.
[2] WHO, “Primary health care.” https://www.who.int/health-topics/primary-health-care#tab=tab_1 (accessed Sep. 27, 2020).
[3] X. Liu et al., “Knowledge, attitudes, and practices related to the establishment of the National Hierarchical Medical System (NHMS) among outpatients in Chinese tertiary hospitals,” Med. (United States), vol. 97, no. 35, 2018, doi: 10.1097/MD.0000000000011836.
[4] Y. Wang, L. Sun, and J. Hou, “Hierarchical Medical System Based on Big Data and Mobile Internet: A New Strategic Choice in Health Care,” JMIR Med. Informatics, vol. 5, no. 3, p. e22, 2017, doi: 10.2196/medinform.6799.
[5] “The 13th Five Year Plan of China.” http://www.gov.cn/xinwen/2016-03/17/content_5054992.htm (accessed Sep. 13, 2020).
[6] J. C. Wyatt and F. Sullivan, “eHealth and the future: promise or peril?,” Bmj, vol. 331, no. 7529, pp. 1391–1393, 2005, doi: 10.1136/bmj.331.7529.1391.
[7] M. Roland, B. Guthrie, and D. C. Thomé, “Primary medical care in the United Kingdom,” J. Am. Board Fam. Med., vol. 25, no. SUPPL. 1, pp. 6–11, 2012, doi: 10.3122/jabfm.2012.02.110200.
[8] NHS England, “Digital First Primary Care,” Website, 2020. https://www.engage.england.nhs.uk/consultation/digital-first-primary-care-policy/user_uploads/digital-first-primary-care-consultation.pdf (accessed Nov. 01, 2020).

Preliminary scope of work

Preliminary Scope of Work

Introduction

China moved to a market economy in the 1980s. The role of government has been substantially reduced in all economic and social sectors, including healthcare. It was the time China started its healthcare reform.

Unlike Europe, most people do not have their own general practitioner due to the large population and insufficient primary medical facilities in China. Most of patients choose to go to a large hospital for PHC directly which seriously increases the burden of medical institutions. This phenomenon has become more prominent in recent years.

Therefore, primary health care (PHC) became one of key areas in China’s health system reforms since 2016. PHC is a crucial part and foundation in healthcare system. It is the first level for healthcare to contact and connect with individuals, family and community. PHC constitutes the first element of a continuing healthcare process.

Nowadays, China is promoting the establishment of hierarchical medical system to ensure people have a functional primary health care system. Medical institutions of different levels undertake the treatment of different diseases, and gradually realize the medical process from general treatment to professional.

To be better developed, I would like to explore the situation of PHC in China in this paper and try to find what are the difficulties while implementing government measures and how e-health may be benefiting it. In the end, I would like to analysis good experience and approaches from UK which could be applied in the PHC development in China after localization.

Key words: Primary healthcare, hierarchical medical system, healthcare reform, china, e-heath

Objectives:
1) State the healthcare reform in China and focus on the part of primary healthcare
2) Find inspiration experience through analyzing other countries example

Research Question:
What is the future direct of primary health care policy in China?

Theoretical framework:

-Theory: A Framework for Future Strategic Directions by WHO.
Currently China in the second primary health care scenario (strengthening PHC to meet new challenges). WHO provide direction for countries who are under this scenario to improve their PHC development and give some strategic advices. [1]

- Primary health care (PHC) addresses the majority of a person’s health needs throughout their lifetime. This includes physical, mental and social well-being and it is people-centred rather than disease-centred. PHC is a whole-of-society approach that includes health promotion, disease prevention, treatment, rehabilitation and palliative care.[2]

-Primary care medical institutions commonly referred to as grassroots medical institutions play an extremely important role in the National Medical and Health Care System (NMHCS) in China, with many Chinese officials and policy makers supporting the implementation of “community-based medical institutions first” to develop and enhance the service capacity of these primary care medical institutions.[3]

-There are many problems in the medical system, such as biased resource allocation and extremely high patient flows to large hospitals.[4]

-The 13th Five Year Plan (2016-20) for deepening medical and health system reform aims to basically establish a hierarchical medical treatment system in accordance with China's actual conditions by 2020.[5]

-Through e-health, patients could easily access to health information, healthcare services and medical supplies. In case of long distance or lack of health care sources, people can still get better general treatment. [6]

-Since 1948 health care in the United Kingdom (UK) has been centrally funded through the National Health Service (NHS). The NHS provides both primary and specialist health care which is largely free at the point of delivery. Family practitioners are responsible for registered populations of patients and typically work in groups of 4 – 6 self-employed physicians. [7]

-NHS aims to enable digital access to GPs for every patient in England by 2023/24. The Digital First Primary Care plan is to enable all patients to have the right to online and video consultations by 2021. [8]

Preliminary scope of work in English

Preliminary Scope of Work

Preliminary Scope of Work

Introduction

China moved to a market economy in the 1980s. The role of government has been substantially reduced in all economic and social sectors, including healthcare. It was the time China started its healthcare reform.

Unlike Europe, most people do not have their own general practitioner due to the large population and insufficient primary medical facilities in China. Most of patients choose to go to a large hospital for PHC directly which seriously increases the burden of medical institutions. This phenomenon has become more prominent in recent years.

Therefore, primary health care (PHC) became one of key areas in China’s health system reforms since 2016. PHC is a crucial part and foundation in healthcare system. It is the first level for healthcare to contact and connect with individuals, family and community. PHC constitutes the first element of a continuing healthcare process.

Nowadays, China is promoting the establishment of hierarchical medical system to ensure people have a functional primary health care system. Medical institutions of different levels undertake the treatment of different diseases, and gradually realize the medical process from general treatment to professional.

To be better developed, I would like to explore the situation of PHC in China in this paper and try to find what are the difficulties while implementing government measures and how e-health may be benefiting it. In the end, I would like to analysis good experience and approaches from UK which could be applied in the PHC development in China after localization.

Key words: Primary healthcare, hierarchical medical system, healthcare reform, china, e-heath

Objectives:
1) State the healthcare reform in China and focus on the part of primary healthcare
2) Find inspiration experience through analyzing other countries example

Research Question:
What is the future direct of primary health care policy in China?

Theoretical framework:

-Theory: A Framework for Future Strategic Directions by WHO.
Currently China in the second primary health care scenario (strengthening PHC to meet new challenges). WHO provide direction for countries who are under this scenario to improve their PHC development and give some strategic advices. [1]

- Primary health care (PHC) addresses the majority of a person’s health needs throughout their lifetime. This includes physical, mental and social well-being and it is people-centred rather than disease-centred. PHC is a whole-of-society approach that includes health promotion, disease prevention, treatment, rehabilitation and palliative care.[2]

-Primary care medical institutions commonly referred to as grassroots medical institutions play an extremely important role in the National Medical and Health Care System (NMHCS) in China, with many Chinese officials and policy makers supporting the implementation of “community-based medical institutions first” to develop and enhance the service capacity of these primary care medical institutions.[3]

-There are many problems in the medical system, such as biased resource allocation and extremely high patient flows to large hospitals.[4]

-The 13th Five Year Plan (2016-20) for deepening medical and health system reform aims to basically establish a hierarchical medical treatment system in accordance with China's actual conditions by 2020.[5]

-Through e-health, patients could easily access to health information, healthcare services and medical supplies. In case of long distance or lack of health care sources, people can still get better general treatment. [6]

-Since 1948 health care in the United Kingdom (UK) has been centrally funded through the National Health Service (NHS). The NHS provides both primary and specialist health care which is largely free at the point of delivery. Family practitioners are responsible for registered populations of patients and typically work in groups of 4 – 6 self-employed physicians. [7]

-NHS aims to enable digital access to GPs for every patient in England by 2023/24. The Digital First Primary Care plan is to enable all patients to have the right to online and video consultations by 2021. [8]