北京眼睛医疗改革战役的城市“超级医院”

StephenW

Beijing eyes urban 'super hospitals' in healthcare reform battle

By EJ Lane

China healthcare policymakers are fighting a losing battle to curb the growth of public urban "superhospitals" that now see expansion as more important than ever in the face of a move in May to scrap a 15% markup on drug prescriptions, Reuters reports.
Citing the nearly 7,000 bed-Zhengzhou First Affiliated hospital in central China as a prime example, Reuters reported that the world's biggest hospital scrambles daily to handle patient loads that lead to makeshift beds in the hallways and gurneys holding patients and relatives "in brightly lit stairwells."
In May, China's State Council announced it would scrap a 15% markup on drug sales in major hospitals nationwide in a pilot that aims to transform pharmaceutical cost and quality problems over a two-year horizon as part of a major health system overhaul. It also cuts a key source of revenue for the "superhospitals."
The move was followed in June with guidelines for an expansion of private hospitals by allowing subsidies and finance to flow to new companies as a way to allow patients access to newer services and ease demand on the public system, and stem a tide of patients avoiding rural clinics in favor of city-based mega hospitals.
Reuters, citing Ma Jingdong, associate professor at Huazhong University of Science & Technology in Wuhan, said 60% to 80% of patients in big hospitals could be treated at community medical centers.
Reuters said China has 16 public hospitals with more than 3,000 beds, citing figures from Becker's Hospital Review, compared to 2,478 beds at the largest U.S. hospital, New York-Presbyterian. The size of these operations serve as a testimony to a lack of public confidence in rural clinics that are meant to provide triage in the massive national system.
Also in May, the State Council and the National Health and Family Planning Commission established several other targets to gain control of costs in the nation's healthcare system, forecasted by McKinsey to reach $1 trillion by 2020, while expanding coverage for a population of more than 1 billion people.
But as Reuters reported, last summer Beijing also issued a directive restricting expansion of public hospitals that appears to have been ignored by administrators.
Instead, Reuters reported, some hospitals are so large they have their own police stations and one doctor at First Affiliated Hospital even briefly wore roller skates to get around the wards faster after the hospital was expanded further.
Liu Tingfang, a professor at Tsinghua University, told Reuters, "Hospitals have to expand if they want to survive."
The loss of income from drug markups has also hit drug companies, with traditional sales models changing rapidly as well.
Many drug company executives are watching to see if online pharmacy sales are approved as suggested by policymakers earlier this year. That would join growing over-the-counter products now sold by the likes of Alibaba ($BABA) and JD.com, a trend noted by Johnson & Johnson ($JNJ) CEO Alex Gorsky on the second-quarter earnings call as he discussed the outlook for consumer sales.
- here's the story from Reuters
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StephenW

北京眼睛医疗改革战役的城市“超级医院”
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中国医疗卫生政策制定者注定要失败，遏制城市公共“superhospitals”现在看到的在5月转会到报废药物处方有15％的加价，面对扩张比以往更加重要的增长，据路透社报道。

理由是近7000床 - 郑州第一附属医院在中国中部作为一个典型的例子，据路透社报道，世界上最大的医院打乱日常处理病人的负荷，导致凑合床的走廊和轮床保持在明亮的楼梯间病人及亲属“ “。

今年五月，中国国务院宣布，将放弃在各大医院销售药品15％的加价在全国范围内开展试点，目标是在两年的地平线改造药品成本和质量问题作为一个主要的卫生系统改革的一部分。它还减少财政收入的主要来源为“superhospitals。”

此举随后在六月与私立医院的扩展准则允许的补贴和资金流向的新公司，以此来让病人获得新的服务和方便市民的系统需求，茎患者避免农村潮诊所有利于城市为基础的大型医院。

路透社援引麻京东，华中科技大学武汉副教授说，60％至80％的患者在大医院可以在社区医疗中心进行治疗。

路透社说，中国有16个公立医院3000多张病床，援引贝克尔医院复查，相比2478张病床，在美国最大的医院，纽约长老会的数字。这些操作的大小作为证词缺乏公众信心，这是为了分流提供了大量的国家制度的农村诊所。

同样在5月，国务院和国家卫生和计生委设立的其他几个目标，以获得在该国的医疗系统，预测由麦肯锡达到一万亿美元，到2020年控制成本，同时扩大覆盖超过1人口十亿人。

但路透社报道，去年夏天北京还发出指令，限制扩大公立医院，似乎已经忽略了管理员。

相反，据路透社报道，一些医院是如此之大，他们有自己的警察局和一个医生第一附属医院甚至一度穿着旱冰鞋避开病​​房更快医院后进一步扩大。

刘伍廷芳，清华大学教授，告诉路透社记者，“医院必须扩大，如果他们要生存。”

收入来自药品加价的损失也打击制药公司，与传统的销售模式迅速变化为好。

许多药物公司高管都看，看看网上药店销售被批准为今年早些时候建议的决策者。这将加入越来越多的非处方产品目前销售的阿里巴巴（$ BABA）和JD.com，在第二季度财报电话会议指出，强生公司（JNJ $）首席执行官Alex Gorsky，他讨论了趋势的喜欢前景为消费者销售。

- 这里是来自路透社的故事

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