Peking University, March 18, 2022: As the economy develops, population aging and rapid urbanization, unhealthy lifestyle choices have become major problems in China's society. As a result, morbidity rates of major diseases - especially cardiovascular diseases - are on the rise. It is estimated that about 330 million Chinese people are currently suffering from cardiovascular diseases, and the mortality rate in rural areas has been higher than that in urban areas since 2009. Presently, however, doctors working in rural areas are unable to provide quality healthcare services which meet the needs of rural residents.
I. Existing problems
Currently, rural medical institutions have the following shortcomings.
1. Morbidity rates of major diseases - especially cardiovascular diseases - are on the rise as the population ages. Rural medical institutions and rural doctors are increasingly tasked with public health services, while the provision of specialized treatments is on the decline.
2. Due to cross-regional economic inequality, medical resources are unevenly distributed. Some rural areas have very little investment in medical facilities; hence, many rural regions lack necessary drugs and medical equipment to provide basic treatments or treat chronic conditions.
3. Due to the aging of personnel in the healthcare industry, low income and the insufficiency of official job postings, there is a lack of incentives for experienced doctors to work in rural areas. Most rural doctors cannot diagnose and treat patients properly because they have not been systematically trained. In some areas, the government fails to implement medical triage policies and build appraisal systems in practice.
II. Suggestions
1. Local health administrations should allocate resources more effectively and increase the investment in rural medical institutions. They should also formulate policies to improve the capacity of rural medical institutions in accordance with the county-rural integration scheme and rural revitalization strategy. Local socioeconomic conditions (including population, transportation, and medical resources) should be put into consideration when setting up village clinics or other regional medical facilities.
2. The government should improve the quality of specialized medical services while implementing the county-rural integration system. Medical institutions at the grassroots level are crucial to disease prevention and treatment. County hospitals shall act as a support for rural hospitals to promote the establishment of chest pain treatment units. Subsequently, chest pain treatment centers in village clinics shall also be established. In addition, the screening system for hypertension, hyperlipidemia, and hyperglycemia, and the management system for common chronic conditions should be established to provide lifelong public health protection.
3. The government should combine rural revitalization strategy with resource investments to improve the welfare of rural doctors and the capacities of rural medical institutions. Local administrations should actively implement the "three insurances and one housing fund" policy for rural doctors and boost their source of income by encouraging township health centers to prioritize employing practicing (assistant) doctors. Basic diagnostic and resuscitative equipment (such as electrocardiographs and defibrillators) and medicine for major chronic illnesses (such as cardiovascular diseases or cerebrovascular diseases) should be provided.
4. Local administrations should actively carry out systematic medical training for rural doctors to improve the quality of healthcare services in rural regions. Performance appraisal systems should be put into practice.
Written by: Zhou Zixuan
Edited by: Shi Xinyao, Hu Rong
