I have always had an interest in reading local official research documents. First, compared with the central level document, it provides a more “grassroots angle” of viewing problems and the way they get things done. Second, it is enriched with cases rather than theories. It’s just more practical. Third, it has a specific format and is easy to read after you get familiar with it. For today’s episode, I bring the study made by the Luoyang government in Henan province (in the very middle of China). It studies the transformation of “Secondary hospitals“ in the region and gives some policy suggestions to the Luoyang government.

Source: https://mp.weixin.qq.com/s/xjigOOLs2embN5C5QpnH7w

This report was published by the official WeChat account of Luoyang Municipal Committee Policy Research Office; I also translated one of the previous reports published on it, talking about LGFVs. Feel free to check:

So, before we go into the report, what are “Secondary hospitals“?

According to the Ministry of Health, Chinese hospitals are classified into a 3-tier system based on their ability to receive patients and conduct research. Which are Primary, Secondary, and Tertiary hospitals.

For Primary hospitals, they are basic healthcare facilities that provide preventive care, basic medical services, and rehabilitation services to a community-level population.

For Tertiary hospitals, they represent the highest level of medical institutions in China, serving as regional and national medical centers. Usually concentrated at the provincial economic centre or first-tier cities like Beijing and Shanghai. They have the most advanced medical equipment and services, and they are also famous for conducting significant medical research.

Secondary hospitals are mid-level regional healthcare institutions that provide services for a region, taking in referrals from primary hospitals and also taking some degree of teaching and research.

Secondary hospitals were described as the backbone of the Chinese medical system; however, that middle position also put it in a relatively awkward position. Patients typically choose primary hospitals for minor ailments but bypass secondary facilities in favor of tertiary hospitals for serious conditions. This “hollowing out” of secondary hospitals has forced them to seek new survival strategies, with many now providing integrated healthcare and elderly care services.

Below are four examples picked by the Luoyang Municipal Committee Policy Research Office. Two of them are local examples; the other two are from other provinces.

1. The Third People’s Hospital of Yiyang County(a county under the administration of Luoyang)

a. Transformation of Development Approach

The Third People’s Hospital of Yiyang County, formerly a township health centre, had relatively weak capabilities and lacked distinctive medical services, facing significant survival pressures. To overcome these challenges, the hospital ultimately determined its development direction as “establishing a specialised geriatric hospital and implementing integrated medical-nursing services.” Building upon the upgraded original Wenming Road campus (township health centre), the hospital subsequently developed the Lingshan campus (medical-nursing integration centre) and People’s Road campus (a comprehensive geriatric hospital). The township health centre primarily provides basic medical and public health services, the comprehensive geriatric hospital offers treatment, rehabilitation, and health promotion services, and the medical-nursing integration centre focuses on providing full-cycle integrated care for disabled and semi-disabled elderly.

b. Service System Enhancement

The hospital established an elderly health assessment centre to strengthen physical and cognitive function evaluations. After hiring new professional medical teams, they are now able to provide medical care for disabled, semi-disabled, and chronically ill elderly; short-term care and rehabilitation services for those recovering from illness or fractures; and hospice care for end-stage patients, meeting diverse medical and nursing needs. The hospital signed service agreements with six community centres, 16 elderly........

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