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Jiading highlights effective hospital reform

( ) 2019-05-31

Jiading district of Shanghai has been listed by the State Council among areas with significant improvements in public hospital reform, making it eligible to receive a newly-added subsidy of 5 million yuan ($724,725) from the central government.

In 2018, Jiading's permanent population reached 1.58 million, including a 625,200 registered population. The district had two third-grade public medical institutions, seven second-grade ones and 20 community health service centers and sub-centers. The average life expectancy of registered residents in Jiading was 84.44 years. The infant mortality rate was 2.3 per thousand while the maternal mortality rate was zero.

Life expectancy, maternal mortality rate and infant mortality rate are regarded as the three major indexes of a regional health development situation. The health level of Jiading is higher than the city's average level and has remained on par with developed countries and areas for years. Jiading's success can be attributed to the government's efforts to accelerate the reform of its public hospitals with specific measures including the enhancement of the government's guiding role, the establishment of a modern hospital management system, intensified supervision and evaluation, control of medical expenses, the promotion of intensive medical services and regional medical alliance construction.

Jiading has set up a management committee of public hospitals to build a solid management system. The district has attracted the settlement of Ruijin Hospital North Shanghai Jiaotong University School of Medicine and Eastern Hepatobiliary Surgery Hospital, and reached agreements for settlement with Shanghai Chinese Medical Hospital. In addition to building and renovating a number of community health service centers, Jiading is speeding up the construction of multiple hospitals, including the second phase project of Jiading Central Hospital, Anting Hospital and Jiangqiao Hospital.

Meanwhile, the district government has mapped out suggestions for investment in public hospitals to add fiscal input on health annually. The fund of public health has risen from 70 yuan per person in 2015 to 85 yuan per person.

Taking advantage of the diagnosis-related groups system (DRGs) platform, Jiading has created its own model for public hospital management. It adopts closed-loop management methods, covering government fund allocation, cost budget, service supervision, information notification and discipline evaluation, with a focus on monitoring the data of medical cost increases, medical resource utilization, medical income structure and medical service efficiency, in a bid to control the unreasonable increase of medical costs.

Furthermore, Jiading is planning for medical partnerships across the district to seek better treatment for patients. Currently, it has established medical partnerships between the Renji Hospital and Jiading Central Hospital, Ruijin Hospital North and Nanxiang Hospital, Eastern Hepatobiliary Surgery Hospital and Anting Hospital. Such alliances will also be formed between Shanghai General Hospital (Jiading branch) and Jiangqiao Hospital.

Works promoting expert help under the medical partnership and unifying drug lists are in full swing. Jiading also strives to set up a hierarchical medical treatment system in which medical institutions at various levels receive patients according to the degree and urgency of the diseases they have so as to optimize the medical treatment efficiency.

The efforts also include deepened cooperation with Shanghai Children's Hospital, forming a paediatrics medical alliance among the children's hospital and community health service centers. The district's second-grade hospitals have built paediatric centers and all 13 community health centers are able to diagnose common childhood diseases. In 2018, community hospitals reported 33,400 visits for paediatric diagnosis, up 11.74 percent compared to the same period last year.

Jiading now has five medical service centers, covering electrocardiogram diagnosis, medical imaging, clinical testing, ultrasonic diagnosis and pathology consultation.

The development of Internet Plus healthcare has not only boosted the sharing of quality health resources in the district, but also enhanced Jiading's medical support in raising the levels of healthcare in poor regions. With the help of such information platforms as remote imaging centers, Jiading has helped the hospitals of Jiuzhi county of Qinghai province and Deqin county of Yunnan province with 3,100 consultations via remote CT scans last year.

In addition, Jiading focuses on the promotion of family doctor practices. By the end of 2018, Jiading had organized 277 family doctor teams covering the whole district.



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