Published by ChinaMNC · Luqu

China's Primary Care Reforms: What Foreign Founders Need to Know

China's National Health Commission addresses public concerns about local healthcare, including chronic disease prescriptions and family doctor services. Here's what foreign founders operating in China should understand about the evolving primary care system.

China's Primary Care Reforms: What Foreign Founders Need to Know

Foreign founders operating in China often need to understand the local healthcare system—both for their own families and for their employees. A recent Q&A from China's National Health Commission (NHC) sheds light on current challenges and reforms in primary care. The NHC responded to citizens' concerns about seeing doctors and getting prescriptions at local clinics, covering treatment quality, chronic disease medication processes, and the role of family doctors. Below is a summary of the key points, framed for foreign entrepreneurs.

Strengthening Local Medical Capabilities

One citizen described how her father, suffering from acute cholecystitis, could not be treated at the county hospital and was transferred over 700 kilometers to a provincial capital, where a simple surgical procedure resolved the issue without hospitalization. She urged improvements in county-level hospital capabilities to reduce misdiagnosis and missed diagnoses.

The NHC's Department of Medical Administration acknowledged that such cases reflect insufficient service capacity in some local primary healthcare institutions. In response, localities are implementing the "Several Measures for Accelerating the Construction of a Tiered Diagnosis and Treatment System," issued in April of this year. The goal is for common diseases to be resolved at the city and county levels and routine illnesses at the grassroots level.

To achieve this, the NHC is promoting "tightly-knit medical consortiums" led by stronger hospitals in collaboration with primary care institutions. These consortiums are expected to:

• Establish outpatient clinics for common and chronic diseases at primary care facilities.
• Extend expert teams from higher-level hospitals to provide general outpatient services at grassroots institutions.
• Ensure that every township health center and community health service center has long-term support from mid- to senior-level personnel from higher-level hospitals.
• Promote "general practice + specialty" joint clinics so residents can access both general practitioner health management and specialist guidance at their doorstep.
• Expand mobile medical services to all counties with weak resources and continue pairing urban public hospitals with county hospitals and community health centers.

For foreign founders, these reforms signal a gradual improvement in local healthcare access, which can benefit employees and their families. However, the pace of implementation may vary by region.

Simplifying Chronic Disease Prescriptions

Citizens also raised concerns about cumbersome prescription processes for common chronic conditions among the elderly, such as hypertension, diabetes, and emphysema.

The NHC's Department of Primary Health responded that for common diseases at the grassroots level, the principle is "medication follows the disease." For patients with clear diagnoses, stable conditions, and long-term medication needs, long-term prescription services of up to 12 weeks per fill are available. Additionally, efforts are underway to ensure that primary care institutions are stocked with medications for hypertension, type 2 diabetes, and chronic obstructive pulmonary disease (COPD), and to provide long-term prescription services and medication registration and delivery for chronic disease patients.

Foreign founders should note that if they or their employees require regular medication for chronic conditions, accessing long-term prescriptions at local clinics may become more convenient. However, availability may still depend on the specific institution and region.

Enhancing the Role of Family Doctors

A student from a Beijing university shared findings from field research indicating that many residents still prefer higher-level hospitals for routine care and prescriptions, and that family doctor services often suffer from a "signed but not utilized" phenomenon. The student suggested deeper integration of contracted services with priority referral measures.

The NHC explained that family doctor contracted services involve a signed agreement between a family doctor and a resident to provide basic medical care, public health services, and agreed health management. Services include diagnosis and treatment of common and frequent diseases using both Chinese and Western medicine, medication guidance, and long-term prescription services. In some areas, family doctors also make appointments for contracted residents to see specialists at higher-level hospitals.

Moving forward, the NHC plans to:

• Encourage more secondary and tertiary hospitals to allocate a certain proportion of specialist appointments and inpatient beds to family doctors for their patients' use.
• Further implement long-term prescriptions for chronic diseases and align grassroots medication availability with that of secondary and tertiary hospitals.
• Strengthen proactive contact with contracted residents and provide services such as home hospital beds for those in genuine need.

For foreign founders, these developments suggest that the family doctor system is being refined to improve care coordination. However, as the student's research indicates, uptake may still be limited, and expatriates may need to navigate the system carefully.

Practical Implications for Foreign Founders

Understanding China's healthcare reforms can help foreign founders make informed decisions about employee benefits and personal healthcare. While the NHC's responses highlight ongoing efforts to improve primary care, the actual experience may vary. Foreign founders should consider:

• Encouraging employees to register with local primary care institutions and family doctors where available.
• Staying informed about long-term prescription policies for chronic conditions, which can reduce administrative burdens.
• Factoring in regional disparities when selecting office locations or designing health benefit packages.

These reforms are part of a broader effort to create a more efficient healthcare system, but they are still being rolled out. Foreign founders should consult local authorities or healthcare providers for the most current information.

This summary is based on information published by the relevant Chinese government website and is general information, not legal or tax advice.

For assistance with registering and operating a company in China, foreign founders can contact ChinaMNC on WhatsApp / WeChat at +86 153 1898 8535.