Grassroots clinics improve access to medical treatment

Zhang Changrong's favorite treatment in a community clinic in Beijing's southern suburb involves soaking her feet in hot water that contains traditional Chinese herbal medicines.

It takes the 59-year-old woman, who has had a rapid heart beat for years, just five minutes to walk from her home to the clinic for the treatment, which is believed to help improve blood circulation.

Compared to big, crowded hospitals, "seeking service here is much easier and sometimes enjoyable," said Zhang, a long-time resident of the Guiyuan Residential Community in Daxing District.

"We don't need to queue up for hours to see doctors. Doctors here know us well and the communication process is nice," she said.

The clinic, which covers some 250 square meters, offers basic medical services such as injections, medical examinations, massage and acupuncture. Patients can get prescriptions for about 300 of the most frequently used medicines for less than what a big hospital would charge.

In China, strain on the doctor-patient relationship has continued to worsen, as many patients are dissatisfied with their poor access to treatment.

People have to wait overnight in long queues for a registration ticket to see a renowned doctor in some popular public hospitals. However, the diagnostic process is always too brief to allow for further consultation.

China's urban doctor-patient ratio was 2.8 doctors per 1,000 people in 2011, according to statistics released by the Ministry of Health.

Meanwhile, doctors are overworked and underpaid. Many work more than 10 hours a day and might examine more than 100 patients per shift, according to a study by Peking University.

Experts say 80 percent of outpatients in the country's big hospitals don't need to have their first diagnosis in big hospitals.

Fang Laiying, head of the Beijing Health Bureau, said people should seek medical treatment from lower-level hospitals and community clinics before swarming into larger hospitals.

"Expanding grassroots medical service institutions is the key to tackling the chronic imbalance in supply and demand," said Liu Jun, professor at the Central University of Finance and Economics.

The grassroots healthcare system began to take shape after the People's Republic of China was founded in 1949. However, following China's transformation from planned economy to market economy, medical resources gradually poured into public hospitals, which saw an excessive number of patients but left lower-level hospitals with insufficient business, according to Liu.

Huang Jiefu, vice minister of health, said the uneven distribution of medical investment, resources and talent causes patients to crowd into larger hospitals.

The Chinese government initiated the reform of medical and healthcare systems in the 1980s. The reform was sped up in 2003 after the country won the fight against SARS, and in March 2009, a new round of reform was launched.

Statistics from the Beijing Health Bureau show that by the end of 2011, there were 9,699 grassroots medical institutions in the city of 12.77 million permanent residents, including 1,744 community-based clinics.

Daxing District has developed a three-tier medical service system comprising a number of prominent public hospitals, 19 community-based medical service centers and 129 subordinate clinics, according to Li Jianguo, vice director of Daxing's community healthcare office, which is affiliated with the health bureau of Daxing District.