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October 20, 2019

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City to lead in an integrated public health system

The Yangtze River Delta region is currently one of China’s most densely populated and urbanized areas and it continues to see an increasing influx of people from outside of the region making it their home. As the regional population continues to rise, so does the need for an effective cross-regional health-care system. Establishing an integrated health system already forms a key part to China’s ongoing national medical reforms strategy, and as the region’s economic leader that also boasts world-leading medical resources, talent and other expertise, Shanghai is well-positioned to play a critical role in ushering this forward while shaping the future of the surrounding regions.

Challenges facing the city

Shanghai is central to China’s regional health planning and is well poised to introduce an integrated public health service system. The city has already laid a solid foundation through the steady progress and considerable achievements made in its public health work in recent years. However, in order to integrate public health across the region, there are still a few challenges to overcome.

Firstly, the differences and inconsistencies among provincial and municipal health-care systems as well as the overall administrative systems form a barrier that prevents the region to better utilize its resources, information and talent. Secondly, the lack of unified standards poses another obstacle. Moreover, it takes time to establish and implement a set of systematic rules and standards. Finally, the unbalanced development of cities within the region has caused not only differences in economic development but also in medical technology capacity and talent availability. All of these factors hinder the provision and management of an integrated health-care service.

Leverage Shanghai’s strengths to build the region’s integrated public health system

Located at the center of the Yangtze River Delta region, Shanghai’s economic power has long been the driving force behind the region’s industrial integration and population growth. Today, the city is well-positioned to once again become the region’s driving force and serve as the catalyst to establish an integrated regional health-care service system. It can play a pivotal role in toward building its foundation while also helping to shape the region’s health planning.

Shanghai has already established a rich pool of health-care resources, talent and capabilities. For example, the city now has 11 country-leading first-class disciplines as well as 16 country-leading disciplines. Twenty-five institutions within Shanghai have also been awarded 163 National Key Clinical Specialty Construction Projects. All of this has meant that Shanghai is now home to a large number of top-notch medical experts ­— one of the key factors that ensure the health-care system and the services provided would go from strength to strength.

It is also worth noting that Shanghai’s leading health-care system has positively influenced other cities within the region and has created a ripple effect that saw surrounding areas upgrade the services they are able to provide to patients, develop disciplines as well as cultivate local talent pools. In 2017, more than half of the patients received by level-3 hospitals and around 80 percent received by specialized hospitals were from outside of Shanghai. The majority of those non-local patients came from the surrounding Zhejiang and Jiangsu provinces. Through regional medical consortiums and specialized medical discipline coalitions, the city can support local hospitals to develop medical disciplines and up-skill local staff. For example, Shanghai’s Ruijin Hospital has leveraged its health-care resources to influence areas nearby. To date, it has already established the Ruijin Hospital Zhoushan Branch, Ruijin Hospital Wuxi Branch, and Ruijin-Tonglu Medical Consortium.

Recommendations

To address the challenges outlined above and to leverage Shanghai’s existing strength and resources, a number of initiatives could be considered:

1. Bring coherence throughout administrative systems in the city cluster closely following the guidance of the national strategic concept of Yangtze River Delta regional integration

The top-level design from national strategic level will play a substantial role in driving public health integration in the Yangtze River Delta region as it has put forward clear development directions and favorable institutional frameworks for the integrated development of a regional public health system. Meanwhile, it will be important to transform administrative functions, supported by a rule-of-law and service-oriented government, bringing into play different areas’ comparative strengths.

2. Become a service-providing platform and maximize its strengths

Shanghai has more to offer than just being the driving force behind the integrated public health system in the Yangtze River Delta region. This is because “3 (provinces) + 1 (municipality) is more than 4.” By embracing other cities and creating a collaborative model that is built upon mutual interests and benefits, Shanghai can begin exploring the potential benefits of developing a regionally coordinated health-care system through innovations. By fully leveraging the region’s wide hinterland, there is also an opportunity to optimize the allocation of regional health-care resources. This can help form an inter-complementary city cluster that has the potential to becoming China’s or even Asia’s medical center.

3. Focus on key aspects and follow the Big Health concept to promote integrated development

In order to achieve high-quality development for the Yangtze River Delta Region’s health-care services, there needs to be an integrated mechanism. Under the guidance of the Big Health concept, Shanghai can focus its attention on health-care services, public health services and the health industry. For healthcare services, Shanghai should explore an integrated development mechanism with shared processes and standards for diagnosis, treatment and quality control. The city can further establish a joint collaboration model between small and medium-sized cities across the region. For public health services, Shanghai should form a regional public health service system that balances disease prevention and control, health risk warning and health education and promotion. For the development of the health sector, Shanghai can play an important role in integrating health technologies and industrial resources across the region by gathering leading national and international medical disciplines as well as encouraging the high-quality private capital investment into the health-care industry. Last but not least, Shanghai should fully support informatization, accelerate the development of the ”Internet-plus-health care“ model and encourage the exchange and sharing of health-related information.




 

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