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

China's National Health Commission responds to public concerns about primary care, chronic disease prescriptions, and family doctor services. Here's how these policies may affect foreign founders operating in China.

China's Primary Healthcare Reforms: A Guide for Foreign Founders

Foreign founders establishing a business in China must navigate various regulatory environments, including healthcare. Recent public feedback highlighted concerns about primary medical institutions' diagnostic capabilities, chronic disease prescription processes, and the role of family doctors. The National Health Commission (NHC) responded with policy measures that may influence how you and your employees access healthcare. This article summarizes those responses based on official government information.

1. Strengthening Primary Care and Tiered Diagnosis

One netizen shared a personal experience: her father suffered from acute cholecystitis, but the county hospital could not treat him. They had to travel over 700 kilometers to a provincial capital, where a simple surgical drainage solved the problem 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, various regions are implementing the "Several Measures for Accelerating the Construction of the Tiered Diagnosis and Treatment System" issued in April this year. The goal is for common diseases to be resolved at the city and county levels, and routine illnesses at the grassroots level.

Under this framework, within a certain region, hospitals with strong comprehensive capabilities lead the formation of "tight medical consortiums" (紧密型医联体) that unite primary healthcare institutions to share resources and collaborate. Key measures include:

• Higher-level hospitals within tight medical consortiums must open clinics for common and chronic diseases at primary healthcare institutions.
• Expert teams from higher-level hospitals will extend general outpatient services to primary institutions.
• Every township health center and community health service center aims to have long-term dispatched 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 medical guidance at their doorstep.
• Continue mobile medical services to cover all counties with weak resources, and support city public hospitals in pairing with county hospitals and community health service centers.

2. Simplified Prescription Processes for Chronic Diseases

Netizens Zhu and Sun noted that chronic conditions like hypertension, diabetes, and emphysema are common among the elderly, but the prescription process is cumbersome.

The NHC's Department of Primary Health responded that for common diseases at the primary level, the principle of "medication follows the disease" is upheld. For chronic disease patients with clear diagnosis, stable condition control, and need for long-term medication, long-term prescription services are available for single prescriptions not exceeding 12 weeks. Additionally, support is provided to ensure primary healthcare institutions stock medications for hypertension, type 2 diabetes, and chronic obstructive pulmonary disease (COPD), and to guarantee chronic disease patients access to long-term prescriptions and medication registration and delivery services.

3. Enhancing the Role of Family Doctors

A university student in Beijing, Xing, conducted research in other regions and found that many residents still prefer higher-level hospitals for routine care and prescriptions, and that family doctor services suffer from a "signed but not engaged" phenomenon. He suggested deeply integrating contracted services with priority referral measures.

The NHC's Department of Primary Health thanked the netizen for the suggestion. Family doctor contracted services involve family doctors signing service agreements with residents to provide basic medical care, public health services, and agreed health management services. These services include:

• Diagnosis and treatment of common and frequently occurring diseases using both Chinese and Western medicine.
• Medication guidance.
• Long-term prescription services.
• In some places, family doctors make appointments for contracted residents with higher-level hospitals.

Next steps outlined by the NHC include:

• Encouraging more secondary and tertiary hospitals to allocate a certain proportion of expert appointments and inpatient beds to family doctors for providing outpatient, examination, and hospitalization services.
• Further implementing long-term prescription services for chronic diseases and promoting the alignment of primary-level medications with those of secondary and tertiary hospitals to better guarantee patient access to medicines.
• Strengthening proactive contact with contracted residents and providing services such as home hospital beds for those in genuine need.

Implications for Foreign Founders

These reforms aim to improve healthcare accessibility and efficiency, which can benefit foreign founders and their employees. As primary care capabilities strengthen and chronic disease management simplifies, routine medical needs may be met more conveniently at the grassroots level. However, foreign founders should note that specific implementation varies by region and that the healthcare system continues to evolve. It is advisable to stay informed about local policies and maintain adequate health insurance coverage for expatriates and local staff.

For personalized guidance on navigating China's healthcare and business regulations, consider consulting professionals.

Call to Action: Foreign founders can contact ChinaMNC on WhatsApp / WeChat at +86 153 1898 8535 for help registering and operating a company in China.

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