Medical service unity: an effective approach for medical care in rural areas in China

Context: Medical care in China has long suffered from the fact that the medical resources are concentrated in major hospitals in cities. The patients in rural areas thusly do not have affordable access to quality medical services. To tackle such issues, the policy of Tiered Medical Scheme (TMS) was promoted by the Chinese State Council in 2015, which defines hospitals into three tiers and encourages collaborations among different tiers within a region in order to provide better accessibilities to medical care for patients in rural areas.

Issue: The implementation of the TMS policy has not been successful, because the previous funding model, which allocates funding to each hospital according to the number of patients treated, does not facilitate the close collaborations between different hospitals. In this report, the Medical Service Unity (MSU) approach which has been piloted in the Funan County is reported. The MSU organises the tiered hospitals as a unity in terms of medical capabilities and financial abilities. With a radical reform of financial decentralisation, three flows are thereby enabled: the funding flow binds together the hospitals into a real unity; the patient flow spreads the pressures on the providers and eases barriers to access; and the resource flow ensures accessibility and affordability for patients.

Lesson Learned: The MSU approach has been shown by the polite project in Funan to be effective for the realisation of the TMS policy benefiting hospitals, doctors and patients as a win-win-win outcome. The successful experience of the Funan MSU can be introduced to other regions across China and other countries. In particular, future finance reform policies for the health system will largely benefit the health reforms and especially the decentralisation of medical resources to the rural areas.