Aug 10, 2020 07:43 PM

Public Hospitals Restructure as Patient Visits Plunge

Visitors sit in the entrance hall of a hospital in Wuhan, Central China's Hubei province, on July 23.
Visitors sit in the entrance hall of a hospital in Wuhan, Central China's Hubei province, on July 23.

Hospitals across China are navigating a plunge in revenue and outpatient volume as people are reluctant to visit the doctor due to fear of Covid-19.

Experts discussed the difficulties faced by hospitals struggling to adjust to the “new normal” at a forum on modern hospital management co-hosted by the National Health Commission (NHC) and Xiangya Hospital of Central South University last week.

Shrinking medical service revenues and increasing costs associated with coronavirus-related prevention have far exceeded insufficient government subsidies, threatening public hospitals’ post-pandemic recovery, said Zhang Weiguo, party secretary of the First Affiliated Hospital of Dalian Medical University.

Most hospitals still have empty beds and employees on furlough despite a brief period where some were overwhelmed by the surge in virus patients. In the first four months of this year, hospital visits across China contracted by 26.8% year-on-year while bed utilization fell 20.9%, according to the National Health Commission (link in Chinese). A Shanghai-based dentist has told Caixin the average monthly merit pay for doctors in their department, which makes up some 80% of their income, was just 606 yuan ($87) in February.

Xu Yong, party secretary of Shenzhen’s Second People’s Hospital urged hospitals to consider the possibility of demand for medical treatment remaining low for a long time. The impacts can be particularly staggering for departments handling mild and chronic cases, such as pediatrics and endocrinology, according to Xu.

But some optimists, such as Chen Yong, deputy party secretary of Beijing’s Chaoyang Hospital, said this is also a “heaven-sent opportunity for health care reform” as it allows hospitals to restructure.

Chen said the hospital he works in kept a third of its workers on duty with the remaining staff available on call at home when patient volumes fell due to the epidemic. To cope with the crisis, the hospital concentrated resources on its strongest revenue-generating disciplines such as critical illness and surgery.

Yang Aiping, director of the NHC Capacity-Building and Continuing Education Center shared Chen’s outlook, saying the pandemic has “forced hospitals to develop” despite the tolls it has taken.

The epidemic has added urgency to health care reform and may bring in more financial support, Yang said. “We used to argue [over the health-care reform], but now the Covid-19 pandemic has made clear what we have to do.”

One avenue for reform that received a boost from pandemic-related restructuring is online health care, which boomed this year as more people sought medical advice online to avoid in-person hospital visits.

Peking University Cancer Hospital, according to its vice president Xing Mo, saw its outpatient volume tumble by more than two-thirds due to Covid-19. But demand from cancer patients remained high, and the hospital now serves about 350 patients per day after starting to offer online consultations in June.

But Wang Rong, vice president of the First Affiliated Hospital of Shandong First Medical University, worried about challenges to further developing online medical care, in terms of hospitals’ human resources and limited policy support.

Cui Yong, vice president of the Beijing-based China-Japan Friendship Hospital, also pointed out (link in Chinese) in July that there is a lot of duplication of work and wasted funds as hospitals rush to roll out online services, and said not every hospital needs to spend energy and money on building an online counterpart.

Cui suggested the government provide more complete support for internet hospitals and build a national-wide online platform in a bid to facilitate online services and save resources.

Contact editor Gavin Cross (

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