Letter from China: One day in Shanghai's community health center

SHANGHAI, Aug. 19 (Xinhua) -- Ensuring accessible and high-quality medical services to an extremely large population is a global challenge, and for China, an emerging economy with over 1.4 billion people, the task is particularly complex.

As Monday marks the seventh China's Doctors' Day, also known as Medical Workers' Day, we were lucky to have the opportunity to film a documentary at the Dapuqiao Community Health Service Center in Shanghai's Huangpu District. Spending a day there with the doctors provided us with a profound revelation on the evolution of community healthcare in China.

The country's healthcare landscape is vast, with 980,000 grassroots medical institutions and 4.95 million frontline health workers, all committed to a sprawling network of preventive care and medical treatment. With nearly 20 years of work experience, Jin Ying, director of the Dapuqiao Community Health Service Center, is one of them.

In China, top-tier hospitals primarily undertake the diagnosis and treatment of critical illnesses and complex diseases, secondary hospitals mainly handle general complex diseases and common diseases, and primary health service centers deal with the diagnosis and treatment of common diseases, chronic disease management, and rehabilitation.

Statistics show that most of the country's high-quality medical resources are concentrated in large cities, with most of these resources allocated in a few high-level hospitals. Many patients rush to large hospitals for treatment, even for minor ailments, mainly due to a lack of trust in primary healthcare, as the quality and level of service at primary healthcare institutions are significantly different from those at large hospitals.

In 2019, when Jin Ying began working at the Dapuqiao Community Health Service Center, she initiated a renovation and expansion project, increasing the building area from 4,162 square meters to over 8,300 square meters, and equipping it with a full set of intelligent rehabilitation equipment, including nebulizers, spirometers, CT scanners, etc.

Moreover, the center can also perform common surgical procedures such as the removal of superficial tumors, wound debridement and suture, and burn washing and debridement. In the bigger picture, more than 60 percent of community health service centers in Shanghai can perform minor surgeries.

This year, the Shanghai Municipal Health Commission has facilitated the allocation of upper-level hospital appointment slots to community health service centers, enabling 50 percent of the top-tier hospital appointment slots available for community health service centers. With policy support, Jin has invited nearly 20 experts from top-tier hospitals to visit the center and conduct teaching consultations.

We met Zheng Yongjun, director of the Pain Department at Huadong Hospital, who is a leading figure in pain intervention treatment in China, in a clinic room at the Dapuqiao community health service center. He told us that he comes to the center once a week and his clinic is always fully booked, with most of the patients being middle-aged and elderly people living nearby.

In China, a long-term mechanism for medical staff to serve at the grassroots level is taking shape. This not only allows residents to enjoy a higher level of medical and health services at their doorstep, but also significantly enhances the capabilities of doctors from community health service centers. This is a win-win situation.

Like health workers from other community health service centers, Jin Ying and her colleagues extend their services beyond the hospital walls, regularly visiting residential communities and business complexes to provide health checks and consultations, particularly addressing common issues like neck and shoulder pain and insomnia among white-collars. The collaboration between community health service center and business complex is not just a healthcare initiative but also a key component in improving the business environment.

By the end of 2023, the total registered population in Shanghai was over 15 million, with people aged 60 and above accounting for 37.4 percent of the total, and those aged 65 and above accounting for 28.8 percent. As the city witnesses a pronounced trend of demographic aging, the demand for medical services becomes more diversified.

In the wards of the center, we met a 75-year-old woman who had fallen down at home and an elderly man who had recently undergone lung surgery and was transferred from another hospital. We found that the interactions between the patients and the medical workers were like family members.

In the hot summer, the high temperature has become a major obstacle for community residents, especially the elderly, who need to seek medical treatment and medication. In response to the convenience and welfare service measures for primary healthcare institutions released by the National Health Commission of China for 2023-2025, the Dapuqiao Community Health Service Center launched nighttime medical services last November to meet the off-peak medical needs of different groups.

Around 7 p.m., we saw elderly people coming to the community hospital for medication and young people coming for rehabilitation, where various rehabilitation robots and systems are available. With an average daily outpatient volume of 1,200, and peaks reaching 1,900, the center has become a vital healthcare hub.

For us, experiencing a day at a community health service center reveals the promising potential for the evolution of China's primary healthcare services. Concurrently, the aspiration for community health centers to evolve into dependable and esteemed hospitals, readily accessible to the public, is gaining momentum.