With the formation of the national network of national regional medical centers in 2022, the problems of expanding high-quality medical resources and regional balance have been basically solved initially.
The question is, how should these regional medical centers be positioned, how should they fulfill their mission, and how can they better play their role? This has undoubtedly attracted widespread attention from both inside and outside the industry.
The roadmap for the construction of national regional medical centers is basically clear.On July 28, the National Development and Reform Commission, the National Health Commission, and the State Administration of Traditional Chinese Medicine jointly issued the "Notice on the List of Output Hospitals for the Construction of Newly Added National Regional Medical Centers," outlining the top-level design ideas for accelerating the expansion of high-quality medical resources and regional balanced layout, and basically clarifying the roadmap and timeline for the construction of national regional medical centers in various batches.In October 2019, with the approval of the State Council,the National Development and Reform Commission and the National Health Commissionand four other departments jointly issuedthe "Pilot Program for the Construction of Regional Medical Centers"(hereinafter referred to as the "Work Program"), marking the official launch of the construction of national regional medical centers.In addition, the State Council clarified thatthe pilot program will continue to expand next yearto cover all provinces, complete the national planning and layout, and strive to basically complete the construction task of national regional medical centers by the end of the "14th Five-Year Plan".
Three Speculations on National Regional Medical Centers
After more than a year of operation, the pilot program for the construction of national regional medical centers has made positive progress and achieved phased results. Based on the experience of more than a year of construction, the following three speculations on regional medical centers are proposed.Speculation 1: The construction of national regional medical centers may trigger a new wave of new infrastructure constructionSince the Central Economic Work Conference in 2018 proposed "new infrastructure construction" (hereinafter referred to as "new infrastructure"), all walks of life have been accelerating the process of digitalization and intelligence, and new infrastructure has become a new engine driving民生发展. The "Healthy China 2030" Planning Outline has clearly identified the development of the health industry as one of the five major tasks of the "Healthy China" construction, and proposed the strategic goal of developing the health industry as a pillar industry of the national economy.Currently, the national level strongly supports the construction of regional medical centers. As an important part of new infrastructure, in addition to basic infrastructure, will national regional medical centers generate a large demand for hospital instruments and equipment and high-value consumables?It is clear that during the 2020 COVID-19 epidemic, Huoshenshan Hospital in Wuhan Caidian District and Leishenshan Hospital in Jiangxia District were completed and put into use in just ten days. While demonstrating "China speed," they also became successful examples of China's new infrastructure.It is reported that during the construction of Huoshenshan Hospital and Leishenshan Hospital, more than 2,500 large-scale equipment and transportation vehicles, more than 4,900 containerized board houses, 200,000 square meters of anti-seepage membranes, and a large number of cables, wires, switchboards, and sanitary ware were used. 1608 suppliers and 952 subcontractors from all over the country actively participated in the hospital construction, providing strong support for the overall acceleration of hospital construction.Therefore, the construction of national regional medical centers may trigger a new wave of new infrastructure!Speculation 2: Output hospitals and pilot hospitals face the challenge of "homogeneous management"With the continuous expansion of China's public hospitals, many hospitals, especially tertiary hospitals, have developed a "one hospital, multiple districts" model. The "one hospital, multiple districts" operation model is inseparable from homogeneous management. As the first unit to unveil its signboard among the first 10 pilot regional medical centers nationwide, the Zhongshan Hospital Affiliated to Fudan University in Xiamen has explored a unique model for homogeneous management.Wang Hesheng, Vice Minister of the National Health Commission and Director of the Chinese Center for Disease Control and Prevention, pointed out during his investigation of the Zhongshan Hospital Affiliated to Fudan University in Xiamen thatthe construction of national regional medical centers is not just about the output of medical resources or simple "replication," but also about giving full play to the advantages of newly built hospitals,implementing advanced infrastructure and management models that could not be implemented in a timely manner due to objective factors such as systems and land use in output hospitals.It is introduced that Zhongshan Hospital Affiliated to Fudan University innovated a "homogeneous" management model, comprehensively outputting talents, technology, and management to Zhongshan Hospital Affiliated to Fudan University in Xiamen, forming a unique "Fudan Zhongshan Xiamen" model for the construction of regional medical centers.In terms of "homogeneous talent," more than 120 senior experts and backbone staff from the Shanghai headquarters of Zhongshan Hospital Affiliated to Fudan University have been stationed in Xiamen Hospital; directors of various disciplines and experts from famous doctor studios will also take turns to Xiamen for consultations, surgeries, teaching, and ward rounds every week; and senior attending physicians will form medical teams to participate in discipline construction in batches.At the same time, the two hospitals also implement the "dual director" system for clinical work and "vertical management" for administration, i.e., the directors of various departments of the Shanghai headquarters concurrently serve as the directors of clinical and medical technology departments of Xiamen Hospital, and the heads of functional departments of the headquarters are the first responsible persons of the corresponding functional departments of Xiamen Hospital. Whether it is medical level, diagnosis and treatment standards, or work procedures, emergency plans, etc., the core management of the hospital ensures the "Fudan Zhongshan standard".Today, the advanced and mature multidisciplinary diagnosis and treatment (MDT) model of the Shanghai headquarters has been transferred to the Zhongshan Hospital Affiliated to Fudan University in Xiamen, providing patients with individualized, multidisciplinary, and comprehensive "one-stop" precise diagnosis and treatment. Using "homogeneous" management as a lever, the high-level diagnosis and treatment technology and management capabilities of the output hospital will be synchronized to the provinces and regions with a shortage of high-quality medical resources, truly realizing the balanced layout of high-quality resources strongly advocated by the country.Speculation 3: The pilot program for the construction of national regional medical centers calls for "new policies"The construction goal of national regional medical centers this year is to further improve and orderly expand the work plan for the construction of national regional medical centers, guide 12 newly added provinces and the Xinjiang Production and Construction Corps to speed up the preliminary work, and ensure that at least one project is started in each region this year.With the formation of the national network of national regional medical centers in 2022, the problems of expanding high-quality medical resources and regional balance have been basically solved initially. The question is, how should these regional medical centers be positioned, how should they fulfill their mission, and how can they better play their role? This has undoubtedly attracted widespread attention from both inside and outside the industry.Looking to the future, the construction of regional medical centers is never simply about hardware. Under the strong promotion of the national level, whether relevant policy documents will be issued to encourage the implementation of regional medical centers with substantial preferential policies and supporting measures, and to ensure their sustainable and healthy development, this point carries too many expectations.
Ten-Year Journey:
Changes and Invariants in the Construction of National Regional Medical Centers
As early as 2009, the former Ministry of Health issued the "Principles for the Establishment of Regional Medical Centers (Trial) (Draft for Comments)", proposing that national medical centers be established in seven regions, with 1-3 national medical centers in each region, and 1-3 national specialized medical centers for relevant specialties. This also marked the inclusion of regional medical centers on the agenda in the context of the launch of a new round of medical and health reforms.In January 2017, the former National Health and Family Planning Commission issued the "Notice on the Planning for the Establishment of National Medical Centers and National Regional Medical Centers during the 13th Five-Year Plan Period", requiring the selection of comprehensive hospitals with leading levels in medical treatment, teaching, research, prevention, and management in each province to establish and construct one national regional medical center of a comprehensive category. Based on the coverage area and population distribution, leading hospitals in six regions (North China, Northeast China, East China, Central South China, Southwest China, and Northwest China) were selected, and national regional medical centers were established according to specialties such as pediatrics, oncology, cardiovascular, obstetrics and gynecology, infectious diseases, stomatology, and psychiatry.Years later, the construction of national regional medical centers finally started in 2019; however, the roadmap and layout plan are vastly different from the past.Pilot areas were initially selected in eight provinces with a shortage of high-quality medical resources. Later this year, 12 provinces were included in the construction scope of national regional medical centers, basically covering provinces with large patient outflow and those with relatively weak medical resources. By next year, all provinces will be covered to complete the national planning layout.This is inconsistent with the 2009 principle of "setting up according to seven regions"; it has actually changed to a principle of "allocation based on demand", prioritizing provinces with a shortage of high-quality medical resources and then gradually expanding to the whole country.From the issuance of the "Principles for the Establishment of Regional Medical Centers" by the former Ministry of Health in 2009 to the formal launch of the construction of national regional medical centers in 2019, the construction of national regional medical centers has not been smooth sailing over the 10 years, and the reasons are unknown.However, restarting the construction of regional medical centers with renewed efforts is undoubtedly an important measure to implement the "14th Five-Year Plan" and the Outline of the Vision for 2035.Based on the new stage of development, adhering to the new development concepts, and building a new development pattern, the mission of regional medical centers to expand high-quality medical resources and achieve balanced regional distribution has never changed.
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