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Health Series: Expert Comment

Understanding China’s Healthcare System

Dr Yaru Chen, Centre for Healthcare Innovation Research (CHIR), recently spoke to the BBC World Services’ World Update programme about the current state of China’s healthcare system in light of its  coronavirus outbreak.

by Shamim Quadir (Senior Communications Officer)

Dr Yaru Chen is a Research Fellow at the Centre for Healthcare Innovation Research (CHIR) a joint initiative of the School of Health Sciences and Cass Business School at City, University of London. She is currently working on a project investigating the use of primary, secondary and tertiary care in China, and her work has focused on the City of Wuhan, in Hubei province.

On Friday 7th February, Dr Chen spoke to the BBC World Service’s World Update programme to comment on the current state of the healthcare system in China within the context of the current coronavirus (2019-nCov) outbreak centred on Wuhan.

She was first asked about how people in China access hospitals, and whether they have local care and general practitioners. Dr Chen responded:

In China, the healthcare system is a bit different to what we have in the UK, so when you get ill in the UK, you probably go to the GP practice as the first point of contact.  Whereas in China people are in the mindset of going to tertiary care straight away rather than going to the primary care.


“However the government is trying to change this mindset, or this trend, by investing more in primary care over the past ten years, since the 2009 Healthcare Reform, but public hospitals are overstretched. Although they are investing heavily, so moving more towards an NHS system, but still on the way.”

Dr Chen was also queried on the phenomena of hospitals (in Wuhan) being built within ten days, and on images of those facilities making them look like ‘military barracks’, and seeming to provide ‘not really very gentle care’. Dr Chen responded:

‘Well, yes, but under the current situation that is a necessity because of so many diagnoses, and this is a more efficient way of treating and controlling this virus.’

She was lastly asked whether there is money in China’s healthcare system, and given the historical example of the disparity between the policy of Communist governments in Eastern Europe of providing universal healthcare systems when, in actuality, bribery was commonplace to receive certain standards of care from doctors. Dr Chen replied:

“Well, in China, as a nation since the 2009 reform, public hospitals have been publicly funded, and the insurance covers quite a lot actually, around 80%, but still 20% of costs are coming out of pocket from patients.

“Whereas for this current virus, everything is free, so the system asks you pay 20% for the costs, but now currently you don’t because of this ongoing virus."

About the academic

Dr Yaru Chen is a Research Fellow at the Centre for Healthcare Innovation Research (CHIR) a joint initiative of the School of Health Sciences and Cass Business School at City, University of London.

Dr Chen’s research lies in the field of public management and organisation studies in healthcare. Her research is informed by a number of theoretical perspectives, including professional identity, role identity, sensemaking, sensegiving, and job crafting. Dr Chen’s recent work has focused on applying these theoretical lenses to explore the adoption and diffusion of technological innovation in healthcare organisations. 

Read her full profile at the Cass website.

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