World Hospitals and Health Services - International Hospital ...

POLICY: CHINESE HEALTHCARE TRENDS
The dual burdens of developing countries have fallen
hard on the population giant China: the fastest rate of
population ageing in the world accompanied by a
dramatic yet inequitable rise of standards of living has led
one-fifth of the world’s total population towards a
diversifying portfolio of chronic diseases. The needs of this
population, marked with the rise of a young urban middle
class, are currently unmet by the Chinese public hospital
system through the lack of access to care and dissatisfaction
with service.
Growing middle class
China’s economic transition from a command to market
economy in the past quarter of a century has led to
significant improvements in living standards 1 . Today, the
average annual disposable income 2 of China’s urban
households is 31,500 RMB (US$4,500) with the upper
middle class around 41,600 RMB (US$6,000) 3 . Adjusted for
purchasing-power parity, the urbanaffluent
of China’s population,
mostly concentrated in the “first
China” cities of Beijing, Shanghai
and Guangzhou, has a spending
power nearing global affluence.
These steady increases have fueled
consumer spending, increased
savings, and are projected to
continue throughout the rest of the
21st century.
However, the true size and
spending power lies within the
emerging young, massive urban
middle class. Making up more than
half of the urban population, this middle class is young
(compared to that of most developed markets), well
educated (majority college graduates) and is projected by the
Figure 1: Lifestyle of average Chinese urban household
1.
Blumenthal, D., Hsiao, W. “Privatization and its
discontents: the evolving Chinese health care system.”
N Engl J Med. 2005 Sep 15;353(11):1165-70.
2.
Disposable income = after-tax income.
3.
National Bureau of Statistics of China. 2007. China
Statistical Yearbook 2007. Beijing: China Statistics
Press; 2007 Sept.
Figure 2: Factors influencing hospital of choice (multiple choices, %)
Disposable
Income
Total
Exp end iture
Food Clothing Medical
Transport ation/
Commu nicat ion
Utilities
Beijing
Average 2,854 2,118 30.8% 9.7% 8.9% 14.6 % 8.2%
Middle
High 20% 3,299 2,350 30.2% 10.2% 8.3 % 14.7 % 8.6%
Top20% 5,231 3,3 60 24. 6% 10.2% 7.4% 19.4 % 9.1%
Shanghai
Chengdu
Average 2,953 2,109 35.6% 7.0% 5.2% 15.8% 9.7%
Middle
High 20% 3,285 2,259 36.1% 7.3 % 5.6% 13.9 % 10.0%
Top20% 6,126 3,761 27.7% 7.7% 5.1% 22.6% 9.3%
Average 50 8 1,37 8 35.3% 8.4 % 6.2% 19.4 % 9.7%
Middle
High 20% 1,868 1,652 31.1% 9.0% 6.2% 17.1% 11.6%
Top20% 2,613 2,613 26.3% 8.7% 6.4% 27.8% 7.4%
Sources: Beijing Municipal Bureau of Statistics. 2007. Beijing Statistical Yearbook 2007. Beijing: China Statistics Press; 2007 June.
Shanghai Municipal Statistics Bureau. 2007. Shanghai Statistical Yearbook 2007. Shanghai: NBS Survey Office; 2007 July.
Chengdu Statistic Bureau. 2006. 2006 Statistical Yearbook of Chengdu. Beijing: China Statistics Press; 2007 July
Table 1: Annual per capita basic condition of urban household (2006)
12 | World Hospitals and Health Services | Vol. 44 No. 4