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Healthy China 2030: Trends in rehabilitation

China reps at CARF

Dr. Jianan Li, center right, and a group of delegates from China visit CARF in Tucson, Arizona.

by Jing Walker, International Advisor, CARF Europe

The Chinese government issued Healthy China 2030 (HC 2030) in October 2016 as a strategic guideline and action plan to improve the overall health of China’s residents. Thirteen core indicators used to measure outcomes will be reported in 2020 and 2030, delineating the vision of a healthier China from various perspectives.

HC 2030 has put China's relatively young but fast-growing rehabilitation and aging services industries back in the spotlight.

Dr. Jianan Li is an international associate of the National Academy of Medicine in the U.S. and a former president of the International Society of Physical and Rehabilitation Medicine. He also is chair of the Rehabilitation Medicine Centre at Jiangsu Province Hospital in Nanjing. The center achieved its three-year CARF accreditation in 2015 and is preparing for its next survey.  

Dr. Li shared with CARF his insights on HC 2030, major trends in Chinese health and human services, and the role of CARF accreditation in advancing quality healthcare in China.

Major trends in China’s rehabilitation and aging services

Creation of rehab hospitals
The past decade has seen accelerated growth of the rehabilitation industry in China. Major cities and provinces such as Beijing, Shanghai, Tianjin, and Jiangsu have actively transformed their surplus Level II hospitals into rehabilitation facilities.

All Level III hospitals have been urged to include rehabilitation departments. Governmental support is a main facilitating factor. A regulation launched January 1 in Shanghai significantly increased the number of rehabilitation services reimbursable by national health insurance.

The “early diagnosis, early intervention, and early rehabilitation” concept promoted by HC 2030 and other policy initiatives has prompted a large-scale interdisciplinary collaboration among rehab and medical professionals. By advocating functional outcomes and fewer unnecessary medical treatments, these emerging programs aim to increase effectiveness while decreasing hospitalization time.

Integration of med rehab and aging services
Dr. Li describes one of the major trends as “a gradual integration of medical rehabilitation and aging services.” Rehabilitation hospitals, nursing homes, and skilled nursing facilities are encouraged to collaborate more intensively to provide health management and medical consultancy to residents.

For aging services, a home-based model supplemented by institutional care will no doubt be predominant. In Confucian philosophy, the younger generation is expected to fulfill its duty of filial piety by caring for aging parents.

Given cultural considerations, it is not surprising that the majority of aging Chinese people prefer to live in their private residences. However, demographic shifts have called for social support and institutional care to ease the burden on Chinese families. “Aging programs and services provided by the public or private sector will be strongly encouraged, supported by further development of standards around the elderly with disabilities, regulations on their care, and insurance policies,” Dr. Li says. “High technology also enables new business models to operate and manage rehab and aging services.”

HC 2030 – What does it mean to rehabilitation services in China?

Focus on value-based care
HC 2030 clearly indicates a shift from treating diseases to promoting health and well-being. It requires the government to continue refining the healthcare delivery system to optimize service quality and to make it accessible to everyone.

Vulnerable populations
China also has made it a priority to strengthen healthcare services for vulnerable groups. HC 2030 will increase the scale of financial aid for low-income populations needing rehabilitation. Healthcare resources will be further decentralized.

The initiative calls for quality-driven, convenient healthcare services to be provided in the community. Gaps in the continuum of care will continue to be identified, and the needed services are to be delivered in an innovative and coordinated way.

Enhancing health literacy and healthy lifestyles also are strategic targets. Continuous education is emphasized to raise public awareness and to remove barriers.

Reduction in early mortality due to major chronic diseases
A core indicator of HC 2030 is premature mortality due to major chronic diseases, and the target is a 30-percent decrease from the 2015 rate.

“Chronic conditions can result from various uncured illnesses,” Dr. Li explains. “Morbidity and disability attributed to chronic diseases have become the major culprits accounting for draining healthcare resources. It is important to use rehabilitation approaches to tackle the impairments caused by chronic diseases. Through the rehabilitative pathway of improvement, compensation, and substitution, most people suffering with chronic conditions will obtain higher functioning, enjoy improved quality of life, and return to the community. In the battle against chronic diseases, rehabilitation therapy also is cost-effective. International multi-center studies have proven that rehab can effectively reduce medication consumption.”

“The blueprint of Healthy China 2030 means more governmental attention to the rehabilitation and aging industry,” Dr. Li summarizes. “Trends in the national health insurance policy, the price of commodities, and the healthcare management framework all support the development of medical rehabilitation. Rehabilitation will play a more important role in the healthcare system.”

CARF: How can we help?

The healthcare reform campaign emphasizes outcomes measurement, which the CARF standards support, Dr. Li explains. “The emphasis is now on the functioning of persons served, in accordance with ICF framework. The concept of dynamic functioning has replaced the traditional idea of static function.”

In China’s push toward quality-driven rehab services, CARF-accredited organizations are naturally looked upon as quality pioneers, Dr. Li says. CARF accreditation facilitates quality programming, functional outcomes, and person-centered care, concepts echoed in HC 2030.

6/19/2018
(Medical Rehabilitation)


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