THE ROLE OF PATIENT VALUE AND PATIENT-CENTRED
CARE IN HEALTH SYSTEMS78 国家卫计委等三部门亮“组合拳”防控伤医
医闹行为 The National Health and Family
Planning Commission and three other
departments work together to prevent and
control violence against doctors], China
Central Television News, July 13th 2017; 官
方严惩涉医犯罪： 行为异常患者由保卫
人员陪诊 [Officials severely punish drug-
related crimes: patients with abnormal
behavior are accompanied by security
personnel], People’s Daily, July 12th 2017.
79 ““进一步改善医疗服务行动计划（2018-
2020年” [Further Improvement of Medical
Services Action Plan (2018-2020)], 2018.
80 Huixuan Zhou et al, “The development
of indicator measure for monitoring the
quality of patient-centered care in China’s
tertiary hospitals,” PLoS One, 2018.environment where doctors can treat us with respect and have more time for us. That is probably
one of the biggest causes of dissatisfaction. The respect that they can give to the patients, the dignity
patients should receive, that is what we should do better to develop.” Ultimately, he adds, this will
require a greater shift in demand toward strengthened primary care.
Chinese policymakers are certainly aware of the tension between patients and clinicians. In fact, a
joint policy statement in July 2017 from China’s National Health Commission and the Ministry of Public
Security included, among ten steps to deal with medical violence, beefed up hospital security and
harsher penalties for attacks, but also for institutions to make services more patient-centred.^78 More
generally, the National Health Commission’s latest action plan under the 2015 Healthcare Improvement
Initiative calls for numerous initiatives to create much more integrated, continuous care in hospitals. It
also includes goals of making it easier for patients to obtain treatment and for their experience to be
improved. Listed policies for the latter include hiring medical social workers to improve communication
between doctors and patients and bettering the care environment, including by providing waiting
patients with reading, catering and other emotional comfort services in public areas.^79
Nevertheless, patient input into how things should change is still missing. Indeed, a National Health
Commission team developed a set of 56 indicators to measure the quality of patient-centred care in the
country ’s leading tertiary hospitals. Although all these metrics encourage the institutions to take steps
that are likely to improve patient experience, none look at patient input into hospital policymaking.^80
Mr Liu expects that this is unlikely to change soon. “I don’t think China has the conditions that would
allow social groups, including patient groups, to play an effective role to influence national policy and
I don’t think that is something the government would encourage at the moment.” That said, he could
foresee situations where policymakers considering specific questions, such as research priorities,
might integrate patient representatives into their discussions. “I hope patient voices can be heard in
more formal channels in future, but I can’t say how long it would take.”
Without a greater patient role, however, the results of Chinese efforts to implement patient-centred,
integrated care will show the extent and limits of what can be done without actively partnering with
patients.