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ABSTRACT: China's public health system has gone through a number of development stages. This paper aims at showing how, from its inception as a hierarchical system, the healthcare system then lost its structure, to finally give birth to a focalised system where the first point of entry in the treatment process has become the hospital, in particular the healthcare establishments that offer the most reliable standards of care. These days, the widely-acknowledged inefficiencies of the healthcare system have led to a climate of violence between medical staffand their patients, caused by the overwhelming demand that hospitals must bear, the ambiguous status of public establishments, financial benefits and other perks for medical staff, as well as the medical staff's civil servant status, and the implications thereof. Policies to foster the development of primary health centres are struggling to gain traction, while digital healthcare offers promising solutions and is developing fast.
KEYWORDS: healthcare system, hospital, inefficiency, violence, digital healthcare.
Introduction
Today, China's public hospitals manage 90% of consultations for what English-speakers would call ambulatory care or outpatient care, and 90% of hospital inpatient admissions. (1) As such, public hospitals deal with demands for treatment by consultation just as they must deal with treatment for inpatients.
China is in the midst of a paradox. There has been a spectacular upward surge in health indicators, matching the similar increase in economic indicators. It is also a colossal market, with healthcare expenditures reaching $511.3 billion in 2013. (2) That is equivalent to 5.6% of GDP. (3)On the other hand, the health system has officially been described as inefficient, and there is a toxic atmosphere between medical staffand patients.
Before we examine the healthcare system in all its various permutations, we will first offer a brief overview of the current state of China's health and healthcare. In 2015, mainland China had a natural population growth of 5.21 per thousand, with a crude birth rate of 12.37[per thousand] and a crude death rate of 7.16[per thousand]. Urban residents now account for 54.8% of the total population (or 1.4 billion people). The population is 51.2% male and 48.8% female. (4) Life expectancy has improved considerably over the years: while in 1990 it was 67 years for men and 70 for women, by...