China's Primary Healthcare Gatekeeper Model: Comparing China and Germany in a Multi-level Analytical Framework

Although the life expectancy of the Chinese population has almost doubled since the 1960s, and has approached that of industrialized countries, the access to medical resources and services in China’s primary healthcare is still not efficiently, equally and fairly distributed. Despite many different policy measures during the last decades, Chinese citizens still prefer to go to a hospital in hope of receiving a better treatment in comparison to consulting a general practitioner (GP) in their proximity. This leads to a number of consequential problems. Not only are hospitals oftentimes overloaded, and congested with mild-case patients, but the profession of a GP working in a grassroot community health center finds itself in a negative spiral of path dependency. They have a poorer reputation at the level of primary medicine, and are subsequently less demanded, although could ensure a faster and more efficient treatment process in many cases. Systemic reforms are needed, that also include "soft" approaches to create more trust between GPs and patients, to tackle a variety of challenges in the long term.

In many European countries, the primary care with GPs at the core, represent the fundament of healthcare systems, and create a hierarchical treatment process in which family doctors function as the first port of call for any non-emergency medical issue. In the process of multiple workshops between Chinese and German stakeholders, different fields of action have been identified and thoroughly discussed. The policy paper by the author, Prof. Dr. Liu Tao, includes the textualization of those results, and provides recommendations for a sustainable development of the primary health care sector in China.

The publication is available for download in English and Chinese.