Patient Doctor Conflicts
But even as patients flock to them, giant hospitals have become magnets for controversy.
Patients come expecting to see top doctors, says Li Huijuan, a Beijing-based lawyer who handles medical cases.
But rapidly expanding hospitals have to hire less experienced medics, says Li, creating a gap between patient expectations and reality that “can cause or exacerbate conflicts between doctors and patients.” Rapid expansion can also increase pressure on medical personnel, as increases in bed numbers may outpace growth in staffing levels.
And as the recent MERS outbreak in South Korea showed, large and oversubscribed hospitals can be conduits for infection and disease. About half of the nearly 200 cases in the country were traced to the 1,900-bed Samsung Medical Center in Seoul, where long waits for a bed are common.
“When you have a lot of people packed in a small area, it increases the risk of transmission of infectious pathogens,” says Neil Fishman, associate chief medical officer at the University of Pennsylvania Health System.
An official at Zhengzhou First Affiliated said the large volume of patients was a reflection of demand, and that the hospital did daily inspections to ensure patient safety. The hospital declined requests for an interview. According to its website, it plans to add 3,000 beds at another location.
Low Returns on Investment
The problems that giant hospitals create ripple through China’s healthcare system. Some 60 to 80% of patients in big hospitals could be treated at community medical centres, says Ma Jingdong, associate professor at Huazhong University of Science & Technology in Wuhan.
Big hospitals may have high cost bases and be poorly suited to providing continuous care for chronic diseases. “We may be spending a lot but in reality, we may not seeing the same level of returns in terms of public health,” says Prof Ma.
Chen Xiaoming, president of the First Affiliated Hospital of Wenzhou Medical University, told Reuters that the number of beds at his hospital—currently 3,770 at two locations—may decline in coming years in line with government reforms.
But the public’s faith in big hospitals may be hard to shake. Standing in a swirl of people at the Zhengzhou hospital, a man who would only give his name as Cai said he hadn’t thought twice about rising at 5 a.m. and waiting for several hours so that his wife could see a gynaecologist, perhaps for a minute or less.
