Published: 30 August 2014
We are thankful to The Lancet for covering hospital violence in China.1 According to a survey by the Chinese Hospital Association between December, 2012, and July, 2013,2 violence against medical staff has increased from 20·6 assaults per hospital in 2008, to 27·3 in 2012, based on data from 316 hospitals in more than 30 provinces. 96% of medical staff have been abused or injured in 2012, and 39·8% of staff planned to give up the medical profession or switch to another profession.2
What is the reason for this surge in hospital violence in China? First, there is a serious shortage of investment in health. China’s population accounts for 22% of the world’s total population, whereas China’s total health expenditure accounted for only about 2% of the world’s total expenditure. In 2008, the total health expenditure was only 4·3% of GDP, health expenditure was 10·3% of government expenditure, and health expenditure was US$146 per head in China, whereas in the USA these were respectively 15·2%, 18·7%, and $7164. The number of physicians per 1000 citizens is 1·4 in China, whereas it is 2·7 in the USA.3 Second, medical costs increased rapidly. The total health expenditure rose from ¥361·9 to ¥1490·1 per head and out-of-pocket health expenditure nearly tripled from 2000 to 2010.3 Third, there is an imbalance between high workload and low income for doctors. About 80% of doctors describe themselves as overworked and underpaid. For example, in my hospital, from 2001 to 2012, the number of admissions increased from 1·423 million to 3·504 million, an annual average rate increase of 7·8%. The number of inpatients increased from 22 406 in 2001 to 70 424 in 2012. The number of surgeries tripled during the same period of time. However, the number of doctors increased from 438 to 720 during the 12 years, an annual average increase of only 4·23%; therefore, the workload greatly increased from 12·94 to 19·39 patients per doctor per day, a 49·79% increase. Even in cities, many doctors earn as little as ¥5000 ($780) a month or less. The imbalance can lead to medical errors, corruption, and poor communication between health professionals and patients.
I hope that hospitals in China will become safe by increasing governmental investment, vigorously promoting primary prevention of chronic diseases, spreading public health literacy, and improving the status of doctors.
Courtesy: The Lancet
Linnk – http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61438-0/fulltext?rss%3Dyes