Source: New York Times
China does not have a distributed primary and community-based network of healthcare. The picture here may make you think Chinese are waiting in line for football game tickets. In reality, it is the line to get care at the Shandong Qilu Hospital. During the recent Chinese holiday, 985 people registered for hospitalization in one day, setting a record high of that province. On Feb 27, Beijing Cancer Hospital received 2927 outpatients by 4 pm. The hospital has to stop receiving any new patients at its outpatient department for two hours.
This crowdedness of care is due to the lack of quality distributed primary care and community-based care system. The quality of care in China varies by location and levels of hospitals. Since the best care can usually be found in public level III hospitals at big cities. Patients from all over China flood in to these large level III hospitals with good reputation, imported western equipment and skilled staff. For example, the gap of top hospitals concentrated in the east coast of China compared with the less developed hospitals in the west part of China resulted in a high ratio of mortality rate. The mortality ratio for children under 5 between the west and east region of China is 2.69.
Since China CFDA has increased dramatically the number of medical devices that need clinical trials in China, the fact that 32% of hospital beds are concentrated in the top 20 major cities can certainly help reduce the time to improve the efficiency of clinical trials in China
For medical device manufacturers, the concentrated care system brings benefits. It is easier for them to recruit patients for clinical trials. Although since Jan 11, 2018, CFDA began to accept data of clinical trials conducted abroad, the vast patient number is an important factor that foreign manufacturers have to consider. The variety of diseases also matters. The concentrated care will enable the clinical trials to find patients for specific diseases. For example, the patients of Pneumoconiosis, one of the most striking occupational diseases, are heavily populated in North China where there is concentrated coal mining industry.