Wednesday, 26 February 2014

3 medical tales from China: the good, bad and the fake

by Michael Woodhead

Hospital performance pay system revealed

Hospitals in China are adopting performance-bonus schemes for their staff based on a concept called the balanced scorecard (BSC) according to an academic paper in the Health Policy and Planning. Researchers from Jinan in Shandong did a literature search and found details of 90 hospitals that had adopted the scorecards for staff as a way of improving performance, staff motivation and patient satisfaction. The hospitals typically compiled the score cards on a monthly basis at a department level and the score systems were usually linked to increasing hospital revenue.  A scorecard might also measure parameters such as operations management (eg bed utilisation), patient satisfaction, learning and attitude to work. The score card-based bonuses were generally well accepted and had become an important part of the staff income, the study found.
(Some interesting facts revealed in the study: China has around 20,000 hospitals, but hospitals receive only about 10% of their operating costs through government subsidies. And medical salaries are low, only about 12% above average earnings.)

Shanxi Hospital swindling exposed

A hospital in Taiyuan, Shanxi is under investigation for swindling women through 'special offers' for treatments including abortion. The provincial Price Bureau started an investigation of the Yellow River Hospital after receiving complaints from women who said they had been charged much more than advertised and had not received the services promised. In one case, the hospital held a special 'Women's Health Week', during which time they offered a special price of 480 yuan to perform painless abortion and IUD insertion. However, women who used the hospital services said they were charged 4288 yuan, not 402 yuan. Part of the excess fee was for 'educational materials' that were widely available elsewhere and cost just a few yuan. The hospital also offered ultrasound scans for for 10 yuan, but women said they were forced to pay 120 yuan. One woman was told she needed magnetotherapy and microwave therapy, for which she was charged almost 10,000 yuan, but no doctor had recommended them. A spokesman for the hospital said the women's health price offer was only available during a certain period and the women in question had treatment outside those dates.


Rat poison kebab death: the fake hospital rumour

A story doing the rounds on Weibo claims that a 12-year-boy has died in a Hangzhou hospital after eating a  rat poison-tainted meat kebab bought from a street stall. The post purports to come from a  doctor at the hospital, who said the boy had a massively increased prothrombin time (known as an INR) of 150. The usual range is around 2-3. The post has been widely circulated, with many netizens commenting that it shows yet again that food in China was unsafe. However, when a reporter contacted the hospital he found there had been no such patient. A doctor said he had heard the rumour being attributed to many hospitals in China, most of which proved to be fake. However, he said there had once been a genuine case of rat poison-tainted food ingestion at the 301 PLA Hospital, but had not been fatal. It was true that rat poison could cause bleeding problems because it was based on the blood thinner warfarin. His general advice was that truth or rumour, it was best to be prudent about eating food from street stalls.

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