An elderly woman performs rehabilitation exercises with the help of a carer in a healthcare center in Rizhao, Shandong Province, on July 22 (XINHUA)
New wards offering additional care are becoming increasingly popular in hospitals around China. Staffed with teams of professional carers, the wards are reducing the pressure on the families of patients.
In China's hospitals, doctors and nurses are usually charged primarily with providing patients with medical care, while other necessary care, such as feeding and bathing, is provided by patients' families or by carers families bring in to help. For the families of high-needs patients, such as those who are elderly or seriously ill, the financial, emotional and sometimes physical burden of providing care can be great.
In late October, the National Healthcare Security Administration (NHSA) issued guidelines on setting nursing service prices, including the prices of personal care offered by nurses and professionally certified care workers hired by hospitals wards. These carers are either employed directly by the hospital, or by the hospital in partnership with third-party agencies. In addition to basic caring duties, the carers are trained to provide massages and assist nurses in monitoring patients.
Forty-seven-year-old Xu Luhua, who placed her mother in one such ward in a hospital in Beijing, told Beijing Review she was pleased with her decision and with the level of care her mother received. "My mother slipped and fell on the stairs and it took her two weeks in hospital to recover, but I'm only entitled to 10 days of leave from my company. Besides, one needs to possess professional skills to assist a patient with fragile and injured bones," Xu said. She added that the hospital provided a professional carer at a reasonable price and that she felt the carer contributed to her mother's quick recovery.
"I think (the service) is a life saver for both patients and their family members who are working full time," Xu said.
A sound solution
The NHSA provided guidance for hospitals to provide multiple levels and categories of care to cater to the needs of families in a variety of situations. It also established pilot zones for carrying out the services, including Tianjin Municipality and Zhejiang and Fujian provinces, and issued a price reference based on local GDP and residents' incomes.
"If patients were to hire private caregivers for one-on-one services, they would need to pay an average market price of 200 to 250 yuan ($28-34) per day, while the fees for one-to-many services provided by professional medical caregivers hired by hospital wards are 60-80 yuan ($8-11) per day, and the service quality is ensured by the hospital," Ge Lili, Deputy Director of the Nursing Department of Zhejiang Provincial People's Hospital, told newspaper Workers' Daily.
According to Jiang Changsong, assistant dean of the National Medical Insurance Research Institute at Capital Medical University, prior to the launch of the ward-provided personal services, inpatients were primarily taken care by their respective families, care workers hired by the families, or nurses. Yet family members usually lack professional medical skills and, if in full-time
employment, may be unable to provide the necessary round-the-clock care. Carers hired by the patients' families are usually expensive, which often places high economic pressure on families. Some families have also chosen to depend on the nurses in hospitals. However, the number of nurses is insufficient in some hospitals, and the nurses need to focus on medical care instead of providing personal care to patients.
"Therefore, this new service is the best solution for many—the staff are professionally trained, they can work in shifts to look after patients all day long, and they are affordable for most people," Jiang explained.
More hospitals are on the way to offer the service and train the caregivers to meet the increasing need for carers in hospitals.
"With problems relating to aging population becoming more prominent than ever, along with the increasing number of patients suffering chronic diseases and people's increasing health awareness, the demand for this kind of caring service will make multiple surges in the near future," Deng Yong, a law professor at Beijing University of Chinese Medicine, told news portal Cnr.com.
"In addition, the new system is an important supplement and improvement to China's current medical service system, striving to alleviate young people's burdens and keep the whole family on track. It also helps to reduce the difficulty of hospital management and cut down the potential risks caused by non-professional family members looking after patients," Deng added.
Quality services
With services delivered by appropriately trained and certified care workers, "families can rest assured that the patients are in good hands," Tian Chunli, head nurse in the healthcare center at People's Hospital in Jishou, Hunan Province, told news portal Fengone.com. "Every carer has experience working in multiple departments, allowing them to react immediately in a variety of situations. The hospital requires carers to hold a relevant certificate issued by the Ministry of Human Resources and Social Security, and receive extra training and assessment before they are placed on duty."
"The training given by hospitals includes nursing skills and theory, medical ethics, nutritional science and fire safety," Liao Yutian, head nurse in the trauma medicine department of Zhuzhou Central Hospital in Hunan Province, told Fengone.com.
Even though the cost of care provided by hospital wards is not covered by public health insurance, which means that patients have to pay for the fees out of their own pocket, it has been widely acclaimed in a number of pilot zones.
According to statistics given on hospital websites, Longgang Central Hospital of Shenzhen began offering ward-provided personal care in 2023. Since then, the proportion of inpatient care provided by family members or privately hired carers has dropped from 79.81 percent to 13.3 percent, and the proportion of patients from other districts seeking medical treatment in the hospital has increased from 25.61 percent to 35.35 percent. Shenzhen Pingle Orthopedic Hospital in Pingshan District of Shenzhen has seen the percentage of inpatient care by family members decline by over 70 percent since it introduced ward-provided personal care two months ago.
Hospitals have also made adjustments to improve the services carers provide, both according to patients' needs and in line with the hospitals' strengths. Shenzhen Pingle Orthopedic Hospital, which is renowned for its orthopedic department and traditional Chinese medicine treatment, trained its carers to offer services such as Baduanjin, a traditional Chinese fitness program, and traditional Chinese medicinal foot baths and massages, which are beneficial for foot and leg injuries.
"For the next step, the government should establish a set of strict standards and training requirements, create a list of assessment indicators for carers and allow patients, nurses and family members to assess the carers to ensure the quality of service," Wang Yue, professor at the School of Health Humanities at Peking University, told China Media Group.
(Print Edition Title:Enhanced Support)
Copyedited by G.P. Wilson
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