Healthcare in China

HealthcareinChinaINFRASTRUCTURE,GOVERNMENT&HEALTHCAREContents1Introduction2Healthcarestatistics5HealthcarereforminChina8ImplicationsoftheplannedhealthcareinitiativesinChina10HealthcarereformsinHongKongSAR12Implicationsofthereforms–HongKongSAR15Conclusion16AboutKPMG©2009KPMG,aHongKongpartnershipandamemberfirmoftheKPMGnetworkofindependentmemberfirmsaffiliatedwithKPMGInternational,aSwisscooperative.Allrightsreserved.1HealthcareinChinaIntroductionHealthcarereformhasbeenoneofthekeytopicsonthegovernmentagendabothinChinaandHongKongSAR.InChina,abasicframeworkforthemedicalandhealthcaresystemisbeingdevelopedwithconsolidationinthepharmaceuticalssectorlikely.InHongKongSAR,considerationsregardingthepromotionofpublic-privatepartnershipsinthehealthcaresectorandmedicalfundingreformswereaddressedduringthefirststageofpublicconsultationin2008.Developedcountries,suchasAustraliaandJapan,havewelldefinedmedicalandhealthcaresystemsandstrictlyregulatedpharmaceuticalmarkets.TherapideconomicgrowthofChinaoverthelastdecadehasbroughtaboutfundamentaldemographicchangesandshiftedthebalancebetweenthecountry’surbanandruralpopulations.Thesechangesarethedriversbehindthegovernment’sdevelopmentofanationalhealthcarereformplan,whichaimstoprovideabasicframeworkformedicalservicesandthehealthcaresystemfortheshortandlongerterm.Asaresult,weareseeingopportunitiesforinvestorsinthemedicalandhealthcaresectorsduringthemarketdevelopmentandconsolidationphasesoverthenextdecade.TheobjectiveofthisreportistoprovideahighleveloverviewofhealthcarereformsinChinaandHongKongSARtogetherwithabriefdiscussionoftheirimplications.Wehopeyoufindtheanalysesinthisreportusefulandwewouldbepleasedtodiscussthefindingswithyou.AndrewWeirPartnerincharge,ChinaInfrastructure,Government&Healthcare©2009KPMG,aHongKongpartnershipandamemberfirmoftheKPMGnetworkofindependentmemberfirmsaffiliatedwithKPMGInternational,aSwisscooperative.Allrightsreserved.2HealthcareinChinaHealthcarestatisticsIn2008,totalhealthexpenditurepercapitawasUSD139inChina,comparedwithUSD1,532inHongKongSAR,USD3,138inJapanandUSD4,403inAustralia.TotalhealthexpenditureasaproportionofGDPwas4.2percentinChina,comparedwith5.0percentinHongKongSAR,8.1percentinJapanand8.8percentinAustralia.ThesefiguresandotherstatisticspresentedbelowsuggestanurgentneedforChinatoachieveconsensusbetweenthepublicandindustryparticipantsandrolloutconcreteplansforhealthcarereforminordertocreateahealthiernationby2020.TotalhealthexpenditurepercapitainHongKongSARiseleventimesthatinChina.InJapan,thegapisanevengreatertwentytwotimesthatinChina.TotalhealthexpenditureasaproportionofGDPinChinaishalfofthatinJapanandAustralia.AlthoughChina’sbirthrateisthehighestofAsiancountriesdisplayedinthetable,lifeexpectancyinChinaisthelowestamongallcountriesdisplayedinthetable.CountryTotalhealthexpenditureShareoftotalhealthexpenditureinGDPBirthratesLifeexpectancyatbirth:totalpopulationUS$percapita%oftotalGDPPer’000inhabitantsYearsChina138.74.212.372.4Singapore1,169.03.28.380.1SouthKorea1,515.37.29.979.1HongKongSAR1,531.85.07.082.0Japan3,137.88.18.082.5NewZealand3,174.41015.180.3UK4,184.68.812.179.5Australia4,402.88.812.781.3Canada4,796.010.211.080.6Netherlands5,041.69.511.080.6Switzerland7,302.511.29.581.8USA7,422.515.414.378.0Source:EuromonitorInternationalfromOECD/WHO/nationalstatistics©2009KPMG,aHongKongpartnershipandamemberfirmoftheKPMGnetworkofindependentmemberfirmsaffiliatedwithKPMGInternational,aSwisscooperative.Allrightsreserved.3HealthcareinChinaNumberofbedsinhealthinstitutions20032004200520062007Hospitalsandhealthcentres(1,000units)2,9553,0463,1353,2713,438Sanatoriums(1,000units)4854524643Maternityandchildcarecentres(1,000units)81879499106Otherhealthinstitutions(1,000units)80818796114Numberofhospitalbedsper100,000population(units)234240245253263Source:NationalBureauofStatistics,ChinaStatisticalYearbook2008China’shealthcarestatisticsThenumberofcertifieddoctorsper100,000populationhasbeenincreasingataslowerpace(approximately1percentyear-on-year)thanthenumberofhospitalbedsper100,000population,whichincreasedby2-4percentannually.Numberofpersonsemployedinhealthinstitutions20032004200520062007Certified(assistant)doctors(1,000persons)1,8681,9061,9381,9952,013Registerednurses(1,000persons)1,2661,3081,3501,4261,543Numberofcertified(assistant)doctorsper100,000population148150152154154Source:NationalBureauofStatistics,ChinaStatisticalYearbook2008Source:NationalBureauofStatistics,ChinaStatisticalYearbook2008Numberofhealthinstitutions(2007)66.04%20.28%10.84%1.02%0.62%1.2%HospitalsandhealthcentresCentreforDiseaseControlandPreventionOtherinstitutionsClinicsMaternityandchildcarecentresSanatoriums,specialisedprevention&treatmentcentres,andresearchinstitutionsofmedicalscienceMedicaltechnicalpersonnelManagerialpersonnelLogisticworkersOthertechnicalpersonnelSource:NationalBureauofStatistics,ChinaStatisticalYearbook2008*Thisincludescertifieddoctorsandassistantdoctors,registerednurses,pharmacist,andlabtechniciansPersonsemployedinhealthcareinstitutionsbyoccupation(2007)6.04%4.11%8.79%81.06%*©200