Interviewing Zhongguoren - I am afraid.

[bottledpoetry]

Hi all

Hope this is in the right section! My name is Joanne and I'm a regular lurker on this forum. I've basically lived vicariously through everyone's China experiences, since I haven't been back for two years.

ANYWAY. I will be back this upcoming winter - january and february, working on my International Studies thesis on Hospital Accessibility and Medical Technology in the ol' PRC. I plan to interview patients within the Chinese medical care system, and hospital directors if (and that's the if I'm working on) possible. There are a few things that are making me run around like a chicken with it's head cut off, in these few, short preparatory months:

1. If I feel that my Chinese oral schools aren't good enough to conduct an interview involving medical lingo (I can carry basic convos) - where can I go to find a translation on a frugal research budget?

2. Has anyone had experience within the Chinese healthcare system, and can give me input? All is appreciated

3. I plan to look at questions of who gets denied medical access in China, and why. I know the hospital system in the PRC has a system to determine who gets into the best hospitals, 2nd best, and so on. Any general advice on that besides safety precautions?

Thank you

Joanne

[gato]

Maybe try posting an ad to see if some local university student can help as a translator.

[Han-tiger]

You might want to look for assistance from students in local medical colleges and conduct an on-line research on Chinese healthcare system. It is efficient and economical.

[bottledpoetry]

Han-Tiger - can you tell me more about how to conduct online research on the healthcare system? Do you mean pulling up articles and papers and such? Thanks.

Gato - I'm trying to get in contact with a tutor I had at BeiShiDa. Hopefully that will pay off - thanks for your advice!

Joanne

[Han-tiger]

Well…well… I prefer to make my points clear by answering your questions one by one.

A. An efficient and economical way of getting a translation is to seek assistance from students in local medical colleges.

B. I suggest you not to expect for any on-line opinion regarding this topic, which is considered a piece of tough meat by Chinese government.

C.

a. I’ve never heard that there is a system in China to determine who gets into the best hospitals, 2nd best, and so on.

b. I don’t know exactly what is the meaning of “medical access” or “Hospital Accessibility”. In China, every one can get access to medical service provided he or she can pay the bill. The point is only those patients who take part in the Social Medical Insurance Program (note: distinguished from business health insurance) do not need to pay the total amount of medical service fee. The major part of the bill is paid by Administration Agency of Social Medical Insurance. Therefore, might I take “medical access” or “Hospital Accessibility” for “Access to Social Medical Insurance”? Your study seems to involve Chinese hospital system, Chinese Social Medical Insurance system, and Chinese current medical reform. This issue can be very… very… complicated.

On-line research is a good way, but not the only way. You may browse the relevant websites to collect news reports, articles, and theses in this area. But language is a problem to you. you need some one to give you consistent assistance.

[cdn_in_bj]

Well, as far as I know anyone can go to any hospital here if you're paying for it yourself. If you're covered by medical insurance, then there are designated hospitals that you should go to in order to receive reimbursement, however you can apply to get these changed.

The main headache is that you often have to show up real early in the morning to "挂号" in order to see a doctor. The exception is if you're suffering from a respiratory ailment and high fever, in which case they promptly usher you to the SARS screening area for x-ray and blood tests.

I have heard stories about doctors in certain hospitals who will prescribe unnecessary medications, or tell you that your condition is more serious than it really is. With the "better" hospitals, it can sometimes be hard to schedule procedures or get the type of room you want without the right connections.

I just realized you are also looking for input on experiences with the medical system. One thing that strikes me is the mandatory annual health checks for full-time workers here. They do a full physical check-up including vision, blood and urine tests, and chest x-ray. Which I think is a good thing with such a large population here, except for the x-ray. Even though they have started using digital x-ray machines, it is still not recommended (by western doctors) to get chest x-rays that frequently. It is somewhat amusing that most of the men in my office have some sort of liver problem ("fatty liver") and how they all laugh it off, but it really is a serious problem.

Also, when applying for work most companies here will ask to see a health check as a condition of getting a job offer. Which also leads to an interesting topic, what is the extent of descrimination based on health (such as hepatitis carriers, AIDS, etc.)?

[bottledpoetry]

Cdn_in_bj - I definitely have also seen situations similiar to when doctors prescribe unneccessary medications. In my case, the hospital has called my grandparents in like clockwork during non-busy seasons, offering to put him in his own hospital room even when he isn't think. He gets full coverage of his hospital stay bills because he is a veteran. Thanks for the advice - I do plan to look at medical insurance.

Hantiger -

a. I'm pretty sure a system of classification is in play. When I took my grandpa to a hospital in China (and this was an emergency) - he was actually rejected from treatment at the closest hospital because the hospital's ranking was above what he could have. They put him up in the lobby, and we had to leave for a farther, "rank-appropriate" hospital the next day by ambulance, and a few weeks later, he was transferred to yet another hospital. The patients in his ward had similiar experience.

b. By medical access - I mean who has access to the hospital's medical services. In my experience, money will get you into a hospital during a low-demand time, but not if there are other people with more guanxi in the line with you.

Thanks for your input

[gougou]

he was actually rejected from treatment at the closest hospital because the hospital's ranking was above what he could have.

Could that have to do with him being a veteran? I had a look at the hospital sector recently (not very in-depth on the regulatory side though) and didn't find any such regulation; quite on the contrary, the numbers indicate that the higher the ranking, the higher the bed occupation rate.

[bottledpoetry]

gougou - according to my uncle (yay for forcing family members to be my translators!) who was with us at the time, my grandpa qualified for a "first rank, second class" hospital of some sort. The first hospital we went to was a "first rank, first class" hospital - one level above his eligibility. I never considered it as a matter of him being a veteran, since I met other people in the hospital (non veterans) who had the same thing happen to them. I'm going to look into that though - don't want to get to China and realize the rug has been pulled from under me Where were you looking at these regulations? Could I access them from across the pond (via internet)? Thanks!

[gougou]

I wasn't doing the regulation part myself, only saw some of the results. You could try calling (or in your case, having somebody call) the [pop=Ministry of Civil Affairs/mínzhèngbù]民政部[/pop]. Maybe you'll find something on their web page, as well.

[simonlaing]

Yes I am in a second tier city Nanjing with tons of military bases. (I think we're out of range of Taiwan is the reason.) There are military medical univeristy here, and Military clinics probably hospitals aswell. (I had a friend who took me to dinner on the campus, and noted that I wouldn't be able to get in without him accompanying me.)

Anyway I have been to several different hospitals in Nanjing. (When I knew someone who knew a doctor I was able to jump to the front of the line.) But other times I had to wait in line and pay small fees every time I needed something, see a doctor, get an x-ray, see a specialist, have tingly, ankle wrap applied and buy lots of bitter, pyschological chinese medical pills.

It seemed that most of it was a money issue.

I think the major access issues you should investigate are Urban Rural issues that are real. Most rural areas and even some suburban areas have very little in terms of medical services. One reason why people protest their houses being forcibly moved from the city center to the suburb is due to lost of proximity to a hospital.

In the 70s I think they had a bare-foot doctor program which had doctors and other medics climbing mountains and traveling to villages regularly to treat people. The funding for these dried up in the early 80's I think.

Compared to trade, constrution and enginneering; The usual money makers Medicine and Law are not highly paid in China, though this is changing slowly,

You may want to try WHO for some public health documents on China.

Also a recent Sex survey used a self adminstrated Lap top survey that seemed to work well. if your survey can use this method it might be good as a it will help with getting people to convery ideas they might be shy to speak out loud.

Good luck,

have fun,

SimoN:)

[kudra]

there's this recent Economist article, which I have barely started, but which looks relevant.

@bottledpoetry -- pm me if you can't access it for some reason.

[gougou]

I think the major access issues you should investigate are Urban Rural issues that are real. Most rural areas and even some suburban areas have very little in terms of medical services.

But then again that has been covered so often that everybody is aware of it by now. Including the CP, who has made shortening the gap between rural and urban health services the focus of the current 5-year plan.