Nanchuan district in Chongqing achieves universal health insurance for its impoverished population

Hu Zhengyou, a resident of Huanggan village in Nanchuan district, Chongqing municipality, broke his leg while working in 2018. The incident caused him to lose his ability to perform manual labor, and he fell into poverty. Hu’s family doctor from the community hospital has been treating him for more than a year, however, and Hu is now able to engage in odd jobs near his home.

Ensuring that impoverished people have access to healthcare is a key part of the battle against poverty. The Nanchuan government has made great efforts to ensure thatl ess poverty-stricken people in the district will catch a disease, and when they are ill, they will have access to medicare service and can afford to pay for the needed medical treatment. It has signed contracts with doctors, upgraded medical facilitiesin the district, and implemented medical insurance reimbursement policies in order to achieve this goal.

Family doctors visit impoverished people regularly

All of Nanchuan district’s impoverished residents can get house calls from contracted family doctors like Hu did. The doctors visit these citizens regularly and conduct physical examinations and provide medical consultations for them.

Seventy-one-year-old Shanwangping town resident Luo Xianzhu has suffered from high blood pressure for more than 20 years. His wife has diabetes and heart disease and also has high blood pressure. Their family doctor has taught them how to manage their conditions, and they now lead a healthier life. Luo has been very enthusiastic about the visitations that they receive.

In recent years, the Nanchuan government has created 220 family doctor service teams in order to offer medical services to impoverished residents and provide universal medical insurance coverage to poverty-stricken households.

Nanchuan utilizes a smart medical and health platform that incorporates facial recognition technology and Global Positioning System services and records personal information in order to improve healthcare services in the district. The approach unifies service standards and enhances records by automatically incorporating residents’ medical information into their files, which improves integrity and accuracy and is especially useful for elderly people with hypertension and diabetes.

“Authorized family doctors are able to access residents’ electronic health files and all of their medical records,” Nanchuan District Health Commission Information Center Director He Jiang explained. “They can learn about their patients’ health status and diagnosis and treatment historyso as to provide more precise service. They also record advice and prescription information in order to provide useful and accurate details that can be incorporated into follow-up treatment and diagnosis.”

Improving medical records and facilities

The construction of a new inpatient building is currently underway at the Nanchuan District Hospital of Traditional Chinese Medicine. As of April 11, the foundation had been completed, and the frame is about 30 percent done. The undertaking symbolizes the improvements that have been made to Nanchuan’s medical facilities.

In recent years, Nanchuan has renovated and expanded the Nanchuan District People’s Hospital’s pediatric building and seven township health centers, relocated the Nanchuan Maternal and Child Healthcare Hospital, and constructed standardized clinics in 244 of its villages. All of the township health centers are equipped with automatic biochemical analyzers, B-scan ultrasounddevices, and other equipment, and central facilities possess digital radiography (DR) and computed radiography (CR) equipment.

The Nanchuan District People’s Hospital has achieved AAA status, the Nanchuan District Hospital of Traditional Chinese Medicine has been certified as a AA facility, and infrastructure has been comprehensively upgraded at 33 primary-level medical institutions. The Nanchuan government has unified medical data standards at the district-level hospitals, township health centers, and private hospitals in the district and established a regional medical and health information database that includes standardized information about medical institutions and medical staff as well as disease catalogs, diagnosis and treatment catalogs, surgical catalogs, and drug catalogs.

“Nanchuan has integrated more than 15 million pieces of effective medical and health data from 40 public medical institutions, 12 private hospitals, and 100 private clinics,” He Jiang noted. “We will incorporate information from 279 village clinics into the platform next.”

The Nanchuan government classifies impoverished people who have major, severe, and chronic diseases into corresponding groups and provides personalized treatment plans for them that include diagnosis and rehabilitation. A health management system has been implemented that involves special staff members handling disease control and follow-up procedures. The measures ensure that rural impoverished patients receive timely and effective treatment.

One-stop settlement with affordable copayments

“Basic medical insurance policies make it possible for me to afford my medical expenses,” a 57-year-old Shimao resident surnamed Peng recently explained at the Nanchuan District People's Hospital. Shimao is a village in Shuijiang town, Nanchuan district. Peng underwent a surgery due to acute myocardial infarction that cost about 36,477 yuan (about US$5,099). Peng’s basic medical insurance covered 90 percent of the cost, which greatly eased her medical burdens; her copayment was about 3,648 yuan (about US$509).

The basic medical insurance plan that Peng is enrolled in was created by the Nanchuan government. It ensures that impoverished residents’ out-of-pocket expenses do not exceed 10 percent of the cost of a hospital stay and do not exceed 20 percent of the total outpatient charge for treating major, severe, and chronic diseases.

The Nanchuan government has also implemented a policy that allows patients to be diagnosed and treated at public institutions and pay later via a district-level platform that provides one-stop settlement services in order to strengthen health security for impoverished people.

The Nanchuan Health Commission cooperates with the district’s bureau of human resources, department of civil affairs, disabled persons’ federation, and some other  authorities in order to provide basic medical insurance and strengthen supervision and inspection of township participation. All of the impoverished people in Nanchuan’s rural areas currently have basic medical insurance and serious illness insurance.

In 2019,the total doctor’s visits by Nanchuan’s impoverished residents amounted to 15,078, the medical fund for poverty-stricken people reached 3.5 million yuan (US$488,950), and the government covered 7.25 million yuan (US$1.013 million) of impoverished patients’ medical costs. They paid an average of 9.86 percent of the inpatient care cost and 18.10 percent of the outpatient care cost for treating major, severe and chronic diseases. The measures that have been implemented in Nanchuan have greatly reduced the medical burdens of its impoverished residents.