Lessons from the U.S.-China Healthcare Conference

BOSTON – April 11, 2012: A number of articles have been written about the U.S.-China Healthcare Conference, held in March at The Wharton School of the University of Pennsylvania. Although the conference is now over, the ideas which were shared will make a lasting impact. A selection of the articles is provided below:

China Law Blog: China’s Healthcare System

Dr. Adam Powell and Dr. Youfa Wang, two of several presenters at this past weekend’s US-China Intercollegiate Healthcare Conference held on Wharton’s campus, exhibited a shared awe of the rapid changes taking place in China’s healthcare profile. Among the many themes and viewpoints presented at the conference, the sense of awe emerged as the common meeting point for all attendees.

 

“Just look at what China has been able to do,” Dr. Powell gushed while pointing at a chart depicting the staggering rise of insurance coverage in China from 2000 to 2012. The rate of China insurance coverage has reached 95%, according to the latest numbers put forth in this months March 2nd issue of medical journal the Lancet. “In ten years [Chinese health planners] have managed to cover a billion people.”

 

“Every time I visit China, I’m very surprised by the many changes,” Dr. Wang, a Johns Hopkins Medical School Professor and probably the leading expert on nutrition in China, said as he pointed at his own PowerPoint slide earlier in the day, a map depicting all of China’s KFC restaurant locations. The image made the audience of ninety students and health professionals chuckle and wiggle uncomfortably in their seats.

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Asia Healthcare Blog: China healthcare internship opportunity: California China Heart Watch

One of my co-panelists at this past weekend’s Intercollegiate US-China Healthcare Conference at Wharton Business School, was Roy Y. Chan, the Program Coordinator at China California Heart Watch (CCHW), a non-profit organization. The organization’s mission is “to provide clinical care, research, and public service in the rural Yunnan Province of China.”

 

For those unfamiliar, Yunnan is one of China’s poorest provinces and was the outbreak point of China’s AIDS/HIV epidemic in the 1980s, thought to be directly attributable to the high prevalence of intravenous drug users in the Province relative to other areas  of China.

 

Mr. Chan noted that CCHW has couple of facilities in Yunnan province, a 1200 sq ft clinic and an 800 sq ft community center, from which it operates a research and public service program for Yunnan residents. The public service efforts are carried out in improvised clinics in various villages, and staffed by students from the United States, under the leadership of Dr. Robert C. Detrano, MD, PhD from the University of California Irvine.  While the intent of the clinics is to monitor the blood pressure of villagers otherwise hard pressed to get medical care, the students and CCHW doctors (there are other doctors besides Dr. Detrano) often turn into more.

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Asia Healthcare Blog: Improving Outcomes for the Neonate in China

This is the kind of issue in Chinese healthcare I find especially relevant. As billions of RMB is poured into China’s healthcare industry, there is a large scale gap between technology (stuff money can buy) and expertise (stuff money cannot buy). At last weekend’s US-China Intercollegiate Healthcare Conference (see co-blogger Damjan Denoble posts for more), there was a great session by a neonatalogist on the state of the NICU (neonatal intensive care unit) in China, “Can China Become a Worldclass Neonatal Provider in Ten Years”. While it is too early in this current five year plan cycle to truly know, we do know very well that perinatal outcomes worldwide are improving through access to technology and provider training. For premature, critically ill infants, however, learning how to use technology must be coupled with more sophisticated training in order that the infant may not only survive, but thrive and contribute to the country in the long-term.

 

Dr Huayan Zhang is a neonatalolgist at Children’s Hospital in Philadelphia (CHOP), and has compiled data from an informal e-mail survey comparing 20 hospitals in China to CHOP and UCSF*. She found that Chinese neonatal care has improved dramatically over the last decade, but their outcomes do not yet compare to either American center. For example, the lowest survival gestational age at CHOP and UCSF are around 24 weeks, whereas at a large Beijing hospital it is over 30 weeks. CHOP and UCSF both have been able to provide care for infants born at 500g; in Beijing, most infants with higher survival rates are well above 1,000g. This is partly due to technology access, but more to the immense amount of educational and training programs that have been developed for the NICU’s here.

 

In the United States, newborn intensive care units are special units in the hospital for critically ill or preterm infants. They are typically staffed by Neonatalogists and Fellows, Neonatal Nurse Practitioners (NNP) and Neonatal RN’s. A neonatal nutritionist is also an integral part of the multidisciplinary team, participating in team rounds, assisting with parenteral nutrition orders, and overseeing the nutritional care of the infants. In the U.S., especially at large medical centers such as CHOP, UCSF and New York Presbyterian, where I work as a NICU nutritionist, years of training and experience are required for any position in the NICU.

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 Asia Healthcare Blog: Is China the fattest country in the world? Probably.

This is a continuation of my recap from this past weekend’s US-China Intercollegiate Healthcare Conference, hosted by GCC and Penn Biotech Group. (For more coverage of the event, go here and here)

 

Dr. Youfa Wang, MD, PhD, a nutrition expert and Associate Professor at Johns Hopkins Bloomberg School of Public Health, posed the following question during his conference presentation this weekend – Is China the fattest land?

 

His question was a redrafting of the title to a best selling 2003 book by Greg Critster, “Fat Land: How American Became the Fattest People in the World.” The cover image of this post is a reworking of Greg Critster’s book as it might have looked like, since the argument can be made that in 2003 China was already the world’s fattest country. That is because, as I explain below, already in 2003, if the Chinese standard for BMI is taken into account, the number of overweight Chinese was over four hundred million (for explanation of the standards click the box below, which quotes an explanation by Jia Shen et al. in their 2011 paper “The Emerging Epidemic of Obesity, Diabetes, and the Metabolic Syndrome in China”) . For context, that’s like if 130% of America were overweight.

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