Strengthening China’s Academic Health Systems
China’s top medical university and hospital leaders, joined by a half dozen international leaders in health policy, discussed how they might work together to improve medical education, research, and healthcare services at the fourth Westlake Forum, held on November 17-18 in Shanghai. The theme of this year’s Forum was “Strengthening China’s Academic Health Systems (AHS).”
AHS are systems that seek to integrate medical education, research, and service functions, both vertically (from primary to tertiary curative and preventative care) and horizontally (from within a single university to cross-university partnerships) in the context of global collaboration. AHS are especially relevant to China as its dual reforms in education and health have sparked reconsideration of the integration of medical universities into comprehensive universities and deepening reform of public hospitals.
At the core of AHS are the relationships between medical universities and affiliated hospitals and service systems at community and other levels. Westlake Forum IV (WLF4) sought to strengthen these relationships by establishing a platform for debate, discussion, and collaboration among participating medical leaders and faculty, researchers, and medical service providers. During question-and-answer sessions, participants reacted to expert commentaries and shared lessons from their own work. Working groups gave participants opportunities to brainstorm strategies for connecting medical university and clinical training; linking education, research, and services into community systems; and accelerating translational research in China. Medical education. Hospital leaders expressed excitement about the exchange of new ideas and strategies. Xu Xuehu, Vice President of the Third Affiliated Hospital of Guangzhou Medical University, for example, noted that the meeting stimulated many new ideas.
A presentation by Shanghai Vice Mayor Shen Xiaoming (沈晓明) generated strong interest among participants. Shen described Shanghai’s ambitious plan to develop a more integrated and efficient healthcare system by creating regional healthcare coalitions that will promote preventive care, reduce costs, and provide more power of choice for patients. “In the next two years, Shanghai will develop a Regional Health Alliance (RHA) system, Shanghai’s own version of an Academic Health System. RHA will consist of a tertiary hospital and a dozen community health centers, which will work together to provide comprehensive care to Shanghai's residents. RHAs will receive payments according to the number of residents that sign with them, and referrals within the RHA will improve efficiency of care. The RHA must take financial responsibility if overspending occurs; but it also retains any profits if costs come in under-budget. Shanghai residents will ‘vote with their feet,’ choosing which RHA to join.” Shen’s presentation sparked active debate among attendees, who posed questions and offered comments for an hour following his talk.
WLF4 also featured commentaries from Chinese and international experts, including Jane Henney of the University of Cincinnati; Jeffrey Koplan of Emory University; Gilbert Mudge of Partners Healthcare System; Jordan Cohen of the American Association of Medical Colleges; China Medical Board (CMB) President Lincoln Chen; Jin Shenguo (金生国) of the Ministry of Health; Shi Pengjian (石鹏建) of the Ministry of Education; Wang Longde of the Chinese Association of Preventative Medicine; and Ba Denian (巴德年) of Zhejiang University; among others.
The Westlake Forum, jointly initiated by Zhejiang University and CMB, aims to periodically bring health academic and policy leaders together for exchange on China’s major health challenges. WLF4 was organized by Fudan University, Shanghai Health Bureau, Zhejiang University, and China Medical Board. Previous Westlake Forums were conducted in 2007 (“Health Equity and Health Security Systems in Hangzhou); 2009 (“Healthy China 2020: Policy and Action” in Hangzhou); and 2011 (“Comparing China and USA Health Reforms: Similarities, Differences, and Challenges” at Emory University in Atlanta, USA).
Conference background note, which provides the definition, history, and alignment of Westlake Forum IV's theme on Strengthening China's Academic Health Systems.