From:Beijing Municipal Commission of Health and Family Planning
Date:11/30/2016
    Text[1]

  The year 2015 marks the ending of the "12th Five-Year Plan" period. During the past year, healthcare and family planning departments at all levels in Beijing have been working hard for a detailed implementation of the program for planning, fulfilling and deepening the reforms of the medical and healthcare system mentioned in the "12th Five-Year Plan". The departments have adhered to the reform of public hospitals as their focus and encouraged medical practice by social organizations while further advancing the separation of medical services from medication, two-way patient referral, medical partnerships, and graded diagnosis and treatment. They have actively explored the reasonable allocation of medical health resources in Beijing, Tianjin and Hebei, besides consolidating and improving the basic medicine system and the new operational mechanism of medical and healthcare institutions at the grassroots level. Moreover, they have promoted the reform of related fields in a comprehensive and balanced manner, in a bid to drive the sound and sustainable development of healthcare undertakings in the capital.

  I. Health Resources

  (1) Total Number of Medical and Healthcare Institutions

  By the end of 2015, the total number of medical and healthcare institutions in the city reached 10,425, including 10,270 medical institutions, which include 109 Class-III, 144 Class-II and 652 Class-I medical institutions, and 155 other healthcare institutions. Over the previous year, the number of medical and healthcare institutions increased by 156. Specifically, the number of medical institutions increased by 159, of which community health service centers/stations went up by 21, while that of other institutions decreased by 3 (see Table 1). Compared with the end of the “11th Five-Year Plan” period, the figure increased by 9.4%.

  Based on their economic types, 701 hospitals are classified into 269 public and 432 private hospitals. Among them, 682 are local hospitals, which are further classified as follows on the basis of the number of beds: 491 hospitals with less than 100 beds, 64 with 100-199 beds, 60 with 200-499 beds, 35 with 500-799 beds, and 32 with more than 800 beds.

   

Table 1. The Numbers of Medical and Healthcare Institutions, Beds and Personnel in Beijing

  Type of Institutions

  Number of Institutions

  Number of Registered Beds

  Number of Actual Beds

  Number of Medical Personnel

  Number of Medical Technician

  Number of Practicing (Assistant) Doctors

  Number of Registered Nurses

           

   

   

   

   

   

   

   

   

  Total

  10,425

  118,384

  111,555

  321,151

  256,531

  96,445

  114,294

  I. Hospitals

  701

  108,795

  104,644

  239,155

  194,203

  68,184

  95,895

  Public Hospitals

  269

  87,191

  82,792

  198,290

  165,610

  57,304

  83,148

  Private Hospitals

  432

  21,604

  21,852

  40,865

  28,593

  10,880

  12,747

  Hospital Class: Class-III

  108

  65,744

  62,171

  164,005

  137,698

  46,940

  71,010

  Hospital Class: Class-II Hospitals

  125

  26,291

  25,373

  47,337

  36,733

  12,920

  17,166

  Hospital Class: Class-I Hospitals

  440

  15,654

  16,069

  25,139

  18,016

  7,680

  7,007

  Unrated Hospitals

  28

  1,106

  1,031

  2,674

  1,756

  644

  712

  Hospital Type: Comprehensive Hospitals

  336

  62,824

  62,005

  158,970

  133,244

  46,487

  68,290

  Hospital Type: TCM Hospitals

  187

  22,140

  19,810

  35,503

  28,351

  11,496

  11,108

  Hospital Type: Specialized Hospitals

  171

  23,731

  22,729

  44,619

  32,568

  10,186

  16,482

  Nursing Centers

  7

  100

  100

  63

  40

  15

  15

  II. Healthcare Institutions at the Grassroots Level

  9,487

  6,509

  4,442

  61,757

  48,444

  23,893

  14,954

  Community Health Service Centers/Stations

  1,979

  6,509

  4,412

  31,428

  26,193

  11,631

  7,716

  Outpatient Departments

  1,070

   

  30

  14,499

  11,491

  5,678

  4,042

  Clinics

  3,623

   

   

  12,079

  10,448

  6,310

  3,158

  Village Clinics

  2,815

   

   

  3,751

  312

  274

  38

  III. Specialized Public Healthcare Institutions

  115

  3,080

  2,469

  14,868

  11,475

  3,905

  3,263

  Emergency Centers/Stations

  14

   

   

  1,713

  931

  469

  327

  Blood Collecting and Supplying Agencies

  7

   

   

  883

  585

  38

  329

  Maternal and Child Health Centers/Stations

  19

  2,416

  1,935

  6,229

  5,135

  1,992

  2,220

  Specialized Disease Prevention and Control Hospitals/ Stations

  25

  664

  534

  872

  550

  201

  235

  Centers for Disease Control and Prevention

  30

   

   

  3,876

  3,073

  1,199

  147

  Medical Supervision Offices/Centers

  18

   

   

  1,276

  1,189

   

   

  Other Specialized Public Healthcare Institutions

  2

   

   

  19

  12

  6

  5

  IV. Other Institutions

  122

   

   

  5,371

  2,409

  463

  182

  Sanatoriums

  1

   

   

   

   

   

   

  Medical Science Research Institutions

  28

   

   

  3,294

  1,462

  174

  12

  On-The-Job Medical Training Institutions

  9

   

   

  200

  26

  2

  11

  Clinical Testing Centers/Stations

  23

   

   

  836

  422

  35

  4

  Others

  61

  

  

  1,041

  499

  252

  155

  

  

  (2) Total Number of Medical Personnel

  By the end of 2015, the number of medical personnel in the city reached 321,000, an increase of 12,000 persons, up by 13.9% over the previous year. Compared with the end of the “11th Five-Year Plan” period, the figure increased by 29.3%.

  Of the total number of medical personnel, there were 257,000 medical technicians, 14,750 other technicians, 16,065 managerial staff, 28,486 staff with specialized skills and 3,439 rural doctors and medical technicians. Among the medical technicians, there were 96,000 practicing (assistant) doctors and 11,400 registered nurses. Over the previous year, the number of medical technicians increased by 10,000 persons, up by 4.2%. Compared with the end of the “11th Five-Year Plan” period, the figure increased by 31.6%.

  In 2015, there were 14.8 medical personnel, 11.8 medical technicians, 4.4 practicing (assistant) doctors and 5.3 registered nurses out of each one thousand permanent residents.

  (3) Number of Beds in Medical Institutions

  By the end of 2015, the officially registered beds in medical institutions of the city reached a total of 118,384, an increase of 4,731 over the previous year, up by 4.2%. Compared with the end of the "11th Five-Year" period, the figure increase by 23,803, up by 25.2%. Among the beds, there were 108,795 officially registered hospital beds in total (accounting for 91.9% of the city’s total amount), an increase of 4,713 over the previous year, and up by 23,399 compared with the end of the “11th Five-Year Plan” period. The total number of officially registered beds in community health service centers reached 6,509 (accounting for 5.5% of the city’s total amount), a decrease of 9 over the previous year and an increase of 678 compared with the end of the “11th Five-Year Plan” period.

  The actual total number of beds in the medical institutions of the city was 111,555, an increase of 1,766 over the previous year, up by 1.6%. Compared with the end of the “11th Five-Year Plan” period, the figure increased by 18,684, up by 20.1%. Among them, the actual total number of beds in the hospitals of the city was 104,644 (accounting for 93.8% of the city’s total amount), an increase of 1,793 over the previous year. Compared with the end of the “11th Five-Year Plan” period, the figure increased by 18,709. The actual total number of beds in community health service centers was 4,412 (accounting for 4.0% of the city’s total amount), a decrease of 103 over the previous year. Compared with the end of the “11th Five-Year Plan” period, the figure increased by 174.

  In 2015, there were 5.5 beds officially registered in medical institutions for each one thousand permanent residents and the actual figure was 5.1. Over the previous year, both the figures increased.

  (4) Development of the Healthcare Service System at the Grass-Roots Level

  By the end of 2015, there were 1,979 community health service centers/stations in the city, of which 326 were community health service centers and 1,653 were community health service stations. The total number of personnel at the community health service centers was 28,744 (including 24,059 medical technicians), with an average of 88.2 persons at each center. The total number of personnel at the community health service stations was 2,684 (including 2,134 medical technicians), with an average of 1.3 persons at each station. Over the previous year, the number of community health service centers/stations increased by 21, and health personnel by 752.

  By the end of 2015, there were 2,815 village clinics in the city, served by 3,439 rural doctors and medical technicians. Over the previous year, the number of village clinics decreased by 46 while that of rural doctors and medical technicians increased by 33.

  (5) Expenditure and Financial Subsidies for Medical and Healthcare Institutions

  In 2015, the total expenditure of medical and healthcare institutions in the city reached RMB 168.84 billion, an increase of RMB 20.27 billion over the previous year; up by 13.6%. The financial subsidies amounted to RMB 27.15 billion, an increase of RMB 4.61 billion over the previous year; up by 20.5%. It accounted for 16.1% of the total expenditure, increasing by 0.9 percentage points over the previous year. Compared with the end of the “11th Five-Year Plan” period, the total expenditure of the city's medical and healthcare institutions increased by RMB 87.88 billion, while the financial subsidies increased by RMB 14.75 billion.

  In 2015, the total expenditure of medical institutions in the city reached RMB 160.02 billion. The expenditure of government-run medical institutions accounted for 79.5% of the total expenditure of medical institutions. They received RMB 21.14 billion of financial subsidies. The total expenditure of the city's Class-III medical institutions was RMB 107.76 billion and they received RMB 11.88 billion of financial subsidies. The total expenditure of the city's Class-II medical institutions amounted to RMB 24.64 billion and they received RMB 3.44 billion of financial subsidies. Compared with the previous year, the total expenditure of medical institutions increased by RMB 18.39 billion; an increase of 13.0%, while the financial subsidies they received rose by RMB 2.68 billion; or 14.5%. Compared with the end of the “11th Five-Year Plan” period, the total expenditure of medical institutions increased by RMB 84.13 billion while their financial subsidies rose by RMB 11.12 billion.

  In 2015, the city continued to strengthen its efforts for developing the grass-roots health service system. Statistics show that in the year, the total expenditure of the city’s community health service centers/stations was RMB 14.55 billion while their financial subsidies amounted to RMB 5.21 billion. Compared with the previous year, the total expenditure rose by RMB 1.74 billion; or 13.6%, and the financial subsidies increased by RMB 850 million; or 19.4%. Compared with the end of the “11th Five-Year Plan” period, the total expenditure rose by RMB 9.21 billion; or 1.7 times, and the financial subsidies increased by RMB 3.3 billion; or 1.7 times.

  In 2015, the total expenditure of the city's 2,815 village clinics reached RMB 100.92 million and the subsidies they received from the superintending authority amounted to RMB 50.29 million. Compared with the previous year, the total expenditure rose by RMB 933,000; or 0.9%, while the subsidies increased by 3.4%. Compared with the end of the “11th Five-Year Plan” period, the total expenditure increased by RMB 37.812 million; or 60.1%.

  (6) Total Health Expenditure

  In 2014, the total health expenditure in Beijing reached RMB 159.464 billion, of which the expenditure of the government, the society and personal cash expenditure accounted for 24.73%, 55.85% and 19.42%, respectively. The total amount of financed health funds increased by 15.90% over the previous year, at a growth rate higher than the GDP (7.30%). The total health expenditure in Beijing accounted for 7.48% of the GDP in 2014, up by 0.56 percentage points over the previous year.

  In 2014, the government’s expenditure on public health accounted for 8.23% of the local budget for public financial expenditure and 1.85% of the GDP, up by 0.25 and 0.02 percentage points over the previous year, respectively. The proportion of personal health expenditure by cash in the total health expenditure fell to 19.42%, down by 0.99 percentage points as against the previous year.

  In 2014, the city's basic medical insurance for urban workers, same insurance for urban residents, expenses for new rural cooperative medical care and urban and rural medical assistance funds totaled RMB 73.082 billion, up by 12.29% over the previous year. Their growth rates were 11.30%, 55.77%, 13.48% and 22.17%, respectively.

  II. Major Health Indicators

  In 2015, the average life expectancy of the city's registered permanent residents was 81.95 years, up by 0.14 years over the previous year. Specifically, the figure was 79.81 years for males and 84.16 years for females.

  In 2015, the city's maternal mortality was 7.16/100,000 permanent residents, or 8.69/100,000 registered permanent residents. The rate has always been controlled under 12/100,000 persons. The city's infant mortality was 2.10% for permanent residents; or 2.42% for registered permanent residents, and the rate continued to remain at a low level.

  In 2015, the city's total mortality for residents was at 6.42% level. The top ten causes for the residents’ death were malignant tumors, heart diseases, cerebrovascular diseases, respiratory diseases, injuries and poisoning, endocrine and nutritional metabolic diseases, digestive system diseases, nervous system diseases, urogenital diseases and infectious diseases, jointly accounting for 94.88% of the total causes of death.

  III. Disease prevention and control

  (1) Reported morbidity and mortality of infectious diseases

  In 2015, a total incidence of 32,460 cases of Categories A and B infectious diseases was reported in the city, including 177 cases of death. The top five reported diseases with the largest morbidity were, according to priority, dysentery, tuberculosis, syphilis, scarlet fever and viral hepatitis, jointly accounting for 88.6% of the total reported cases of Categories A and B infectious diseases The top five reported diseases with the largest mortality were, according to priority, viral Hepatitis, AIDS, tuberculosis, rabies and syphilis, jointly accounting for 96.6% of the total reported deaths of Categories A and B infectious diseases.

  The reported morbidity of Categories A and B infectious diseases was 150.9/100,000 and their reported mortality was 0.8/100,000. The reported morbidity decreased by 8.8% and the reported mortality increased by 8.1% as against the previous year. Compared with the end of the “11th Five-Year Plan” period, the reported morbidity decreased by 43.9% and the reported mortality went down by 39.1%.

  In 2015, a total incidence of 74,895 cases of Category C infectious diseases was reported, including 2 cases of death. The top five reported diseases with the largest morbidity were, according to priority, other infectious diarrhea, hand-foot-and-mouth disease, influenza, epidemic parotitis and rubella, jointly accounting for 99.9% of the total reported cases of incidence. Two deaths were reported, caused by the hand-foot-and-mouth disease and influenza respectively.

  The reported morbidity of Category C infectious diseases was 348.1/100,000 and their reported mortality was 0.01/100,000. The reported morbidity decreased by 28.9% and the reported mortality went down by 71.9% as against the previous year. Compared with the end of the “11th Five-Year Plan” period, the reported morbidity decreased by 37.8% and the reported mortality by 91.4%.

  (2) Reported public health emergencies and the deaths

  There were no reports on major or higher-level public health emergencies in the city in 2015. A total of 21 public health emergencies were reported, all at the general level, with 300 cases of incidence and 8 deaths. Compared with the same period of last year, the number of reported incidents increased by 1, the number of patients decreased by 93 people, and that of deaths went up by 7.

  IV. Medical supervision

  In 2015, a total of 66,000 institutions in the city received supervision; in the whole year, regular health supervision was carried out for a total of 315,000 sites/times, with a qualification rate of 98.9%; there were 5,755 cases of administrative penalty as a result of the health supervision, with a total fine of 11.384 million yuan.

  (1) Health supervision over public places

  In 2015, a total of 29,000 institutions were under supervision in the city for the inspection of health conditions in public places; among the 202,000 employees of these institutions, 99.1% held the health certificate. In the whole year, regular health supervision was carried out at public places for a total of 126,000 sites/times, with a qualification rate of 98.6%; there were 2,430 cases of administrative penalty enforced according to law, with a total fine of 3.788 million yuan.

  (2) Health supervision over drinking water

  In 2015, a total of 10,000 institutions were under supervision in the city for the inspection of drinking water conditions, involving 23,000 employees of these institutions. In the whole year, regular health supervision over drinking water was carried out for a total of 37,000 sites/times, with a qualification rate of 99.5%, resulting in 784 cases of administrative penalty enforced according to law, with a total fine of 1.974 million yuan.

  (3) Health supervision over disinfection products

  In 2015, a total of 135 disinfection products-related institutions were under supervision in the city. Health supervision over disinfectant producers was carried out for a total of 295 sites/times, with a qualification rate of 99.56% and that over disinfectant dealers was conducted for a total of 437 sites/times, with a qualification rate of 100%.

  (4) Health supervision over schools

  In 2015, a total of 3,000 schools were under supervision in the city. In the whole year, regular health supervision was carried out for a total of 14,000 sites/times, with a qualification rate of 99.3%, resulting in 103 cases of administrative penalty enforced according to law.

  (5) Occupational health supervision

  In 2015, a total of 47 occupational health and technology-related institutions were under supervision in the city. In the whole year, regular health supervision was carried out for a total of 138 sites/times, with a qualification rate of 98.5%, resulting in 12 cases of administrative penalty enforced according to law, with a total fine of 100,000 yuan.

  (6) Health supervision over radiation

  In 2014, a total of 1,460 institutions were under supervision in the city for the examination of radiation; among the 210,000 employees of these institutions, radiation workers accounted for 3.7%. There were 170 cases of administrative penalty enforced according to law, with a total fine of 1.189 million yuan.

  (7) Supervision over medical services, blood collection and supply, and over the prevention and control of infectious diseases

  In 2015, health supervision and inspection over medical services, blood collection & supply, maternal & child health care and other sectors were carried out for a total of 50,000 sites/times, with a qualification rate of 99.3%, resulting in 628 cases of administrative penalty enforced according to law, with a total fine of 3.053 million yuan. In the whole year, health supervision and inspection over the prevention and control of infectious diseases were carried out for a total of 41,000 sites/times, with a qualification rate of 99.16%, resulting in 389 cases of administrative penalty enforced according to law, with a total fine of 592,000 yuan.

  (8) Health supervision over tobacco control

  From June 1 to December 31, the health supervisory authorities organized 86,000 persons/times for health supervision and law enforcement. During the period, inspection and supervision were carried out at public places for a total of 42,000 sites/times, and as a result, disqualifications were rated for 6,000 sites/times and the order for rectification were imposed for 6,000 sites/times; there were totally 288 cases of administrative penalty, with a total fine of 729,000 yuan; and 951 persons received administrative health penalty for illegal smoking, with a total fine of 49,000 yuan.

  V. Maternal and child health

  (1) Maternal and child health care

  In 2015, pregnant women’s prenatal examination rate was 99.98%, their postpartum visit rate was 97.55%, the systematic maternal management rate was 97.27%, and the hospital-based delivery rate was 100%, keeping unchanged over the previous year. In 2015, the systematic management rate for children under 3 years old reached 91.34%, up by 0.46% over the previous year.

  In 2015, the incidence of major birth defects was 16.37‰ among perinatal infants from registered permanent households, up by 16.76% over the previous year.

  (2) Children’s mortality

  According to statistics on maternal and child health monitoring, in 2015, the mortality was 3.02‰ for children under the age of 5 from registered permanent households in the city, and the figure was 2.42‰ for infants and 1.52‰ for the neonatal. The city's mortality of children under the age of 5, infants and neonatal ones continued to remain at a low level. The top five causes of death, according to priority, were: premature delivery of low birth weight, congenital heart diseases, birth asphyxia, other congenital anomalies and pneumonia, jointly accounting for 56.65% of the total infant deaths in the city.

  (3) Maternal mortality

  According to statistics on maternal and child health monitoring, the maternal mortality was 8.69/100,000 in 2015, indicating a slight fluctuation from the previous year, down by 28.42% as compared with the figure at the end of the “11th Five-Year Plan” period, namely, 12.14/100,000. The causes of these maternal deaths were: amniotic fluid embolism (36.36%), pregnancy associated with medical complications (27.27%), pregnancy with other diseases (27.27%), and obstetric bleeding (9.09%).

  VI. Mental health

  According to statistics in the annual report on the monitoring of severe mental diseases in 2015, there were 62,430 registered patients with mental disorders in the city, 57,909 patients with severe mental diseases (excluding the number of died patients), among which, 57,070 patients were diagnosed with such severe mental diseases as schizophrenia, persistent paranoid disorder, schizoaffective disorder, bipolar (affective) disorder (including manic episode), mental disorders caused by epilepsy, mental retardation associated with mental disorders. Noticeable results were generated in the management over and service for severe mental diseases; 88.7% of the registered patients were under management and the medical conditions of 98.6% kept stable, which meets with the work objectives required by the state.

  VII. Pre-hospital emergency treatment

  In 2015, the total number of admissions reached 589,000 in the city's emergency network comprising the 120 and Red Cross Emergency Rescue Centers, (including 505,000 admissions of ordinary people and 84,000 admissions of severely ill patients); the figure increased by 1,000 persons/times over the previous year, up by 0.2%.

  According to the analysis on the classification and composition of pre-hospital emergency treatment, the top five diseases in need of emergency treatment in 2015, according to priority, were circulatory system diseases, injuries and poisoning, respiratory diseases, digestive diseases and nervous system diseases.

  In 2015, the city newly set up and adjusted 16 first aid stations, and the total number of first-aid stations reached 299. Ambulances were sent for 628,000 times in the whole year, and 87.8% emergency calls were duly answered.

  VIII. Free blood donation, blood collection and supply

  In 2015, the number of free blood donation in the city totaled 403,000 persons/times, up by 6.1% over the same period last year; the collected blood measured 707,000 units in total, up by 7.3% over the same period last year.

  Statistical results produced on the basis of how the blood were collected are as follows: individuals donated 577,000 units of blood, accounting for 81.7% of the total blood collected, representing a year-on-year increase of 3.3%, while groups donated 68,000 units, accounting for 9.6% of the total blood collected, representing a year-on-year increase of 4%; blood donated on a mutually beneficial basis measured 62,000 units, accounting for 8.7% of the total blood collected, representing a year-on-year increase of 75.6%. 7,195 units of blood were transferred from other provinces, down by 49.3% on a year-on-year basis; 24,730 units of blood were transferred to other provinces, up by 22.8 times on a year-on-year basis. 670,000 units were donated for clinical and medical purposes (including: whole blood, red blood cells and platelets) million institutions, a year-on-year increase of 1.1%.

  IX. Medical services

  (1) Workload of outpatient and hospital services

  In 2015, the number of medical treatment in the city reached 235,016,000 persons/times and the number of discharged patients was 3.381 million persons/times. Compared with the previous year, the number of medical treatment increased by 1.4% and that of discharged patients rose by 68,000, or 2.1%. (See Table 2). Compared with the end of the “11th Five-Year Plan” period, the number of medical treatment increased by 71.308 million, or 48.8%, and that of discharged patients rose by 926,000, or 50.7%.

  In 2015, the number of medical treatment in hospital and the number of discharged patients in the city were 163.498 million persons/times (accounting for 69.6% of the treatment amount of the city's medical institutions) and 3.275 million persons/times (accounting for 96.9% of the discharged amount of the city's medical institutions) respectively, up by 1.4% and 3.2% as against the previous year. Compared with the end of the "11th Five-Year" period, the figures rose by 56.2% and 55.0% respectively.

  Table 3 The medical service workload of medical institutions in the whole city

   

  Table 3. The medical service workload of medical institutions in Beijing

  Unit: 10,000 persons/times

  Type of institutions

  Total number of diagnosed and treated persons/times

  Number of discharged patients

  Total of medical institutions

  2,3501.6

  338.1

  Hospitals

  16,349.8

  327.5

  Public hospitals

  14,870.1

  297.3

  Private hospitals

  1,479.7

  30.2

  Hospital class:

  Class-III hospitals

  11,974.9

  266.6

   

  Class-II hospitals

  3,082.6

  44.7

   

  Class-I hospitals

  1,154.8

  13.5

   

  Unrated hospitals

  137.4

  2.7

  Hospital type:

  Comprehensive hospitals

  10,971.2

  342.9

   

  TCM hospitals

  3,674.7

  33.4

   

  Specialized hospitals

  1,703.8

  51.2

   

  Nursing centers

  0.1

  0.0

  Community health service centers/stations

  4,890.2

  2.2

  The total number of medical treatment by community health service centers/stations in the city reached 48.902 million (accounting for 20.8% of the treatment amount of the city's medical institutions), and the number of discharged patients was 22,000 (0.6% of the discharged amount of the city's medical institutions), up by 0.7% and down by 6.7% respectively as against the previous year, and up by 60.6% and down by 41.7% compared with the end of the "11th Five-Year" period.

  (2) The use of beds

  In 2015, the utilization ratio of registered beds in the medical institutions in the city was 71.8% (and that ratio of actual beds reached 78.4%), of which 75.5% were in hospitals (the utilization ratio of actual beds was 80.6%) and 20.2% were at community health service centers (the utilization ratio of actual beds was 32.3%). The ratio in the city’s medical institutions was lowered by 1.8 percentage points for registered beds (and by 2.6 percentage points for actual beds) as against the previous year, and the ratio in hospitals went down by 1.8 percentage points (and by 2.4 percentage points for actual beds). Compared with the end of the “11th Five-Year Plan” period, the ratio of medical institutions in the city was lowered by 5.7 percentage points (and by 3.8 percentage points for actual beds), and the ratio in hospitals went down by 6.4 percentage points (and by 3.9 percentage points for actual beds).

  The average length of stay in the city's medical institutions (excluding psychiatric hospitals) in 2015 was 10.1 days, a decrease of 0.1 day over the previous year or down by 2.8 days compared with the end of the “11th Five-Year Plan” period.

  (3) Doctors’ workload

  In 2015, the average medical workload of doctors in the city's medical institutions was 10.7 persons/times each day plus a hospital stay for caring 1.0 bed/day, down by 0.4 person/time and 0.04 bed/day over the previous year respectively, or up by 1.7 persons/times and down by 0.1 bed/day compared with the end of the “11th Five-Year Plan” period.

  Table 4. The workload of doctors in hospitals

  

  Average number of diagnosed and treated persons/times per doctor every day

  Average number of cared beds per doctor every day

  Hospitals

  10.5

  1.5

    Public hospitals

  11.9

  1.7

    Private hospitals

  6.4

  1.0

  Hospital class: Class-III hospitals

  11.9

  1.6

  Class-II hospitals

  9.9

  1.4

  Class-I hospitals

  6.6

  1.0

     Hospital type: Comprehensive hospitals

  10.6

  1.4

     医院分类TCM hospitals

  14.2

  1.4

     Hospital type:  Specialized hospitals

  8.3

  2.3

  Community health service centers

  16.7

  0.1

  (4) Patients’ medical expenditure

  In 2015, the average medical expenditure for an outpatient in the city's Class-II or higher-level public hospitals was 436.9 yuan per time (at the price level of the said year, the same below), up by 3.8% over the previous year regardless of the factors related to price increase, and compared with the end of the “11th Five-Year Plan” period, it went up by 11.9%. In that amount, the average cost for an outpatient’s medication was 261.7 yuan per time, up by 1.7% over the previous year, or 3.2% as compared with the end of the “11th Five-Year Plan” period.

  In 2015, the average medical expenditure for an inpatient in the city's Class-II or higher-level public hospitals was 20,513.4 yuan, up by 4.7% over the previous year or 8.1% compared with the end of the “11th Five-Year Plan” period. In that amount, the average cost for an inpatient’s medication was 6,551.0 yuan, up by 1.4% over the previous year, or down by 9.7% as compared with the end of the “11th Five-Year Plan” period. (See Table 4)

  In 2015, the medication expenditure of outpatients in the city's Class-II or higher-level public hospitals accounted for 59.9% of their medical expenditure, down by 1.2[VF2] % over the same period of the previous year or by 5.1% compared with the end of the “11th Five-Year Plan” period; the medication expenditure of inpatients accounted for 31.9% of their medical expenditure, down by 1.1 percentage points over the same period of the previous year or by 6.3 percentage points compared with the end of the “11th Five-Year Plan” period. The proportion of outpatients and inpatients’ medication expenditures in Class-II and Class-III hospitals decreased to different degrees.

  In 2015, the average medical expenditure for an outpatient at the city's community health service center was 195.9 yuan per time, up by 10.3% over the previous year; and in that amount, the average cost for an outpatient’s medication was 169.5 yuan, up by 9.9% over the previous year. At the center, the average medical expenditure for an inpatient was 7,342.9 yuan per time, up by 18.1% over the previous year; and in that amount, the average cost for an inpatient’s medication was 2,963.7 yuan, up by 10.5% over the previous year.

  In 2015, the medication expenditure of outpatients at the city's community health service centers accounted for 86.6% of their medical expenditure, indicating the proportion went down by 0.3 percentage points on a year-on-year basis; the medication expenditure of inpatients accounted for 40.4% of their medical expenditure, indicating the proportion went down by 3.0 percentage points on a year-on-year basis.

Table 5. The average medical expenditure of outpatients and inpatients at Class-II or higher-level public hospitals in Beijing from 2014 to 2015

  Item

  Public hospitals

   

  Class-III hospitals

  Class-II hospitals

  2015

  2014

  2015

  2014

  2015

  2014

  Average medical expenditure of outpatients per time (RMB)

  436.9

  413.7

  462.8

  443.7

  339.9

  319.1

  Increase in outpatient expenditure (%)

  3.8

  3.5

  2.5

  1.4

  4.6

  5.6

  Average medical expenditure of inpatients per capita (RMB)

  20513.4

  19241.8

  21255.3

  20100.5

  15974.6

  14884.8

  Increase in inpatient expenditure (%)

  4.7

  2.4

  3.9

  0.1

  5.4

  9.6

  X. TCM services

  By the end of 2015, there were a total of 187 TCM hospitals in the city, of which: 26 were Class-III, 26 were Class-II, 132 were Class-I, and 3 were unrated hospitals; 52 were public and 135 were private; 158 were TCM hospitals, 26 practiced both TCM and Western medicine in an supplementary manner, and 3 were ethnic hospitals. In the city, there were a total of 211 TCM outpatient departments and 612 TCM clinics. TCM-based institutions accounted for 9.8% of the city’s total.

  In 2015, according to preliminary statistics, each doctor in the city's TCM hospital engaged in outpatient services for 14.2 persons/times each day and took care of 1.4 hospital beds per day. The city's various medical institutions at all levels provided TCM emergency and outpatient services for a total of 52.475 million passengers, up by 3.9% over the previous year. TCM hospitals discharged a total of 334,000 persons/times, an increase of 7.4% over the previous year. Among them, the amount of outpatient and medical emergency services reached 36.747 million persons/times in TCM hospitals, 6.883 million persons/times at the TCM clinic departments of Class-II and Class-III general hospitals, and 8.845 million persons/times in community health service institutions.

  In 2015, In 2015, the average medical expenditure was 394.9 yuan per time for an outpatient, and 16,737 yuan for an inpatient patient at the city's TCM hospital.

  By the end of 2015, the city's various types of TCM hospitals at all levels had a total of 22,140 registered beds, accounting for 20.4% of the city’s amount, up by 15.5% over the previous year; the number of actual beds was 19,810 in total, accounting for 18.9% of the city’s whole.

  XI. Operations of new rural medical cooperatives

  In 2015, 2,239,353 people in the city participated in new rural medical cooperatives, and the participation rate of the agricultural population reached 99.3%, up by 2.6% compared with the end of the “11th Five-Year Plan” period.

  In 2015, the city actually raised 2,911.244 million yuan of funds for the new rural cooperatives, an increase of 1,364.278 million yuan compared with the end of the "11th Five-Year" period. In the amount, 2,503.435 million yuan was subsidies allocated by the local government, 355.916 million yuan was paid by individual farmers, and 51.892 million yuan was interest and other income.

  In 2015, the total compensation for new rural cooperatives in our city was 2,636.505 million yuan, an increase of 1,096.503 million yuan compared with the end of the “11th Five-Year Plan” period, up by 71.2%. In that amount, the inpatient compensation was 1,671.830 million yuan, up by 64.7%, and outpatient compensation reached 720.028 million yuan, up by 51.0% compared with the end of the "11th Five-Year" period.

  In 2015, the total inpatient expenditure of new rural cooperatives in our city was 3,344.115 million yuan, with a compensation of 1,671.830 million yuan, and the actual inpatient-to-compensation ratio was 50.0%; the total outpatient expenditure was 1,985.387 million yuan, with a compensation of 720.028 million yuan, and the actual outpatient-to-compensation ratio was 36.3%.

  XII. Family planning

  In 2015, the family planning rate among registered permanent households was 98.1% in the city, up by 1.5% compared with the end of the "11th Five-Year" period. Specifically, the rate was 98.6% for non-agricultural registered permanent households, public by 1.1% compared with the end of the “11th Five-Year Plan” period; the rate was 93.6% for agricultural registered permanent households, up by 0.8%. The rate for receiving the only-child birth permit was 41.2% in the city's registered permanent households, down by 15.8% compared with the end of the "11th Five-Year" period. Among those registered permanent households, the rate for non-agricultural ones was 36.6%, down by 18.9% compared with the end of the “11th Five-Year Plan” period; and the rate for agricultural ones were 57.5%, down by 2.8%.

   

  

  Brief Notes and Explanation of Key Statistical Indicators

  Brief Notes:

  I. This report mainly introduces the resources of various medical and health care institutions at all levels in the city, the utilization of medical services, major health indicators, health and epidemic prevention, maternal and child health, supervision and law enforcement, and other information. The figures for the indicators of "health resources" and "medical services" are based on complete enumeration, for which the main source of data are the annual statistical yearbooks on the health resources, while the other figures are from various departments, offices and directly subordinate institutions of the Beijing Municipal Health Bureau. The data on the numbers of institutions, medical personnel and medical service workloads from 2012 to 2014 include the data on patients from 15 local military hospitals based in Beijing. The data on the numbers of institutions, medical personnel and medical service workloads for 2015 include the data from 15 military hospitals and 4 armed police hospitals based in Beijing.

  II. The data in this report are based on statistics worked out in line with the requirements of the National Regulations on Health Statistics and Survey. The sources for the statistics are organizations that have obtained the Practicing Permit for Medical Institutions from the administrative authorities for medicine, civil affairs, industries, commerce, and those for the management of institutional registration, and that provide health care, disease control, health supervision services for the community or engage in medical research, on-the-job medical training and other undertakings.

  III. As of the year 2011, the number of village clinics in this report has been included in the total number of medical and health care institutions (and it will no longer be listed separately). Comparisons of data for the same periods of the years are adjusted accordingly.

  IV. The number of personnel in village clinics (including rural doctors, medical personnel, practicing doctors, practicing assistant doctors, and registered nurses) is included in the total number of health personnel.

  V. As a result of policy adjustments in the end of the “11th Five-Year Plan” period, a large number of specialized psychiatric hospital are turning over long-term hospitalized patients in recent years, resulting in fluctuations in the average hospitalized day of discharged patients over these years, therefore in this report, all the sums and totals involving the average inpatient days (including the total of the average inpatient days, the sum of the average inpatient days in general hospitals, and that in specialized hospitals for the same periods of all the years) were adjusted to exclude the figures of specialized psychiatric hospitals.

  Explanation of Key Indicators

  Medical and health care institutions: refer to organizations that have obtained the Practicing Permit for Medical Institutions from the administrative authorities for medicine, or have obtained the Registration Certificate of Legal Entities from authorities for civil affairs, industries, commerce, and those for the management of institutional registration, and that provide health care, disease control, health supervision services for the community or engage in medical research, on-the-job medical training and other undertakings. These institutions include hospitals, sanatoriums, community health service centers/stations, treatment centers, outpatient departments, clinics, emergency centers/stations, blood collecting and supplying institutions, maternal and child health hospitals/institutes/stations, specialized hospitals/institutes/stations for disease prevention and treatment, centers for disease control and prevention (epidemic prevention stations), health supervision institutes/centers, institutions for health supervision and inspection (monitoring and testing), medical research institutes, medical on-the-job training institutions, health education institutes/centers and other health care institutions. The number of village clinics is included in the total number of medical institutions (without being separately calculated any more).

  Medical institutions: refer to organizations that have obtained the Practicing Permit for Medical Institutions from the administrative authorities for medicine, including hospitals, sanatoriums, community health service centers/stations, village and township (residential community) treatment centers, outpatient departments, clinics, maternal and child health hospitals/institutes/stations, specialized hospitals/institutes/stations for disease prevention and treatment, emergency centers/stations and clinical testing centers. The number of village clinics is included in the total number of medical institutions (without being separately calculated any more).

  Hospitals: including general hospitals, TCM hospitals, integrated TCM and Western medicine hospitals, ethnic hospitals, all kinds of specialized hospitals and nursing homes, excluding specialized hospitals for disease prevention and treatment, maternal and child health hospitals, and sanatoriums.

  Public hospitals: refer to hospitals that are wholly state-owned or collectively owned in terms of their economic type.

  Medical and health care institutions at the grassroots level: including community health service centers/stations, township treatment centers, residential community treatment centers, outpatient departments, clinics, village clinics.

  Medical personnel: refer to employees at medical and health care institutions, who are generally counted as paid on-the-job employees in the statistics, including officially registered, contracted personnel, re-employed and temporarily hired personnel (for more than half a year), but excluding retired, resigned personnel and those who have left the employer institutions but still retain the labor relations and those who have been re-employed for not more than six months. They specifically include medical technicians, other technical staff, managerial personnel, workers with specialized skills, rural doctors and medics.

  Medical technicians: including practicing doctors, practicing assistant doctors, registered nurses, pharmacists, examiners, imaging technicians, health supervisors, and probationary pharmacists/nurses/technicians), and other specialized health care personnel, but excluding technicians engaged in management (such as hospital directors, vice hospital directors, party secretary, etc.).

  Practicing (assistant) doctors and registered nurses: They are all counted as the persons who hold the certificate of practicing doctors or nurses and engage in clinical work, excluding doctors and nurses responsible for management. They include practicing (assistant) doctors and registered nurses in village clinics.

  Number of registered beds: The number of beds that are assessed and approved by the health administrative authorities.

  Number of actual beds: refers to the fixed number of beds that are actually counted in the year end, including regular beds, simple beds, nursing beds, extra beds added for more than six months, beds under disinfection and repair, and beds out of use due to expansion or overhaul, but excluding obstetric neonatal beds, prenatal beds at the delivery room, beds in the inventory, beds for observation, temporarily added bed and beds for the patient's family to take care of the patients.

  Number of medical technicians per 1,000 persons = Number of medical technicians / population × 1000.

  Number of practicing (assistant) doctors per 1,000 persons = (Number of practicing doctors + number of practicing assistant doctors) / population × 1000.

  Number of registered nurses per 1,000 persons = Number of registered nurses / population × 1000.

  Number of registered beds per 1,000 persons = Number of registered beds in the medical institutes of the city / population × 1000.

  Number of actual beds per 1,000 persons = Number of actual beds in the medical institutes of the city / population × 1000.

  Total number of diagnosed and treated persons/times: refers to the total number of all the diagnoses and treatment sessions. The number is calculated on the basis of the number of outpatient registration, including: (1) the number of patients’ visits to the hospital’s outpatient and emergency departments; (2) the number of doctors’ diagnoses; (3) the number of persons/times for single-item health examination and consultancy; (4) the number of patients without registration, diagnoses for personnel working in the same medical institutions or free diagnosis and treatment services by these personnel in outside institutions, for whom the statistics is worked out on the basis of the actual visits for diagnosis and treatment. If a patient has visited the doctor only once but registered for a number of times, the statistics shall be made in line with the actual number of treatment; such cases do not include various examinations, treatment, disposal as suggested by doctors.

  Number of discharge patients: The number of persons discharged after their hospitalization. The patients include: those who are discharged after normal childbirth, non-birth hospitalization, diagnosis and examination that indicate no diseases; those who are discharged without treatment; and healthy persons who are normally discharged after an induced abortion or sterilization surgery.

  Total mortality of residents: refers to the average number of deaths per 1,000 persons at a place in a given year, reflecting the overall death level of residents.

  Actual bed occupancy rate = Actual number of days for beds occupancy / actual number of days for bed opening × 100%.

  Registered bed occupancy rate = Actual number of days for beds occupancy / (number of registered beds × 365) × 100%.

  Turnover rate of actual beds = Number of discharged patients / average number of open beds.

  Average number of open beds = Total number of days for actual open beds / 365.

  Turnover rate of registered beds = Number of discharged patient / number of registered beds.

  Average length of inpatient stay = Total number of days for beds occupied by discharged patients / number of discharged patients.

  Average number of diagnosed and treated persons/times per doctor every day = (Number of diagnoses and treatment sessions / number of doctors) / 251.

  Average number of cared beds per doctor every day = (Total number of actual days for bed occupancy / number of doctors) / 365.

  Infant mortality = Number of infant deaths / live births × 1,000‰.

  Maternal mortality = Number of pregnant and lying-in women’s deaths / number of live births × 100,000. The fraction 1/100,000 is generally used as the unit.

  Life expectancy: also known as the average life expectancy, it refers to the life expectancy since the age of 0. It indicates how long the persons at the age of X may continue to live in average at a certain death level. "Year" is generally used as the unit.

  Morbidity of statutorily reported Categories A and B infectious diseases = Number of incidence cases of statutorily reported Categories A and B infectious diseases / population ×100,000/100,000.

  Mortality of statutorily reported Categories A and B infectious diseases = Number of deaths of statutorily reported Categories A and B infectious diseases / population × 100,000/100,000.

  Fatality rate of statutorily reported Categories A and B infectious diseases = Number of deaths of statutorily reported Categories A and B infectious diseases / number of incidence cases × 100%.

  Family planning rate = Number of births that meet the requirements of family planning in a period / number of births in the same period.

  Rate for receiving the only-child birth permit= Number of women at the child-bearing age who have given birth to a child and received the only-child birth permit / number of married women at the child-bearing age.

  ________________________________________

  [1] In the figure, the number of institutions, the number of medical personnel and the medical service workload from 2012 to 2014 include the data on patients from 15 military hospitals based in Beijing, and the data for 2015 include both the above and the additional data from 4 armed police hospitals based in Beijing, representing all the data on the resources and service workload in Beijing. Comparisons of full-text data are based on the same criteria.