Duke aims to help Chinese health care

What started about 10 years ago as a conversation between Duke University Medical Center and high-level Chinese officials is developing into a full-fledged partnership.

This week, representatives of both groups are dissecting China's most prestigious health-care system, Peking University Health Science Center, looking for ways to improve medical-service delivery in the world's most populous country.

The Peking system is made up of eight hospitals and 11 schools enrolling more than 10,000 students. It has 57 accredited doctoral programs.

The system already works with Duke in the training of cardiologists. Officials from both delegations are hoping that this week's discussions will lead to broader agreements in other areas. Partnerships in cancer research seem to be a natural area for collaboration, said Peking University's chancellor, Ke Yang.

In a larger sense, the discussions are an extension of Duke's global outreach. The school has a formal partnership, for example, with the National University of Singapore Graduate Medical School on that nation's Outram campus.

China, however, presents many more opportunities.

"Why would Duke do this? Why wouldn't we do it? " asked Robert Taber, Duke University's vice chancellor for corporate and venture development. "We have an opportunity here to play a part in transforming China's system of health care."

Senior officials of the Chinese system spent much of Tuesday morning detailing the state of their teaching hospitals, which provide the top level of care in the country.

Founded in 1903, the hospitals that are part of the Peking University Health Science Center were owned and operated by the government until China began to convert itself to a market-driven economy.

The government still owns the hospitals, but it has dramatically cut funding to spend more on rural health centers. Government regulations limit how much hospitals can charge patients. The changes have created a wildly uneven system of care.

Still, in some cities, patient facilities match the quality found anywhere in the world.

Looking to cut costs

However, half of China's rural population has no access to hospital services. More than half of China's urban population and a majority of its rural population are uninsured. That helps explain why the delegation is particularly interested in cutting costs by making the health-care system more efficient. Even though the hospitals are part of the same system, for example, they operate independently of one another.

"Our economic success has not brought about a better health-care system yet," Ke said.

The Chinese officials offered a plain-spoken explanation of how they sometimes cover costs in this patchwork approach to care. They make heavy use of high-tech equipment for which they can charge larger fees, and they rely on prescription-drug profits.

"The cuts from the government kill us," said Wang Shan, president of People's Hospital in Beijing.

Still, the Chinese delegation is proud of the country's health-care accomplishments, pointing out places where it would be difficult to distinguish a Chinese hospital from its U.S. counterpart.

"Right down to the lobby, they look the same," Wang said.

The challenge is spreading that quality across a vast country with different customs, regulations and expectations.

"You can only learn so much from our descriptions," said You Wei-cheng, president of Beijing Cancer Hospital. "You must visit us now to really know."

It's an invitation Duke leaders are likely to accept.