There is a shortage of talents in this profession, and the monthly salary of private hospitals is 50,000 people!

On January 20, the Affiliated Rehabilitation Hospital of Nanchang University was officially established, which is the first tertiary public rehabilitation hospital in Jiangxi Province.

On December 10, 2021, the hospitals directly under hubei province held the unveiling activity of "Hubei Provincial Rehabilitation Hospital", which is also the first tertiary rehabilitation specialized hospital directly under the Hubei Provincial Health Commission.

It is understood that the predecessor of the hospital was the Hubei Provincial People's Government Health Center, which was established in June 1949. In October 2021, the Hubei Provincial Health Commission approved the hospital to add the "Hubei Provincial Rehabilitation Hospital" brand and approved the practice of tertiary specialized hospitals, which marked the successful transformation and upgrading of the hospital from a secondary general hospital to a tertiary specialized hospital.

In recent years, the development of rehabilitation hospitals has accelerated significantly, but the speed of private hospitals is much higher than that of public hospitals. According to statistics, as of 2020, there are 739 rehabilitation hospitals in the country, of which 573 are private hospitals, accounting for 77.54%, and only 166 public rehabilitation hospitals, with a slow growth rate in the past decade.

Four disciplines, including rehabilitation medicine and health medicine, preventive medicine, and therapeutic medicine, constitute a modern medical system.

However, for a long time, the concept of "emphasizing treatment over rehabilitation" has been restricting the development of the industry.

Compared with clinical medicine, rehabilitation medicine has not gained its rightful place.

Compound growth rate of rehabilitation industry exceeds 20%

In recent years, the rehabilitation industry has entered a period of policy dividends, and the continuous top-level design has provided a catalyst for the rapid development of the industry.

In June 2021, the National Health Commission and eight other ministries and commissions issued the Notice on Printing and Distributing Opinions on Accelerating the Development of Rehabilitation Medical Work, which gave specific guidance on discipline construction and talent reserves.

In October 2021, the National Health Commission issued the Notice on Carrying Out Pilot Rehabilitation Medical Services, which identified 15 pilot areas for rehabilitation medical services.

In November 2021, the State Council issued the Opinions on Strengthening the Work on Aging in the New Era, proposing to "implement a national strategy to actively address population aging". Tianfeng Securities believes that the rehabilitation industry is an important part of the strategy.

The driving force comes from the continuous improvement of actual demand, and the market size of the rehabilitation industry is expanding at an alarming rate. Between 2014 and 2019, the total number of patients in rehabilitation hospitals in mainland China showed an overall upward trend. Among them, the total number of patients in mainland China in 2019 reached 11.497 million, an increase of 12.0% year-on-year, and the growth rate was a new high in the calendar year.

A report from KPMG pointed out that the total consumption of China's rehabilitation medical market in 2018 was about 58.3 billion yuan, and the agency predicts that the market size will reach 103 billion yuan in 2021 and further increase to 220.7 billion yuan in 2025. The compound growth rate from 2018 to 2025 is 20.9%.

In addition, according to KPMG, the current per capita rehabilitation cost in mainland China is $5.50, which is still nearly 10 times more space than the per capita consumption of $54 in the United States.

Private rehabilitation hospitals dominate

The significance of rehabilitation treatment for patients is that it can speed up the progress of recovery of their physical functions and effectively reduce the recurrence rate. At the same time, it can also save patients overall treatment costs.

According to the research results of the Swiss authority, in the field of rehabilitation, every 1 euro of investment will bring 5 euros of social return value.

It is also out of the expectation of high return on investment that the development of rehabilitation hospitals has accelerated significantly in recent years, especially the speed of private hospitals is much higher than that of public hospitals.

According to statistics, as of 2020, there are 739 rehabilitation hospitals in the country, of which 573 are private hospitals, accounting for 77.54%, and only 166 public rehabilitation hospitals, with a slow growth rate in the past decade.

In the "2021 China Rehabilitation Industry Research Report" previously released by the health industry, it was pointed out that social capital prefers the gap area of the public medical system and the field of specialized hospitals. Compared with public general hospitals, rehabilitation specialist hospitals have a single bed investment, a lower degree of dependence on doctors, and a smaller medical risk, so it is easier for social capital to achieve the expected return on investment.

Bi Sheng, executive vice chairman and secretary general of the Rehabilitation Medicine Professional Committee of the China Non-public Medical Association, told the health community, "The threshold of rehabilitation is relatively lower than that of clinical practice, and there is still a certain gap between the service level of public hospitals and private hospitals, which is the fundamental reason why the latter can dominate the industry."

In recent years, as China has begun to advocate the concept of "great health", the rehabilitation industry, which is in the middle of the entire chain, has a very important position.

Bi Sheng believes that "the importance of the rehabilitation industry should be ranked among the top three among all specialist hospitals."

"At present, many public hospitals have also begun to gradually increase their support in this area. In fact, in some public hospitals with better service levels, the penetration rate of rehabilitation departments is still very high. In the future, with the improvement of public hospital awareness, the pattern dominated by private hospitals is expected to change." Bi Sheng said.

The rehabilitation industry is facing a talent crisis

The rehabilitation industry has obvious interdisciplinary attributes, and in the treatment stage, it is necessary to involve the coordination of neurology, orthopedics, cardiovascular, internal medicine and other departments.

However, it is precisely for this reason that while the industry is making great strides forward, there are also many problems that need to be solved urgently.

According to public data from the China Health Statistics Yearbook, as of the end of 2018, the number of rehabilitation specialized hospitals in China accounted for only 8.1% of the total number of specialized hospitals, and the number of beds accounted for only 2.9% of the total number of beds. In addition, practicing physicians account for only 1.0% of the number of practicing physicians in specialist hospitals.

In June 2021, in the "Opinions on Accelerating the Development of Rehabilitation Medical Work", it was pointed out that by 2022, the proportion of rehabilitation physicians and 10 rehabilitation therapists per 100,000 population should be 6. By 2025, there will be 8 physicians and 12 therapists per 100,000 population.

According to the above goals, China's rehabilitation industry is clearly facing a talent "crisis".

According to the China Health Statistics Yearbook, there are 49,000 rehabilitation practitioners (assistants) in China in 2020.

According to the calculation of 8 rehabilitation physicians per 100,000 population in 2025, there is still a talent gap of 52,000 people.

Talent is currently a "scarce resource" for the rehabilitation industry.

Some insiders pointed out that the talent problem also exists in the European and American markets, and the most effective solution is to increase the salary of practitioners.

Checking the recruitment information of Liepin.com, it can be found that in the northern, upper, broad and deep regions, rehabilitation therapists with 3 to 5 years of experience in Beijing can reach a monthly salary of between 15,000 and 20,000; rehabilitation physicians with 5 to 10 years of experience in Shenzhen can earn a monthly salary of 30,000 to 40,000, while the monthly salary of more than 10 years of experience can reach 50,000.

Image source: Network

China's rehabilitation industry is still in the exploratory stage

"In fact, the rehabilitation industry should first solve the problem of quantity, but quality." Bi Sheng stressed.

"The talent shortage is difficult to solve quickly in a short period of time." Bi Sheng believes that according to international practice, the ratio of rehabilitation physicians to therapists should be around 1:10. And compared with the proportion of rehabilitation physicians in the United States, "China is not significantly lagging behind."

However, American rehabilitation physicians must undergo "elite training" if they want to practice.

"Rehabilitation physicians on the mainland rarely undergo rigorous specialist training. In many hospitals, the director of the rehabilitation department does not even have the relevant experience in the industry." Bi Sheng said. It can be seen that the industry has not paid sufficient attention to the rehabilitation industry, which is not conducive to the development of the industry in the long run.

For the current situation of the industry, Bi Sheng called for the development of employment standards from the national level as soon as possible and the threshold for access should be raised.

In fact, compared with European and American countries, China's rehabilitation industry is still in the "exploration stage".

The United States began to develop the rehabilitation industry in 1917. In Germany, the industry has been booming since World War II. In China, the introduction of rehabilitation medicine began in the 1980s.

Therefore, historically, China has been half a century later than European and American countries since its inception.

In addition, the penetration rate of China's rehabilitation industry is still low, which is not unrelated to the traditional concept of "heavy treatment over rehabilitation".

In China, there are about 13 million stroke patients, and more than 3 million new patients are added every year, but the early recovery rate of stroke patients is very low. Data show that only 10% of such patients receive rehabilitation within a week, while about 40% of patients still do not receive any rehabilitation.

According to Ping An Securities, the overall penetration rate of rehabilitation treatment for disabled patients in mainland China is 42%; for the elderly over 65 years old, 10%; and for postpartum women, the penetration rate is only 3%.

By disease, orthopedic-grade penetration is the highest, but only 20%; for heart disease patients, rehabilitation treatment is almost non-existent.

The concentration of head enterprises will increase

In fact, the development of the rehabilitation industry also has a strong positive correlation with economic growth.

According to the statistics of Ping An Securities Research Report, there is a serious regional imbalance in the development of the rehabilitation industry in the mainland. In 2019, the number of rehabilitation beds in Guangdong Province was 12,300, compared with only 354 in Tibet, and there is a huge gap in the number of the two. In terms of the number of rehabilitation beds per capita, the difference between Tibet and Zhejiang is nearly 9 times.

Bi Sheng also pointed out that the sustained growth of China's economy has provided the most solid foundation for the rapid development of the rehabilitation industry. Especially in the Yangtze River Delta and Pearl River Delta regions, the development of the rehabilitation industry is relatively advanced.

In addition, the choice of payment method plays a key role in the development of the rehabilitation industry.

At present, the U.S. rehabilitation industry has entered the FIM-FRGs payment stage. This method can give different payment standards according to the situation and age, group and classify patients, and then determine the cost quota based on the length of hospital stay, and can be paid in advance.

Ping An Securities believes that the reason why the rehabilitation industry in the United States can enter a stage of high-quality development is inseparable from the changes in its payment methods.

In addition, from the perspective of the industry system, the United States has basically formed a three-level rehabilitation system, which can fully cover the rehabilitation needs of patients at different times. In addition, U.S. rehabilitation facilities have community clinics, rehabilitation clinics, and home care to provide patients with non-inpatient rehabilitation services.

It is worth noting that the head rehabilitation medical institutions in the United States have appeared in the form of chains.

Take Encompass Healthcare Group, which ranks first in the United States in terms of size. As of 2020, the company has 137 hospitals and 241 home care facilities with a total of 9,505 beds.

Ping An Securities pointed out in the research report that based on the population base of 1.41 billion in the mainland, the demand for rehabilitation nursing beds is about 710,000. As of 2019, the total number of rehabilitation medicine beds in mainland China is only 270,000, with a gap of more than 440,000, with a broad space for growth.

Ping An Securities judged that in the future, if the chain development model is adopted, the market concentration of head enterprises is expected to continue to increase.

Sources | the health community

Written by | Zhao Yang