The medical examination center is becoming the "fragrant food" of public hospitals.
Private physical examination institutions have developed to a white-hot stage, from the previous "darling" to the "abandoned son" of capital; and the physical examination centers of public hospitals have also mushroomed, with a large number of civil engineering, relocation, upgrading, reorganization and decoration, and expansion of the territory.
The president of a second-level hospital in Henan, who visited and studied for a year, finally made up his mind to take out 15 million. In June 2021, the physical examination department of the county hospital became a four-story independent physical examination center, and the revenue rose by 250%;
A county hospital in Shandong upgraded the physical examination department to a health examination center. After the upgrade in 2019, the operating flow of the health examination center increased from 2 million to 12 million;
In the past ten years, the health management center of a top three hospital in Beijing has developed from more than a dozen small bungalows with steel plates to a 4-story health management center of 1500 square meters, serving more than 60,000 people every year, the annual revenue of the department accounts for 10% of the total revenue of the hospital, and the net profit is the first in all departments;
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Eight Points of Health Interview found that the physical examination department of public hospitals has undergone dramatic changes.
For many years, the physical examination department in the hospital is more like a "should be a scene" existence, is a marginal department. Nowadays, the physical examination department has become an important business growth point of the hospital and has become impossible to ignore.
Some papers pointed out that in the economically developed cities of the south, the income of public hospital physical examination centers accounts for 20% of the total income of hospitals. Not only has the personnel and area expanded several times, but also more and more attention has been paid by the hospital leaders; even in some hospitals, the physical examination department is independent from the main body of the hospital and develops outside the hospital, and the department has independent houses, equipment, and personnel.
"At that time, as soon as we had the opportunity, we pulled the dean to participate in the academic conference of the physical examination, and the dean gradually realized that the health management center of a hospital not only assumed the responsibility of physical examination, but even could drain the hospital and become a signboard." Zhou Ren, director of the physical examination center of a public hospital in Beijing, told Eight Points.
Especially after the new crown epidemic, the trend of "physical examination fever" began to sink from large hospitals to ordinary municipal and county-level hospitals.
The most profitable department
Public hospitals have increased investment and laid out physical examination centers, which is not a whim.
In terms of revenue share, Zhou Ren admitted that the annual revenue of the physical examination center he worked for accounted for about 10% of the hospital's total revenue, and the net profit was the highest in all departments.
In this proportion, many experts almost all told Eight Points Jianwen that the income of the physical examination center accounts for about 10% of the total income of public hospitals, which is a common phenomenon.
Obviously, "the larger the public hospital, the lower the proportion of the health management center in the total revenue of the hospital." Dr. Zhuang Yiqiang, director of GAHA of Guangzhou Elippi Hospital Management Center, analyzed. But even so, Guo Zhizhi, director of the Shanghai International Medical Center's physical examination center, said that the proportion of his hospital was 10%.
An institutional person who has long served in the physical examination center of public hospitals revealed to Eight Points Health News that the annual physical examination revenue of a third-class hospital in Shenzhen is as high as more than 200 million.
10% of the income ratio, for any public hospital with at least 20 or 30 departments, can not be ignored. For the revenue business of the independently built physical examination center, it also generally shows a growth of 100% to 150%, which is popular for any physical examination center.
The paper "Competitive Environment and Strategy of the Military Hospital Physical Examination Center" mentioned that the physical examination center of the 180th Hospital of the People's Liberation Army in 2008 through the analysis of the marketing environment, targeted marketing strategies, while the physical examination environment was transformed, in 2009 the physical examination volume of nearly 60,000 people, an increase of 58% year-on-year, the growth rate of physical examination income was 105.12%; the total profit, per capita profit ranked first in the hospital.
In addition to the relatively high proportion of revenue, the president of a county hospital in Shandong said that many physical examinations are cash, do not take medical insurance, this income in the hospital is basically pure income, high profits, but also let the county hospital that does not have too many patients, the focus of attention on the physical examination center is full.
On the other hand, with the gradual advancement of the comprehensive reform of public hospitals, the income structure of public hospitals is undergoing great changes.
The difference in financial subsidies to public hospitals cannot meet the needs of public hospitals. Judging from the statistical results of 2017, the state's financial subsidies to public hospitals have always remained at about 8%, which is far from the general expectation of 15%.
Since then, policies such as collection and zero addition of pharmaceutical consumables have sharply reduced the income of hospitals. Public data show that during the two sessions in 2013, Wang Jianfei, vice president of the Xianju County People's Hospital in Zhejiang Province, said that the hospital's income gap after zero addition was 120 million.
Beijing has costed medical projects in 8 public hospitals, all of which have shown serious losses, and nearly half of them are policy losses. In the face of a sudden sharp decline in income, many hospitals seemed a little caught off guard.
In this context, finding new revenue points is the only choice for public hospitals.
"The hospital also hopes that each department will create more value, and the higher the net profit of which department, the higher its absolute value, and the president will definitely pay more attention to it." Zhou Ren told Eight Points.
From "waiting for the patient in the clinic" to "going out to run the customer"
Unlike other departments that "sit in the consultation room and wait for patients", the physical examination center needs to "take the initiative to go out and find customers".
Although from the perspective of the national market share, the physical examination center of public hospitals accounts for 70% of the total, which is in an absolute advantage, but public hospitals also need to fight with private institutions.
Jin Dongsheng, director of the physical examination center of a county hospital in Henan, "spit bitter water" to eight points of health:
"Not only is there competition from the municipal physical examination center, but also in the urban area, the private medical examination center employs a group of employees who have run insurance all year round, and run the business door to door."
Jin Dongsheng will also go to the leaders of public institutions to "brush his face", but there is no other way but to explain the advantages of physical examination in public hospitals.
The physical examination center, which was originally dominated by large customers such as public institutions, has now encountered many walls under the competition of private enterprises.
"Financially, there is no freedom for private medical examination centers." This is one of the reasons why Jin Dongsheng is tied when talking about customers. "The private road is very wild, go up and stuff red envelopes, these public hospitals can't compare."
Similarly, if you want to have a large number of customers, "it doesn't matter, it doesn't work at all."
There have been media reports that in 2001, when Shanghai Baoshan District Central Hospital was preparing to build a physical examination center, the position of director of the physical examination center was vacant, and the hospital leaders, after repeated weighing, finally targeted the deputy director of the neurology department of the hospital at the time, on the grounds that the deputy director was outgoing, enthusiastic, sociable, and "had a big circle of friends."
It is also common to rely on relationships to find high-end VIP customers. "The group purchase of public institutions belongs to the low-cost group", for Shanghai International Medical Center, "there is not much profit margin." "It is still necessary to actively open up the market, do marketing, go to Jiangsu, Zhejiang and Shanghai to develop some rich and high-end customers such as chairmen, and need to do high-end VIPs with more than 10,000 levels per capita, which requires interpersonal relations."
In addition to interpersonal relationships, more ordinary people's physical examination is "seeing the temple".
The director of the physical examination center of a county hospital in Shandong told Eight Points Jianwen, "When the physical examination center opened, the top leaders and presidents of all departments were invited to participate in the opening ceremony. For the people in the county, they see that the doctors in the physical examination center are all at the director level and believe in us even more. After more than a year of slow operation, the revenue in the 10 months of 2021 alone has reached more than 10 million, and the physical examination center has formed a benign upward trend. ”
The physical examination project does not take medical insurance, which also makes the physical examination center "obliged" to compete for customers.
In addition to the drive of profit and income generation, from the physical examination center to other departments diversion, the hospital in the physical examination to find accurate patients, is also its long-term strategy.
"In the past, even if the examination was completed, now after the examination, we will give them centralized consultation, such as a patient who has a lung nodule found out in a month, we will consult on weekends and at the end of the month to monitor the level of blood pressure." The president of the above-mentioned Shandong county hospital told Eight Point Jianwen.
"The development of the physical examination center is equivalent to directly accumulating or expanding a number of disease sources for the hospital." Zhou Ren added.
According to incomplete statistics, the above-mentioned Beijing Top 3 Hospital Health Management Center has more than 60,000 annual physical examinations, of which 7,000 people have been notified by the hospital by telephone to go to follow-up or registered outpatient clinics. A number of county physical examination centers also said that a positive detection rate like 7,000 people, in the county, a large part will be converted into outpatient clinics in other departments.
Public and private, whose hand is the deer who dies?
According to the forecast of the "Prospective Industry Research Institute", the size of China's health examination market will be close to 170 billion yuan in 2019 and will reach 328.4 billion yuan in 2024.
At first, professional health examinations did not do well in public hospitals, and private capital rose at the wrong peak. The professional health examination market has also developed from the early "three-legged standing" of Ciming, iKang Guobin and Meinian Great Health to the "dual opposition" situation of iKang and Meinian.
Some people even said, "Now that the pattern is basically determined, investors basically don't look at physical examinations." ”
Nowadays, with the attention of the top three to the county-level hospitals to the physical examination centers, the public has stirred up this 100 billion market again - in today's pattern, the private physical examination that runs one step ahead accounts for only 30% of the market, and the public hospital still occupies an absolute advantage of 70%.
The vision of public hospitals goes beyond that. In the article "Development Trend and Prospect of Hospital Physical Examination Centers", it is mentioned that one of the main reasons for the rapid development of hospital physical examination centers is that many hospitals recognize that health examination centers are hospital income generation and new economic growth points. At that time, it was already proposed that in the future, medical services, pharmaceutical equipment, and health examinations would become the source of income for the hospital.
This also means that in this continuous expansion of the physical examination industry, there is still a vicious battle between public and private enterprises, and it remains to be seen who kills the deer.
(In the text, Zhou Ren and Jin Dongsheng are pseudonyms)
Resources:
[1] Wang Yu; YU Haixia; XU Baozhu. Competitive Environment and Strategy of Physical Examination Center of Military Hospital[J].Journal of Community Medicine,2010,(23):56-57.
[2] "Development Trend and Prospect of Hospital Physical Examination Center" was strong
[3] Zhang Zhizhi; SUN Ling. Public Hospital Physical Examination Center[J].China Health Industry,2005,(09):51.
[4] Public hospitals seek to physical examination "top three" Chinese hospital president
Luo Chunhao | write
Li Lin | responsible editor
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