Today we are in my comfort zone. We went to visit a community health center. It is one of 8 centers that are affiliated with a hospital. The woman in the turquoise jacket is the nurse who is the director of this location as well as the overall director of the other centers. She was warm and welcoming and quite curious as to the status of our community health centers and home care in the US. This is where I have the most interest and experience. I found that although the location looked different from home there were many similarities. They provide very holistic and comprehensive care to the people of their community. There are multiple aspects of care that is provided from prenatal care to well child care, elder care on site and also home visits, post-partum care home visits, rehab services, lab and EKG, and of course a multitude of traditional Chinese therapies that we have seen in most of our visits. The nurses and doctors were overwhelmingly friendly to us despite our inability to communicate unless with interpreters. Every UML nurse was allowed to go and observe a home visit with a doctor. That was interesting to me in that the doctors performed a significant number of home visits. It was noted by all the UML nurses that the assessments and interventions performed by the doctors are all within the the realm of nursing in the US and that we were surprised that a nurse was not doing that postpartum check or the evaluation of the elderly patient with hypertension. Maybe it was that the doctor wanted to do the visit with us or maybe it was the standard of care for these patients to receive their care from a physician for these type of visits. There was much interest in the number of visits made to the home by either the nurse or doctor. We have been told it can be up to 14-15 visits per day but many of those visits are for quick immunizations. Speaking of immunizations they proudly report about a 100% vaccination rate for their pediatric population and were quite surprise that we were impressed with that number. We didn’t get into the whole controversy over vaccines in the US but we did state that some parents refuse vaccinations. All vaccines that are made in this country are free to patients but any vaccine made out of the country there is a small cost. Another interesting recent development in China ( effective June 1) is that the health care facilities have to provide medication at zero profit. Which means that if they purchase or acquire the drug at a certain cost then they cannot upcharge the fee to the patient. This is a new regulation in the city of Jinan ( all the health care facilities). We believe it is a pilot regulation and will be implemented in the future in the province of Shandong and possibly country wide. Now wouldn’t that be an interesting tactic to address the cost of medicine in the US ( we would have to get the pharmaceutical companies to be realistic with their costs as well).
So much to write about but I will end my blog with my delight in observing the community health center/home care and realizing that in the US we have similar centers and type of care. We were so happy to be able to share with our Chinese counterparts about community based care in the US.