Why Waiting Lists Are Shorter in China

In many countries, long waiting lists for medical appointments and procedures are a common source of frustration. Patients often face weeks, months, or even a year-long wait to see a specialist or get certain treatments. However, perspectives from foreigners living in China suggest a different experience, where waiting times can often be surprisingly shorter. What contributes to this perceived efficiency in the Chinese healthcare system?

Why Waiting Lists Are Shorter in China

Streamlined Appointment Systems and Outpatient Convenience

A key factor appears to be the widespread adoption of digital technologies for managing patient flow. Many medical institutions in China have embraced online booking, timed appointments, and smart pre-consultation systems. For instance, patients can use hospital WeChat accounts to book specific time slots, significantly reducing the need for early morning queueing. Data from September 2022 indicates that 50% of public hospitals above secondary level offer appointment scheduling, with over 4,800 providing precise time-slot appointments.

Foreign residents in China have often found this convenient. A Norwegian botanist noted that seeing a doctor in China is often easier than in Norway, where emergency appointments can take 1-3 days and chronic disease appointments might be booked a year in advance. A Japanese student expressed surprise that Chinese peers would go to large tertiary hospitals for common colds, while in Japan, such minor ailments would typically be handled by local clinics, though acknowledging that Chinese hospitals offer faster same-day queues for those minor issues compared to longer waits in Japanese big hospitals. For those with the economic means, private hospitals in China offer virtually no waiting times, often allowing same-day or next-day appointments.

Rapid Emergency Care

While Chinese citizens sometimes complain about "emergency not being urgent," foreigners from countries like the UK and US have praised the speed of China's emergency services. An engineer from the UK working for Audi China found Chinese emergency rooms to be much faster than those in his home country, where even serious injuries might involve long waits depending on the day. An American executive at Volkswagen China shared similar sentiments, noting that China's emergency care is much quicker than in the US.

This efficiency stems from a triage system that prioritizes based on urgency. While patients might still wait, those with more severe conditions are attended to more quickly. This approach ensures that truly critical patients receive timely intervention.

Advanced Facilities and Technology-Driven Healthcare

Chinese hospitals, particularly the larger ones, are frequently commended by foreigners for their advanced equipment and the professionalism of their doctors. Indian medical students and a Pakistani translator highlighted the sophisticated technology available, enabling quick and convenient examinations and auxiliary operations that might be manual elsewhere. This technological infrastructure is a result of significant investment and a national push towards "smart hospitals" (智慧医院).

The Chinese government strongly supports the application of internet, AI, blockchain, IoT, and big data in healthcare. Initiatives like "Internet+ healthcare" have led to over 2,700 internet hospitals and more than 25.9 million online consultations nationwide by October 2022, ensuring widespread access to remote services. This includes:

• Intelligent pre-screening and navigation services that integrate with electronic medical records for a seamless process from intelligent questioning to appointment booking and medical history collection.

• Online consultation platforms, some even accessible via TV, offering immediate connection with certified doctors and services like remote consultation, online appointments, and medicine delivery.

• Full-course patient management platforms that provide continuous care from pre-diagnosis to post-treatment, including multi-disciplinary teams, online consultations, and home delivery of medicines.

These advancements facilitate the optimization of medical resources across time and space, significantly alleviating the difficulties people face in seeking medical care.

Systemic Context and Nuances

Despite the perceived shorter waiting lists, it's crucial to understand the broader context and challenges within the Chinese healthcare system:

• "Difficulty in seeing a doctor" (看病难): For Chinese citizens, this remains a significant issue, often characterized by difficulty in registering, long waiting times, short consultation times, and dissatisfaction with treatment outcomes. A core problem is the lack of trust in grassroots medical institutions, leading a large number of patients to flock to large, top-tier hospitals for even minor ailments, creating overcrowding.

• Hierarchical Diagnosis and Treatment (分级诊疗): China has been actively promoting a hierarchical medical system since 2009, aiming to guide patients to different levels of healthcare institutions based on the severity of their illness (e.g., primary care for minor ailments, higher-level hospitals for severe or complex cases). This system, which involves primary care first, two-way referrals, and differentiated treatment for acute and chronic conditions, is intended to optimize resource allocation and promote more orderly medical seeking behavior. However, the continued patient preference for large hospitals and the imbalance in medical talent (doctors tend to gravitate towards larger, more prestigious hospitals) remain significant hurdles.

• "Expensive to see a doctor" (看病贵): This problem, while distinct from waiting times, often intertwines with the system's efficiency. Hospitals' financial models, where a significant portion of their operating costs and staff incentives depend on self-generated revenue (due to insufficient government funding), can lead to practices like over-examination and high costs for imported drugs and equipment, which are often self-funded by patients. This incentivizes higher throughput for revenue generation, which might indirectly affect wait times for some services, but at a cost to the patient.

• Patient Experience Trade-offs: While efficient, the sheer volume of patients in public hospitals can lead to crowded environments, lack of privacy, and sometimes unsatisfactory hygiene, as noted by foreigners. Communication barriers, especially for non-Chinese speakers, also pose a significant challenge.

Why Waiting Lists Are Shorter in China

In conclusion, China's healthcare system, particularly in its major urban centers, has made strides in reducing wait times for many common services and emergency care, largely through significant technological integration and a focus on high-volume throughput. However, these efficiencies often come with trade-offs in terms of patient comfort, privacy, and economic burden for its own citizens, highlighting that "shorter waiting lists" are part of a complex and evolving healthcare landscape.