Hangzhou City Profile
The Availability of Healthcare

Hangzhou is a second tier city, developing at an exponential rate. Located in the country of China, a Less Economically Developed Country (LEDC), one of the fastest developing nations in the world, developing their economy at consistently high growth rates. In 2014, the real Gross Domestic Product (GDP) growth rate of China amounted to a 7.4% increase. Furthermore, the nominal Gross Domestic Product of China in 2014 was the second highest in the world, amounting to approximately 10 trillion US dollars. Therefore, it is unsurprising that Hangzhou, too, is expanding and developing, especially as a result of its strategic location.

Hangzhou is a city renowned for its beautiful scenery, as the Chinese saying goes, 天上有天堂,地上有杭州. The city currently has a population of  8.7 million, and a gross domestic product per capita of 12,461 USD. Recently, the city has also been undergoing a substantial amount of urban growth, developing infrastructure. This development is very interesting compared to that of the rest of China because the aesthetic and environmental aspects are taken into account, and the city is not only developing in efficiency, but is also being beatified. This webpage will analyse whether this style of development, that is, relatively sustainable, yet rapid, is apparent in the development of the healthcare in the city.


The total number of hospitals in Hangzhou

Below is a graph detailing the different types of hospitals in Hangzhou, hospital being defined as a medical institution with 20 or more beds. There are 260 hospitals in Hangzhou, and a further 2894 clinics in the city. In total, there are 3154 medical facilities in the city for the people to use, putting the healthcare facility to population ratio at roughly 1:2740. This ratio is quite good, and this suggests that there are enough healthcare facilities in Hangzhou to treat the population in normal times.

As shown by the graph, the most common hospital by far in Hangzhou is a general hospital, which is quite normal for most cities, as they treat a very wide variety of medical issues, making them ideal for general medical treatment in cities. More specialized hospitals, such as cancer hospitals and eye hospitals, are not as common, as they are not as high in demand, due to the fact that they simply treat a very limited amount of health issues.

When visiting the numbers, the second most common hospitals are maternity hospitals and orthopedic hospitals. This suggests that these hospitals are very high in demand. The high number of maternity hospitals suggests that there are many births taking place, and from this it can be inferred that the population growth in Hangzhou is quite rapid. The high number of orthopedic hospitals suggests that orthopedic specialists are very high in demand in this city. This can be attributed to the aging Chinese population, and the very significant age imbalance in Chinese society, as bone diseases are much more prevalent amongst aging people.

Interestingly, there is a much lower number of Traditional Chinese Medicine hospitals than there are general hospitals, and the number of traditional Chinese medicine hospitals in Hangzhou is similar to the number of more specialized hospitals, such as women's hospitals and cancer hospitals. This can possibly be attributed to the fact that traditional Chinese medicine is usually practiced in homes, and usually people only seek out doctors in this field for consultations. Furthermore, Chinese medicine is usually practiced in smaller clinics or shops, which would suggest why this is the way it is.

Ambulances and Emergency Response

Above is a map detailing the distribution of general hospitals in Hangzhou. As seen in this map, the hospitals are distributed quite evenly across the city. While towards the southwest, the hospitals become more spread out, suggesting that these hospitals would be more strained when trying to respond to emergencies, or simple instances of medical problems in the area. However, in the central business district of the city, which is in the middle of the map, the hospitals are much more concentrated. This area would most likely be one of the more densely populated areas in the city, and with the concentration of hospitals in this area, they would most likely be sufficiently prepared to respond to the medical issues posed.

One thing that must be noted is that traffic in Hangzhou is quite moderate, and that it does not take too long to get around, which is good for the movement of patients to these healthcare facilities. However, during rush hour, which is usually at night, from 3PM to 7PM, when a large percentage of the population are mobile on the main motorways, traffic can back up, and transportation gets significantly slower. This could affect the ambulance services significantly, and the transportation of patients in critical states, where the use of an ambulance is needed to quickly transport these individuals to medical facilities, resulting in increased mortality while mobile, and a shorter time frame to treat the patient.

In the case of a disaster of some sort, such as a natural disaster (which Hangzhou is not particularly known for), or a war (also quite unlikely given the modern political climate), the ratio of 1:2740 for healthcare facilites to population would most likely not be sufficient to treat the population of Hangzhou. This can only be worsened by the fact that in such situations, infrastructure and structures would most likely encounter some damage. However, this does not really affect the availability of healthcare in the city, as in the case of such disasters, most places are not sufficiently prepared to respond to such disasters.

Affordability of Healthcare

Public Opinion on Healthcare

A large contingent of the Chinese population distrust Western medicine, roughly 34%. These people usually go to the local Chinese medicine stores and clinics to get their healthcare. However, the wealthier Chinese go to foreign clinics, that practice Western medicine, despite the higher cost, due to an increased distrust in local healthcare.

Interview with 杭州中醫院 doctor

I visited the 杭州中醫院 for C&S, and interviewed a doctor there to gain an understanding of the public opinion on the healthcare in the city. This hospital practices Chinese medicine. I did not manage to record the doctor's name.

Financially, compared to the rest of the Chinese population, where do your patients usually stand?

Usually, I treat middle-class patients, with incomes slightly above the average of the city. These individuals can avail of the healthcare, but have not gained the same distrust that the wealthy have. While every now and then, we will see some wealthier patients, but on the most part, they have moved on to other, foreign clinics.

Has your business been better or worse in recent years?

As a result of the rapid economic development of China, an increasing portion of the Chinese public can access the healthcare I provide at the hospital. Furthermore, with the rapid urbanization of China, middle-class Chinese in the rural communities move to Hangzhou, and come to our hospital as well.

How do you see healthcare in the city developing in the future?

I see the healthcare starting to feel a strain, as the population is growing too fast for the infrastructure to keep up. However, I feel that there won't be any major problems with a lack of healthcare in the near future.

Interview with CISHZ student

To gain an understanding of how expatriates view the healthcare in the city, I interviewed Katie Eu on her opinions on healthcare in Hangzhou.

How did you find your experience at the hospital you visited?

The service was very slow, like I probably waited an hour to an hour and a half for a blood test that lasted a minute. They also made us go from floor to floor, and sit in different waiting rooms for no apparent reason.

Do you trust healthcare in Hangzhou?

I do not trust the health care in Hangzhou, but since I had to take a blood test for rowing there was no choice. I was especially wary of the needles they used, but they seemed professional enough about the whole thing.

What do you define as trustworthy healthcare?

Somewhere with reputable doctors or nurses, or somewhere rated highly or recommended to by friends. I would also trust places that I've been to before for 'bigger' treatments, such as surgeries.

Looking to the Future

Hangzhou is a city with a rapidly growing population, as urbanization in the area occurs, and urban growth occurs to accommodate the increased population, and as people move from rural communities to cities. This rapid growth in population may pose some strains on the healthcare systems in Hangzhou. However, as reassured by a local doctor, the strain will not be too severe, and from professional referrals, we can be assured that this will not pose a major problem. As for the availability of the healthcare for monetary reasons, the rapid economic growth may signal an improved standard of living, allowing for the increased availability of healthcare by the population.

As mentioned above, there is quite a lot of healthcare facilities that the people of Hangzhou can avail from. However, another question regarding the availability of healthcare is whether the general population are financially capable of availing of the said facilities and services. The GDP per capita of Hangzhou is said to be at 12,461USD, roughly the same as that of South Africa. While this is significantly better than the vast majority of Chinese cities, of which Hangzhou is ranked 15th, this is still quite a small amount compared to many of the world's developed countries. This may indicate that the people of Hangzhou have financial stability to a certain degree. However, when comparing this value to the price of commodities such as health insurance and more advanced and specialized treatments, this may not be enough. However, this must be noted that this is the average, and that it can be assumed that there will be significant portions of the population that fall both above and below the average. From this we can then assume that quite a significant portion of the Chinese population will not have access to the healthcare services they may require due to monetary concerns.

However, it must be noted that there are a number of government-run facilities that may offer subsidized healthcare, providing cheaper alternatives to those who may not be able to afford it. According to a doctor at the 杭州中醫院, this healthcare is slightly more affordable, appealing to those who cannot afford it. However, according to the same source, due to the number of patients who would appeal for this treatment, the quality of the healthcare they receive may not be of the highest standard.

It must be noted that privatized healthcare is on the rise amongst the wealthier Chinese population, and that the wealthy are beginning to opt for foreign healthcare. According to BBC, foreign healthcare corporations such as Philips have been doing very well in China. This suggests that there is an increasing distrust in local healthcare, and that the wealthy Chinese are outsourcing their healthcare.

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