: The Ministry of Health and the Yunnan Province Bureau will be offering policy support and technical assistance throughout the implementation of the project. AIDS Care China will be implementing the project in the following phases:
1. Set up support team with health economists, doctors, and community members.
2. Analyze hospital running cost and develop an over all budget and standard clinic charges.
3. Negotiate with the hospital to standardize lab costs and venue/utility costs.
4. Communicate with the local government to confirm available resources, which could be used toward subsidizing treatment costs.
5. Select and contract medical staff.
6. A medical consultant team will be established to monitor expenses and prescriptions in the clinic. This consultant team will also provide mentoring support to improve the diagnostic capacity of local medical staff.
7. Clinic becomes operational.
1. AIDS Care China will modify the strategy and management system of the clinic based on feedback provided in the monitoring and evaluation of the first year's operation. The goal is to ensure better efficiency for the clinic.
2. Continue to operate the clinic under improved operational processes.
Invite health economists and government officials to review the model and abstract key elements of the project that could be replicated nationwide and produce a report on this model. This report is expected to cover the following indicators:
- The cost of the medical service for the patient. (Increase or decreased?)
- Quality of medical service (Death rate and satisfaction from the local community)
- The number of people covered in the project.
- The cost efficiency ( How much was input to the project and how much for per patient)
- Others to be designed by the health economist and medical professionals.
Use the report to recommend the government for public health structure reform.
This commitment will be evaluated against the following performance metrics:
- Number of people expected to gain access to medical service: 2000 - 3000
- Reduction in rate of death for those living with HIV/AIDS in this area: 80% over 2 years
- Average treatment cost: Depends on treatment. Aiming for 20-30% reduction in general.
- Satisfaction rate from the local community: Over 90%
The commitment will directly affect 2-3000 people living with HIV/AIDS in Yingjiang county in Yunnan province. Included in this figure are people living with HIV/AIDS from Burma since Yingjiang county is located at the boarder between China and Burma. The population in Yingjiang tends to be ethnic minorities with very low income-average family income in this area is less than US/year.
The current public health-care system in China is highly commercialized-doctors earn most of their income through prescribing medicine and lab tests, which are quite expensive and sometimes unnecessary. Thus, medical services have become a burden for most people, especially those who are poor and have limited access to healthcare services.
With support from the CHAI China office, AIDS Care China has started a community-based treatment support program in Yunnan province including Yingjiang county. The program has partially improved the efficiency of the local clinic and has achieved outstanding performance, with a greater number of individuals gaining access to the government's free Anti Retrovirus Treatment (ART) program and an increased adherence rate, which leads to higher treatment success rate and higher number of lives saved. Nonetheless, the cost of treating some AIDS-related diseases remains expensive. As a result, patients wait until it is absolutely critical before they seek medical attention, and when they do get to the hospital, the treatment that they need costs even more, which means that they could go untreated and lose their lives.
Through years of working with medical professionals, AIDS Care China noticed that the main problem is the management structure of the health care system. Doctors are paid poorly for offering consultation service (less than US.50/visit), and they are encouraged to earn more money from selling medicine and earn commission money from prescribing expensive medications and lab tests. The pharmaceutical companies, on the other hand, inflate the price of drugs so that they could pay the commission to the doctors. Combined, these factors add to the cost of medical treatment and the patients bear the burden. Thus, most people are reluctant to go seek medical service unless they are really sick. This also adds to the multi-antibiotic resistance problem in China.
This commitment aims to reform the current system by establishing a HIV/AIDS clinic in Yingjiang County Hospital. Reasonable salary of the medical professionals will be contracted by the program, and the consultation fee will be increased to cover for the salary. Doctors will be requested to diagnose and treat the patient in a most economic and efficient way to lower the cost that patient need to pay. (See implementation section for more details) If this model succeeds, the local government will recommend it to the state government for consideration so that it could be implemented throughout China.
AIDS Care China requires funding for the implementation of the program. Technical assistance, such as medical volunteers, and in-kind donations for medical equipment are welcome.
Funds raised will be used towards:
- The salary for the medial professionals and the venue/utility cost should be covered partially from the revenue in the first year. The second year should become balance.
- Part of the funding will be use for project coordinator recruitment and medical consultant team's expenses.
- Part of the funding will be use for facility set up in the clinic and admin cost.
- Part of the funding will be used for support the monitoring and evaluation, and the report writing.