Stop treating tertiary hospitals as mere prescription hubs — stable chronic disease patients should turn to primary care

5. Stop treating tertiary hospitals as mere prescription hubs — stable chronic disease patients should turn to primary care

Cost: No monetary cost involved. The real challenge is breaking the habit of relying exclusively on large hospitals.

In plain terms: Moving forward, tertiary hospitals will primarily handle emergency cases, critically ill patients, and complex medical conditions. Routine follow-ups for common illnesses and regular outpatient visits for patients with stable chronic diseases will gradually be phased out. The same expert physicians who previously saw patients in tertiary hospitals will now provide care at community clinics. Continuing to use large hospitals solely for medication refills will become increasingly difficult as appointment slots dwindle.

Benefit: Tertiary hospitals can better focus on emergency care, critically ill patients, and complex medical issues by gradually reducing routine outpatient services for common illnesses and stable chronic disease cases. This means fewer appointment slots will be available for such visits. Meanwhile, expert medical teams from top-tier hospitals will extend their outpatient services to community-level facilities, making their expertise accessible locally.

Evidence grade: A

Sources: State Council of China (2018). Regulations on the Prevention and Handling of Medical Disputes (State Council of China Order No. 701) Article 16: "Patients have the right to inspect and copy their outpatient medical records, hospitalization records, temperature sheets, medical orders, laboratory test reports (test reports), medical imaging examination data, special examination consent forms, surgical consent forms, surgical and anesthesia records, pathology data, nursing records, medical expenses and State Council of All other medical records specified by China's health authorities. "If a patient requests copying of medical records, the medical institution shall provide copying services and stamp the copied medical records with a certification fee..." If the patient dies, his or her close relatives may access and copy the medical records in accordance with the provisions of these regulations. "Article 15" No unit or individual may tamper with, forge, or conceal. Destroy or seize medical records. "<https://www.gov.cn/zhengce/zhengceku/2018-08/31/content_5318057.htm>; National Health and Family Planning Commission, State Administration of Traditional Chinese Medicine (2013). Medical Institutions Medical Records Management Regulations (2013 Edition): Medical institutions" shall designate departments or specialists (concurrently). Staff are responsible for accepting applications for copying medical records." The copying will be done in the presence of the applicant and stamped with a certification stamp. <http://www.gov.cn/gongbao/content/2014/content_2600084.htm>

Notes: This reflects official policy direction rather than a recommendation. Access to routine outpatient services at large hospitals will become increasingly limited in the future. For patients with stable chronic diseases, primary care clinics can issue medication prescriptions valid for up to 12 weeks — see Section 16 for details.