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《经济学人》疫情期间数百万中国人在线求医

2020 年 03 月 06 日 • 经济学人,商业

本期经济学人杂志【商业】板块下这篇题为《Millions of Chinese, cooped up and anxious, turn to online doctors》的文章关注的是新冠肺炎期间许多中国人在家通过互联网寻求医生的治疗和建议,文章认为疫情结束后许多人仍将继续青睐线上问诊服务。

The Economist, March 7th-13th 2020.

新冠疫情爆发后,“京东健康”每月的线上问诊量增长了十倍,达到了 200 万人次。即使在疫情发生之前,包含问诊和药物销售在内的远程医疗 (telemedicine) 就预计会强劲增长。

“平安好医生”在去年九月宣称其注册用户有 3 亿,这一数目是中国网民总人数的 1/3。据“天眼查”统计,目前中国的本土远程医疗公司超过 1,000 家。但目前为主,大多数远程医疗公司都在提供诸如送药或专家号预约之类的服务。在中国,传统中医不得在没给病人把脉问诊的情况下作出可靠的诊断。

全球监管机构对远程医疗的态度也较为谨慎。在美国大多数的保险不报销病人的在线问诊支出,除了个别地区外中国的全国医疗保险也一样不报销此类支出。大多数线上医生只被允许开一些重复的药方和进行复诊,不允许做初诊。

去年中国已经解除了一些限制,如处方药的线上销售等。新冠肺炎疫情加快了线上医疗政策的开放速度,政府开始鼓励医院提供线上问诊,有些省市允许医保报销线上问诊费用。"阿里健康"、"京东健康"、"丁香医生"等企业也开始烧钱帮助抗击新冠疫情,希望以此赢得政府和消费者的好感。

除政府和消费者外,京东健康也通过减免费用等方式吸引药店入驻,并招募那些工资待遇不高、工作过度劳累的医生在平台提供线上问诊服务。

Millions of Chinese, cooped up and anxious, turn to online doctors

The smartphone will see you now
Millions of Chinese, cooped up and anxious, turn to online doctors

Even after the covid-19 epidemic, many will continue to favour internet hospitals
Business
Mar 1st 2020

SHANGHAI

WHEN SARS, a disease caused by a coronavirus, hit China in 2003 citizens hunkered down at home. This proved a blessing for some businesses. Chinese social media took off. So did e-commerce. Richard Liu, who ran a chain of consumer-electronics shops, shut all his brick-and-mortar stores and set up JD.com. The firm is now valued at $56bn.

The novel coronavirus that has brought China to a halt this year is boosting another fledgling industry: telemedicine. As hospitals turn away patients with other ailments and many Chinese are confined to their homes or steer clear of clinics, millions are seeking treatment and advice on the internet. The government is egging them on.

Xin Lijun, boss of JD Health, says that his platform’s monthly consultations have grown tenfold since the outbreak, to 2m. Some 1.6m tuned in to a talk by a top cardiologist that the JD.com subsidiary live-streamed. Without the outbreak, such a shift in consumer behaviour would have taken perhaps five years, reckons Mr Xin. Chen Qiaoshan of Analysys, a consultancy, thinks China’s online health-care market may near 200bn yuan ($29bn) this year, up from her pre-outbreak estimate of 158bn yuan.

China’s telemedicine market—including consultations and drug sales—had been predicted to grow vigorously even before the latest epidemic. Ping An Good Doctor, a medical-services app run by a big insurer, claimed in September that more than 300m people had registered on its app, equivalent to one in three internet users in China. Tianyancha, a data firm, counts more than 1,000 home-grown telemedicine companies.

Until now, however, most of these firms have stuck to delivering drugs or, in Ping An’s case, booking appointments with specialists, whom Chinese patients favour over general practitioners (GPs), even if it means queuing for hours at a hospital. Prestigious “AAA” hospitals account for one in ten public medical institutions but receive half of all outpatients. And the many Chinese who believe in traditional medicine, with its injunction that a reliable diagnosis cannot be made without feeling the pulse, would not dream of accepting health advice by video link.

Authorities, too, have been cautious. In many countries, including America, the world’s biggest telemedicine market, most insurers do not reimburse patients’ online expenses. Nor, in all but a few regions, does China’s national health-insurance scheme. Most Chinese online doctors are permitted only to handle repeat prescriptions and follow-up consultations, not make an initial diagnosis. A draft government policy from 2017 took “a negative tone” on internet hospitals and recommended they be shut down, recalls Li Tiantian, founder of Dingxiang Doctor, which runs a medical myth-busting-and-advice forum.

Last year the government began to lift some restrictions, such as a ban on the sale of prescription drugs. But covid-19, as the new disease is known, has accelerated the shift. At the peak of the epidemic in early February a health-ministry directive mandated that internet-based medical services be given “full play” to diagnose and treat patients. Another encouraged hospitals to give online consultations. Jiangsu province, China’s industrial powerhouse, authorised reimbursements for online medical care. So have cities including Shanghai and Wuhan, capital of Hubei province, where covid-19 first emerged.

Telemedicine firms are trying to win over the government and consumers by behaving like good corporate citizens. Many, including JD Health, are offering patients consultations free of charge while the epidemic lasts. Ali Health, an arm of Alibaba, China’s e-commerce titan, launched a free “online clinic” for residents of Hubei, which has been under lockdown; in five days 100,000 patients got a remote consultation. WeDoctor, an app backed by Tencent, a tech giant, mobilised 20,000 physicians to work online for no pay. Ping An set up an “antivirus command centre” to dispatch free face masks around the country. Dingxiang Doctor got epilepsy medication to 300 children in Hubei amid an acute shortage of suppliers and delivery firms. Its real-time heat map tracking covid-19 infections has been viewed 2.5bn times.

All this is costing the companies money. But, says Mr Xin of JD Health, it makes “little sense” to focus on profit at the moment. What matters, he adds, is how covid-19 has made people think twice about rushing to hospital and helped foster trust in GPs, who provide the bulk of online advice. It has also broadened the appeal of firms like his, beyond middle-aged patients with chronic conditions to web-savvy youngsters seeking advice for parents and grandparents and healthy types simply seeking reassurance. Of the 10m people who have turned to the internet for health services in the past month, perhaps half were first-time online patients, says Ms Chen. At least a third are likely to keep using such apps, she estimates.

Remote possibilities
It is not just patients and politicians who are embracing telemedicine. JD Health has lured more pharmacies to its platform (in part by waiving the fee it earns on drug orders in Hubei). China’s underpaid, overworked doctors are also keen. Xiao Xingxing left a AAA hospital in Beijing to consult full-time for JD Health; many old colleagues and classmates are doing the same, she reports. And amid a global, virus-induced stockmarket rout, Chinese online-health firms offer a tonic to ailing investors. This year the share prices in Ping An and Ali Health are up by 34% and 66%, respectively.
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