Comparative Analysis of Health Management and Related Industry Development between China and the US - Taking Cancer Disease as an Example
DOI:
https://doi.org/10.61173/vrenvy29Keywords:
Health management, economic burden, medical insuranceAbstract
Under the background of population aging and a rise of chronic diseases, this paper is based on the different development trends of cancer incidence, mortality, and five-year survival rate in China and the US to compare and analyze the health input, medical infrastructure, medical insurance coverage rate, average household income, and proportion of medical expenditure in the health systems of China and the United States. It was found that the high medical cost in China could not be met by medical insurance alone nowadays. The need for commercial health insurance is growing rapidly. To explore the differences in disease management between the medical and health systems of China and the United States in regard to the system characteristics, industrial development environment, and service mode of the health management service industry in China as well as the US. Additionally, to sort out the development direction of the health management industry in China in line with national conditions.
References
million new cases of the disease in 2020, which ranks first in ent types of high-incidence cancers, which have a lower lives. The mortality rate of lung the world due tocancer has significantly its large population base. The incidence of cancer is close to the world average level, but the mortality rate is much higher than the global cure averagerate level.than those in By comparing thethe United top five cancerStates. This suggests decreased as a result types of smoking and the 5-yearcessation in the survival rate United of each cancer typethat between Chinashould and the United China focusStates, as shown prevention and early on cancer States. Reductions in inmortality from8,prostate, Figures 7, Figure and Figure 9,colorectal, the root cause of the high cancer mortality in China is the different and breast cancer havetypes alsoof been high-incidence attributed cancers, which have to better treat-a lowerscreening. cure rate thanCancer treatment those in the depends United States. This on early detection. suggests that China should focus on cancer prevention Most of the and early time,Cancer screening. the effect treatmentofdepends cancer treatment is directly ment and increased access on early to early Most detection. screening [7]. of the time, theChina effect of cancer treatment is directly proportional to the time of detection had 3 million cancer-related [8]. In comparison deaths and 4.57 tomillion the averagenew cost of proportional cancer treatment to theUnited in the timeStates of detection and China, [8]. In comparison to the average annual treatment cost in China for six common the average cost ofgastric cancers, including cancer treatment and lung cancer, in the United States cases of the disease inis2020, which 68 approximately ranks firstyuan, thousand in the whichworld is 2.96 times the average annual disposable income. This and China, the average annual treatment cost in China for due to its large population base. The puts a significant incidence burden on medicalof insurance cancer funds as well as families [9]. The US has a 19.2k disposable personal income, and each person's cancer six treatment commoncosts cancers, including about $600, or 31.25%gastric of and lung cancer, is is close to the world average level, but the mortality rate emphasizes disposable personal income. The data once again approximately that it 68 is difficult to achieve thousand yuan,only which is 2.96 times the is much higher than the global medical average insurance level. to cover Byofcomparthe cost serious illness, and high medical costs in China still need to be borne by commercial insurance. Dean&Francis average annual disposable income. This puts a significant disposable personal income. The data once again emphaburden on medical insurance funds as well as families [9]. sizes that it is difficult to achieve only medical insurance The US has a 19.2k disposable personal income, and each to cover the cost of serious illness, and high medical costs person’s cancer treatment costs about $600, or 31.25% of in China still need to be borne by commercial insurance. 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The Dilemma of China’s Cancer Dis- middle and late stages of the disease due to the low uptake ease Management of cancer screening and even basic health examinations. There was an almost 28 percentage point disparity in the 3.1 Background of Economic Development early diagnosis rate between this country and the United and Population Aging States. The outcome is a high rate of distant metastasis Globally, China is the nation with the highest proportion and even local recurrence, which is highly detrimental to of old people. With 176 million elderly people over 65 in the therapeutic benefit. For example, EGFR is a gene mu- 2019, the world’s elderly population accounted for more tation that results in abnormal cell growth. Studies have than one-fifth of all people over 65. With the deepening of shown that 48% of lung cancer patients in China have aging, the number of disabled elderly is also increasing. EGFR gene mutations, while only 23% of lung cancer pa- The intermingling and metamorphosing nature of disabil- tients in America have EGFR gene mutations [12]. Howity and severe illness readily contributes to the ongoing ever, according to national statistics, only 9.6% of nonincrease in medical costs. Additionally, the informal care small cell lung cancer patients in China have been tested provided by other family members takes up much of the for EGFR mutations. family’s working hours, which lowers family income and (1) Model of diagnosis and treatment pushes the family into medical expense poverty [10]. The Multidisciplinary team (MDT) is one of the most addemand of the elderly for medical services, long-term vanced cancer treatment concepts recognized internationcare, and drugs will increase significantly, which will put ally. A general consultation is held when needed and once, higher requirements on medical resources and medical se- usually for complex and advanced patients only. Particicurity systems but also provide opportunities for medical pation is accessible to all, with no institutional assurance. technology innovation and medical service model upgrad- The MDT model is generally applicable to all hospitalized ing. According to relevant research findings, Major factors cancer patients during the entire course of treatment. Its contributing to incremental cancer deaths increased in the members are arranged into teams, the staff is essentially adult population and population aging; in both nations, fixed, and it is held every week with an institutional guarlower case fatality rates were a contributing factor to low- antee. This approach reflects the idea of patient-centered er cancer fatalities [2]. Therefore, the remarkable feature treatment and considers the patients’ long-term survival. of the aging population also exacerbates the difficulty of However, only a few elite hospitals in China are attemptcancer disease management. ing to implement this model due to institutional constraints and excessive business volume. 3.2 Current Situation of Coping with Cancer (2) Radiotherapy rate Disease China’s access to radiation equipment in 2015 was less China’s overall cancer incidence and mortality have than that of nearly all high-income nations. Furthermore, been rising annually in recent years. The government China has a poor rate of adoption of cutting-edge radiahas implemented several cancer prevention and control tion technologies. Ordinary linear accelerators continue programs, and they have made consistent headway in the to be the mainstay of radiotherapy equipment in China important domains of system development, early detec- today. Only 7.9%, 16.5%, and 1.1% of the units can apply tion and treatment, scientific and technology innovation, VMAT, SBRT, and TOMO technology, but only 70.7%, and popular science education. Nevertheless, it remains 50.1%, and 31.5% of the units can apply international challenging for the current cancer prevention and control conventional 3DCRT, IMRT, and IGRT technology. The system and service capacity to satisfy the population’s efficacy of treatment is adversely affected by flaws in radiexpanding health requirements. The situation surround- ation technology. ing cancer treatment is still dire; the allocation of health (3) New drugs and new treatments are introduced expenditure institutions to large hospitals needs to be Take lung cancer as an example; only six targeted drugs reversed and optimized, the role of social financing as a have been introduced and approved in China, two of
treatment guarantee needs to be fully played, and the sta- which were just approved in 2017. In terms of time, tarbility and sustainability of government health spending geted drugs approved by the CFDA in China are 2-3 years are under intense pressure. later than those approved by the FDA in the United States 3.2.1 Treatment options in medical institutions on average. Almost none of the new drugs developed in the United States since 2014 have been on the market in
Since the 1970s, the treatment of malignant tumors has China. The United States has a more detailed molecular undergone surgery, chemotherapy, radiotherapy, molecular classification of cancer and a greater selection of drugs, targeted therapy, and immunotherapy [11]. which may result in higher cure rates for advanced lung Nearly 90% of cancer diagnoses in China occur in the Dean&Francis cancer. From the patient’s perspective, the number of merce may improve the services of drug enterprises, new drugs available is limited. In this regard, there is a insurance, patients, and other platform participants and serious backlog of review and approval, and the update create a complete e-commerce platform ecology for drug of the medical insurance catalog is slow. Even the drugs purchases. that have been approved and listed in China are not reim- Regarding the issue of high medical costs, primary perbursed by medical insurance, which seriously restricts the sonal health management can be developed into personal level of tumor treatment in China [13] disease management to allow patients to take care of 3.2.2 Family expenditure and psychosomatic effect on themselves, reduce their dependence on doctors, and repatients duce the cost of services. Current personal health management methods mainly provide primary functions such as In China, according to clinical statistical research, more health monitoring, exercise assistance, health information, than 87% of the family members of cancer patients have and health reminders provided by software and hardware different degrees of anxiety, depression, and other nega- such as mobile phone APP, bracelets, blood pressure metive emotions, which is higher than that of cancer patients. ters, blood glucose meters, etc., which have limited help Moreover, the severe psychological stress reaction of the for users’ health management. As the world’s cutting-edge family members of cancer patients cuts off their social in- medical technology continues to mature and move toward teraction and aggravates the degree of bad psychology. public use, personal disease management will be pro- 3.3 Feasible Solutions moted. Based on genetic sequences and comprehensive In view of the current major diseases such as cancer, ef- health monitoring data, individuals will receive more tarfective measures to reduce the economic and mental bur- geted treatment, and artificial intelligence diagnosis and den of patients from the perspective of health management treatment will be made possible. Users will complete the are worth exploring. The fundamental concept of health monitoring, evaluation, management, and intervention of management is preventative medicine, which encompass- chronic diseases and other diseases by themselves, and paes fitness, physical examinations, health food, equipment, tients will be members of their medical team. At the same and other areas. The panel concluded that prevention is time, commercial insurance will evolve from a single role better than cure. Through the intervention of risk factors, as an auxiliary to medical insurance into a diversified role health management can slow down and delay the devel- as a provider of personalized health management services, opment of chronic diseases, rationally allocate medical a promoter of medical informatization, and a participant in resources, reduce medical costs, and reduce the burden of Internet finance. Promoting the expansion, improvement, public health. As an “upgraded version” of general medi- and steady development of commercial life insurance will cal services, health management should also be developed not only help to protect people’s livelihoods but also be an in the direction of individualization and diversification in important part of the national strategy to actively respond the future to better achieve the goal of improving people’s to population aging. At the same time, it will promote cohealth index. On the user side, many cutting-edge tech- operation between the medical industry (such as hospitals) nologies are moving to civilian use, and more targeted and commercial health insurance in a standardized and monitoring and management are realized. On the enter- orderly manner. prise side, the experience of health management should be The combination of advanced medical means and inforimproved from aspects such as device products, service mation technology, according to the individual differences methods, and data interaction. In terms of data accumula- of the demand population, the integration of culture, techtion, health management will become a major entry point nology, products, services, etc., will derive multi-dimenof big data in the medical industry, laying a foundation for sional and multi-angle service forms and development opdiversified services. portunities. Combining medical means such as detection, From the perspective of the health management industry, assessment, and intervention with Internet means such as the burden of drug costs is large, which comes from the smart devices, databases, and information dissemination. “non-separation of medicine and medicine” phenomenon, Then according to individual differences in service, such low charges for medical services, and allowing medical as age, regional differences, personal health concept, livinstitutions to conduct price markups when selling drugs. ing and working environment characteristics, surrounding The government should comprehensively start the stan- medical facilities, personal medical records, personal dardized construction of the centralized drug procurement biological factors, personal lifestyle, and other characplatform, cooperate with the drug industry to achieve teristics, More personalized health management services interconnection, and encourage drug retail enterprises to such as health information, health management, health chain operations. In the future, pharmaceutical e-com- examination, health medicine, massage and acupuncture, Dean&Francis and chronic disease management will promote the devel- experience and inspiration of the coordinated development opment of more medical and health enterprises, increase of basic medical insurance and commercial health insurance.
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