Hospice and Palliative Care in China: Hugely Unmet Need

The need for hospice and palliative care in mainland China is beyond overwhelming – but we strive to focus on the help we can offer to make a difference in the lives of people with life-limiting illnesses and their families.

We focus on what we can do, not what we cannot.

In 2010, the Economist Intelligence Unit (EIU) in conjunction with the Lien Foundation published a research report profiling end of life care around the world.  In comparison to other developed countries, China’s capabilities and approaches to end-of-life care were ranked very low.

In 2012, an estimated 2.5 million people died of late stage cancer in China, representing 30 percent of the death caused by cancer globally, with 3.5 million new cancer diagnosis reported in that year alone. That number increased in 2015, with an estimated 2.82 million people died of late stage cancer, with 4.3 million new cancer diagnoses reported.

Many Chinese patients pass away in hospitals after receiving intensive care which consists of aggressive non-effective medical treatments that only prolong their death, along with a huge financial burden upon their family members and the healthcare system.  It is estimated that 80% of medical cost is spent on the last 30 days of life in hospital on life-prolonging treatment. Other patients die at home with no access to care that can relieve their symptoms and help them pass away with peace and comfort. This situation must change.

Unmet Demand – No Policy Support, No Healthcare System Integration

For the overwhelming majority of Chinese who currently endure progressive, life-limiting illnesses, access to culturally appropriate holistic palliative and hospice care (including effective pain management) is simply not available.  A survey of hospice and palliative care services found that there are only a handful of identified hospice or palliative care facilities in metropolitan cities like Beijing, let alone in the hundreds of smaller cities. There are only a few municipal governments that have integrated hospice and palliative care into the local healthcare coverage and allocated funding to support community healthcare facilities building and establishing hospices for late stage cancer patients. The cities include Shanghai, Changchun, and Jilin.

At the national level, the central government still has not come up with strategies, policy frameworks and guidelines to integrate hospice and palliative care into the healthcare system.

The country still faces an extreme shortage of health care professionals specializing in palliative care.

Opportunities For Change

This vast unmet need for palliative care can only be addressed by the public health approach to palliative care delivery advocated by the WHO and supported by HPCA. This ensures that the right policy frameworks, resourcing and educational structures are in place for palliative care to reach every man, woman and child in need.

Palliative Care in China: Delivery

Palliative care was developed in China by motivated ‘pioneer’ individuals, rather than through mainstream national health systems.  This has resulted in isolated centres of excellence.  Along with other such centers dotted across the country, these provide some excellent demonstration sites for replication, but still are not adequate to reach all those in need. Palliative care remains absent from the vast majority of local governments’ health policies or basic care packages, with almost half of Chinese provinces identifying no hospice or palliative care activity. NGOs, hospices, and other organizations are left with the impossible task of filling the gap.