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Deaths of Seniors in Hospital Fire Point to China’s Elder Care Shortfall


BEIJING — The hospital south of Beijing advertises itself as specializing in vascular tumours, specifically benign birthmarks that often appear in infants.

But when one a fire broke out there last monthkilling at least 29 people, many of the victims went there for a different reason: They were elderly people with disabilities receiving nursing care, some of whom stayed in private hospitals for months, or even years, even though the hospital was not licensed. long-term aged care provider.

The tragedy at Changfeng Hospital — the deadliest fire in the Chinese capital in more than two decades — has renewed scrutiny on a protracted issue. China’s population is aging rapidly, with 400 million people, almost 30% of the population, expected to be over 60 years old by 2040. But medical resources are not keeping up; there are only about eight million nursing or aged care beds by the end of 2020, based on official statistics.

The authorities have recognized the urgency of addressing the shortage, with Beijing’s latest five-year plan pledge increase that number to nine million beds by 2025. But many obstacles remain.

Social stigma against retirement or nursing facilities remains pervasive in a culture that emphasizes children’s duty of care to their parents. Even for those willing to accept care facilities, public facilities often have long waiting lists, and private facilities – not covered by public health insurance – can be very expensive. least.

And then there’s the matter of facilities duly licensed to provide nursing care in the first place, a process complicated by bureaucratic requirements and a lack of trained staff, experts say. . As a result, a number of private companies that want to meet the care needs of the elderly have gone underground.

Local officials are currently investigating whether Truong Phong Hospital illegally provided long-term care for the elderly, according to the report. state media reported. Several survivors of the blaze told Chinese media that some patients’ limited mobility may have contributed to the death toll.

There is no clear link between potential unlicensed care and fire; Deadly fires have also broken out in Licensed nursing home. But the fire drew public attention to the underground market and its reason for existence.

Some victims’ relatives and public health experts have called on authorities to take a closer look at the punishment and work towards bringing service providers out of the shadows.

“This is just the tip of the iceberg,” he said. Sabrina Luk Ching Yuen, a professor at Nanyang Technological University in Singapore who studies aging, added that there could be many similar cases of implicit care. “If the market is there, what is the government trying to do?”

The New York Times’ attempts to reach out directly to victims or their loved ones were unsuccessful. Truong Phong Hospital has been closed since the fire, and when Times reporters tried to interview victims or their loved ones at other hospitals where the injured were transported, they was stopped or escorted out by hospital staff.

Authorities, as usual after disasters in China, tried to control the narrative and prevent reporters from talking to the victims. They only said that the patients who died were between the ages of 40 and 88, with an average age of 71, and that most of out of 21 seriously injured patients all had chronic diseases.

But some Chinese news outlets have tried to interview relatives of patients at Changfeng Hospital, who describe an elderly father who had been there since last summer because of a disability after suffering a brain hemorrhage, and other the man, 76 years old, has no motor skills and lives there full time.

Relatives informed speak they are attracted to hospitals because of their ability to provide medical care to loved ones with disabilities. In contrast, nursing homes in China have historically provided little or no medical care.

Relatives also appreciated that changing beds was not a concern at private hospitals, which, although significantly more expensive than public hospitals, were less crowded. According to one report, one woman said her father was forced to shuttle between various facilities before she found Truong Phong Hospital.

That woman speak she paid about $870 a month in nursing fees for her father. Some online ads for a nursing facility at the same address as Truong Phong Hospital have listed fees as high as $1,400 a month. The average monthly pension in Beijing is 4,157 yuan, or about $600. 2019.

Private hospitals have many incentives to try to capitalize on unmet need for long-term medical care, said Bac Vu, a professor of global health at New York University who has studied aging in China. Even before the coronavirus pandemic, many were struggling to attract enough patients to make money, because of their more expensive rates.

Then, under three years of China’s strict Covid restrictions, those who were able to avoid the hospital did so. Out-of-town patients, who often go to big cities like Beijing for care, have dwindled as the country seeks to limit movement.

Changfeng Hospital’s publicly traded parent company lost more than $14 million between 2020 and the first half of 2022, according to public filings. It did not respond to multiple requests for comment.

“I can see a number of ways that this has prompted private hospitals to say, ‘Hey, we can provide care to these older adults with disabilities because this can be a source of growth. potential revenue’,” said Dr. Wu.

In fact, the government has promote combination of medical care and the elderly, encouraging nursing homes to build medical facilities and hospitals to provide more nursing services.

But China, like many countries, has a serious shortage of trained staff to give special care to elderly patients. And the government agencies that oversee medical care and nursing care are separate, slowing the approval process, Professor Luk, in Singapore, said.

“The intention is good,” she said of the integration plan. “But, in practice, it’s really hard to do.”

She said she hoped an outcome of the Beijing fires would be a call to action for the government: The government should provide more long-term care facilities or make it easier. than for private companies to do it.

Indeed, demand will only increase. According to official statistics, China’s number of elderly people with disabilities is expected to more than double this decade, reaching 100 million by 2030.

Facilities are especially important for those lucky enough to have found space for their loved ones there. Hua Ailing, a postal accountant in a small county in Anhui province, chose to send her 89-year-old mother to a private hospital licensed for long-term care last year, after her mother’s death. ability to walk. She says she feels more comfortable sending her there than going to a traditional nursing home, where medical care can be unreliable.

Without this option, she and her siblings wouldn’t know what to do. “After a while, we couldn’t take care of her on our own,” Ms. Hua said. “After all, we are all in our 60s.”

Bronze Joy report from Hong Kong. Li You Contributing research.

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