The Rise of Violence as a Result of Inefficiency in the Healthcare System.

Summary China is currently experiencing an over-utilization of university hospitals and hospitals with high-tech equipment, usually located in main cities. Even though they have a large capacity, they are faced with congestion leading to long queues. In parallel, there is under-utilization of smaller institutions. The Ministry of Health estimates that 70% of patients treated in university hospitals of a higher level (Level 3) could have received adequate treatment in hospitals of a lower category, closer to their home. In 2009, the Chinese government published a large-scale development plan for the health sector, with over RMB 770 billion to be invested. Four years later, RMB 620 billion was already spent, with a public insurance scheme set-up and a network of Community Health Centres created. Yet, this key issue of the Chinese health system, that is, the concentration of demand on a small number of hospitals, still remains, eventually leading to a tense relationship between doctors and patients, and to increasingly common acts of violence. The origin of such violence as well as possible directions to restore trust, respect, and understanding between patients and medical staff is examined. The decentralization of quality care seems to be the key, but there are different ways to achieve this goal. Obviously, digital tools such as connected health object and other online services are likely to play a growing role in addressing this issue.