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"Clinical medicine gives life to years, and rehabilitation medicine gives life to years". If the main purpose of clinical medicine is to survive, let the patient survive; Then, rehabilitation medicine is to survive and let patients return to society better.
Driven by the "Healthy China" strategy, Kangyang Industry is facing a huge development opportunity. Data shows that by 2022, the market size of the rehabilitation industry will exceed 100 billion yuan.
Opportunity 1: demand explosion
"It is no longer only surgery and drugs that can significantly affect the recovery of diseases. The effect of rehabilitation will become a sign of recovery. Rehabilitation prevention, improving the success rate of patients' surgery, reducing the risk of post-operative operations, and controlling system recurrence and complications will make a great contribution to the development of medical insurance and insurance company expenditure."
Lu Jien, CEO of Ruihua Xinkang, believes that with our country's emphasis on the big health education industry, all fields of rehabilitation will usher in the best 10-year cultural development period, which also indicates that the post diagnosis and treatment information era has officially opened in the development of Chinese enterprises.
The arterial network research report shows that patients after surgery belong to the strong demand rehabilitation group, and surgery will cause varying degrees of trauma to the body. Sports rehabilitation treatment is needed to improve the spirit and restore organ function, and further consolidate the treatment effect.
According to the condition of inpatients in the rehabilitation period, orthopedics, cardiology and neurosurgery are the main sources of postoperative rehabilitation group. Take orthopaedic surgery as an example. If patients who receive pelvic fixation, knee joint replacement and limb reconstruction do not receive scientific rehabilitation treatment after surgery, they will suffer from pelvic dislocation, thromboembolism, prosthesis loosening and other sequelae.
However, as far as the current market situation is concerned, there is no effective connection between orthopedic outpatient service and rehabilitation, and there is no effective connection between orthopedic surgery and rehabilitation. As a result, patients after orthopedic surgery lack systematic rehabilitation treatment and training, and patients' bone and joint problems cannot be effectively solved.
From the perspective of the age of rehabilitation inpatients, the elderly patients after surgery become the main population of rehabilitation medical services. On the one hand, the elderly pay more attention to their own health needs; On the other hand, the medical and health needs of the elderly are more complex than those of other groups.
At present, China is rapidly developing into an aging society. In 2018, the proportion of urban population structure over 60 years old in China can reach 17.9%. It is estimated that by 2020, the elderly population will reach 255 million.
According to the estimates of the Arterial Network and Eggshell Research Institute, about 30% of the elderly need rehabilitation medical services, then the rehabilitation population will increase by 28 million, more than 76 million, especially the disabled and semi disabled elderly will become the key group of rehabilitation services. In addition, the rehabilitation treatment of chronic disease groups will also become an important force to promote the development of the rehabilitation market.
Opportunity 2: policy dividend
Of course, the biggest driving force for the development of the medical industry comes from policy support.
As an important livelihood issue, the elderly care issue has always been the focus of the NPC and CPPCC. This year's government work report proposed to promote the construction of a multi-level old-age security system. At the same time, it pointed out that we should vigorously develop the elderly care industry, especially the community elderly care service industry, give tax relief, financial support and preferential price of water and electricity to institutions that provide services such as day care, rehabilitation care and meal assistance in the community, support the construction of community elderly care service facilities in new residential areas, reform and improve the policy of combining medical care, We will expand the pilot long-term care insurance system.
On September 11, Premier Li Keqiang chaired the executive meeting of the State Council. In order to better meet the needs of the elderly for healthy elderly care, the meeting identified specific measures to further promote the development of medical and elderly care, including simplifying approval, encouraging social forces to set up medical and elderly care institutions, large-scale training of elderly care talents, implementing preferential policies such as taxes and land use for medical and elderly care institutions, and developing medical and nursing insurance.
On August 13, the National Health Commission issued the Notice on Printing and Distributing the List of Pilot Cities for Urban Development of Medical Consortium Construction, and identified 118 pilot cities for urban medical consortium construction projects. Before the end of 2019, each enterprise pilot city is required to build at least one medical consortium with obvious achievements in society. The preliminary design forms a medical consortium resource management system model led by urban tertiary hospitals, based on grass-roots rural medical insurance institutions, and participated by rehabilitation, nursing and other relevant medical and health institutions.
As early as 2011, the Ministry of Health issued the Guidelines for the Construction and Management of Rehabilitation Medicine Departments in General Hospitals, requiring more than two general hospitals to establish rehabilitation medicine departments. The introduction of this policy points out the direction for the construction and management of the "rehabilitation home" hospital.
In 2017, the National Health and Family Planning Commission issued the Notice on Printing and Distributing the Basic Standards and Management Norms of Rehabilitation Medical Centers and Nursing Centers (Trial), which put forward standardized construction requirements for rehabilitation medical centers.
In July last year, the National Health Commission issued the Notice on Formulating Guidelines for Promoting the Reform and Development of Nursing Services, encouraging and promoting the transformation of nursing institutions or some primary and secondary hospitals, encouraging and promoting social forces, stimulating the market, and expanding services such as elderly care, disabled care, rehabilitation care, mother and child care, and hospice care.
In 2019, the transformation from urban secondary hospitals to community hospitals became the top priority of public hospital reform. The ultimate goal is to establish rehabilitation care and hospice care centers.
It is reported that in order to alleviate the current situation of insufficient development of rehabilitation medical information resource management, in 2019, Beijing will continue to promote the transformation of the fourth batch of public hospitals to medical service institutions for rehabilitation treatment nurses. From 2016 to 2019, the municipal finance has arranged a total of 285 million yuan of subsidies for 19 transformation institutions.
Three challenges: talent, operation and management
Encouraged by this policy, health projects have become the object of competition among various capitals. But this big cake is not easy to eat.
The biggest threshold is the scarcity of rehabilitation talents. Zhang Danmei, President of Shouheng'an International Health Medical Research Co., Ltd., has personal experience. "We are all health care team leaders of the 301 Hospital of the PLA. There are four medical doctors in a team of six people, who are experts and have strong credibility. Many middle and high-end people are willing to come to us, but we do not understand the market, capital and operation."
Even 301 Hospital and Union Medical College Hospital have limited development of medical information resources in high-end health education management. The shortage of rehabilitation medical personnel has a direct impact on the coverage of rehabilitation services and the quality of service products.
At the same time, many entrants lack a more comprehensive understanding of the health care industry as an enterprise. Combination of medical care and nursing care We are not just Chinese medical care, but through the whole process of healthy development services, focusing on the front-end health education management, chronic disease management and control, and the back-end disability care, hospice care.
However, taking the current construction of Ankang City as an example, many developers only operate the Ankang industry as a single pension industry, ignoring the Ankang industry in various forms.
In addition to talent, the second problem is survival. "It takes at least 10 years for a hospital to train a doctor who can work independently, and also needs a doctor who can tolerate poverty, loneliness and test. In the hall of a public hospital, experts need not worry about no patients, but for those private hospitals who have gone out of the system and started their own businesses, the situation is different. Whether the patient can survive is a big problem. "Yan Changxiang, director of brain department of Sanbo, a private hospital, once told the media that the reason why the private hospital did not do brain department was why.
In addition, in the private hospital information management system, there are still problems such as non-standard rehabilitation data, strong subjectivity of the evaluation scale, and failure to realize the interconnection of rehabilitation data. It is necessary to further solve the connection problems with HIS, LIS, PACS and other systems of the hospital.
"Now, the national development requires secondary and primary hospitals to start small nursing hospitals, which also requires our hospitals to take the initiative to initiate reforms and make some technological innovations through their own students." Lan Yunfeng, the founder and chairman of China Puda, believes that the main problem is that the way to solve the problem is to rely on the opening of resources, especially in the opening of medical service information system data, Because without the support of Chinese medical related information processing data, it is difficult for them to achieve in hospital and out of hospital evaluation. The open attitude is also a key factor that can truly support patients' home and rehabilitation.
American experience
According to Wang Guangying's observation, China is in the primary stage of development. As a global healthcare and healthcare industry, the development experience and lessons of the United States have encouraged and helped the Chinese industry.
American rehabilitation institutions are characterized by refinement, differentiation and full coverage of medical insurance. Independent rehabilitation institutions play an important role. In the United States, each institution has a clear division of labor and rehabilitation definition. Through different reimbursement policies, a clear division of labor has been formed to effectively relieve the pressure of hospital emergency. The referral route in the United States is very smooth.
In terms of business model, the development and improvement of the American rehabilitation medical service system cannot be separated from the guiding role of the medical insurance payment system. The american medical insurance payment system is a prepaid system based on the united data system of rehabilitation medicine in the united states, with the independent function scale (fim) as the evaluation tool, and classified by function.
More than 80% of the business income of large rehabilitation service companies in the United States is mainly from the national medical insurance management fees (Medicare and Medicaid), "497", Conborn, Best Care, Brookdale and other well-known health care enterprises in the United States.
By analyzing the actual economic development of the rehabilitation industry in China and the United States, the Eggshell Research Institute found that the number of rehabilitation service institutions in the United States is 10 times that of China, the number of rehabilitation physicians is 3 times that of China, and the per capita rehabilitation cost in China is 1/17 that of the United States.
According to the latest rehabilitation medical insurance policy, the Notice on Including Some New Medical Rehabilitation Projects into the Payment Scope of Basic Medical Security (<R.SHB.F. [2016] No. 23), at present, there are only 20 medical rehabilitation projects included in the payment scope of medical insurance in China, mainly bone and joint rehabilitation and children's rehabilitation projects, with limited coverage.
However, it is precisely because of the lack of rehabilitation medicine in China that there is a greater opportunity for development.
According to market research, the per capita rehabilitation cost in China in 2018 was about 32 yuan. With the increase of people's income and rehabilitation costs, it is estimated that by 2022, the per capita rehabilitation cost in China will reach about 74 yuan, and the Chinese rehabilitation market will reach 103.3 billion yuan.
Investment prospects
In the view of a senior investor in the healthcare industry, the rapid development of nursing hospitals and nursing homes is the result of China's population structure: first, aging, and second, the family structure.
"Unlike our previous structure of one mother giving birth to nine children and raising children to prevent old age. Now, under the '421', the elderly problem, especially those over 80 years old, have an average working age of over 82 years old. Professional care services are provided for students who affect the life of the elderly."
From his investment experience, first of all, if private hospitals do not have expert teams, they may not have any core competitiveness. Second, only when patients believe in private hospitals can hospitals develop well and survive. Third, asset re investment, how to solve the problem in hospital needs more in-depth analysis.
"From the perspective of capitalization, a very realistic obstacle is that there are very few private hospitals directly listed on the market. How to make regulators recognize this model is a big problem."
It is reported that at present, investment institutions are inclined to two major trends: first, refined and specialized rehabilitation will become the mainstream rehabilitation service model.
It is reported that the comprehensive rehabilitation hospital has a high threshold in land acquisition, department construction, bed investment, personnel investment, etc., and needs a lot of financial support. In addition, the operation and management of the comprehensive rehabilitation hospital is very complex, and a large number of management personnel are needed in medical personnel, patients, equipment, materials, logistics and other aspects to ensure the normal operation of the hospital.
In contrast, the threshold of specialized rehabilitation service centers (or outpatient clinics) is much lower, the management of enterprise operations is not so cumbersome, and the management system is less capable of operating safety risks, which is more likely to be favored by social capital.
Second, intelligence. With the application of Internet, big data, artificial intelligence, Internet of Things and other high-tech technologies in rehabilitation medicine, the rehabilitation industry has ushered in the 3.0 investment stage, and the rehabilitation medicine has achieved intelligent and information-based innovation.
According to the statistics of the Eggshell Research Institute, the amount of financing in the field of rehabilitation robots is 10 million yuan or more, of which more than 60% of the events occurred before Round A. Similarly, more than 60% of the event financing in the field of tele rehabilitation is also 10 million yuan or more, which occurred before and after the A round. The financing events in the field of rehabilitation informatization mainly occurred before and after the A round, and the financing amount is mainly between 5 million yuan and 10 million yuan, which has a strong attraction to capital.
Complete list of names of medical technology companies : Lihui, Weitong, Ranmao, Huanda, Xunxiang, Kunmei, Haozhu, Jiyan, Dongfa, Zhouhe, Diyang, Quanyou, Duxin, Ninghang, Quanfang, Changming, Poye, Liqi, Mohua, Mener, Xiandian, Sanxiang, Yixi, Ruanying, Ludi, Zhihu, Feijia, Qingshou, Duxun, Qizhi, Yuandao, Junding, Dianlu, Jiming, Tingshi, Wangcang, Zihui, Longren Wu Ru, Xin Yong, Datuo, Qi Shi, Hang Bat, Ji Yu, Er Hu, Shi Yan, Han Di, Wei Hang, Yuan Shen, Jing Yuan, Tongguang, Lianbai, Bu'ao, Hao Zhou, Shunfu, Mangyao, Yangbei, Shan Qing, Cheding, Dazi, Er Yin, Yi He, Xiang Chang, Xin Si, Tian Li, Jie Chen, Men Jing, Huaihong, San Jiang, Shi Fang, Tie Table, Lu Jing, Xie Li, Jing Qiao, Da Lv, Di Jian, Ren Yuan Han Jun, Yawei, Ruxiang, Shineng, Tongjing, Maiji, Meiqiao, Hongbao, Li He, Honggu, Laoyao, Quartz, Zhoushui, West Africa, Feimai, Fuwei, Dingou, Zhaoshun, Renyi, Jinzhu, Xianhu, Zhouneng, Tuanjun
Complete list of names of medical technology companies : Huannong, Youfang, Jingtou, Shengyu, Huangfei, Hengzhao, Fujin, Beijin, Qingzhu, Shengxi, Zhentou, Shanjin, Longyun, Huiyuan, Yatai, Haobang, Chuanzhu, Fuhe, Zongxin, Mengtie, Zenuo, Renji, Shengfu, Woxi, Zheyuan, Yihua, Jingmo, Facheng, Yuyang, Hanghang, Zhiyang, Yuhan, Duye, Shidian, Xixia, Yuanyi, Yitai, Yixi Yasheng, Qiuchai, Chuntan, Cheyou, Huanong, Huiyuan, Tanghuang, Yegai, Mineral Energy, Taihang, Linggang, Gushi, Shengyin, Shangfa, Diqi, Bohong, Zhaolv, Detong, Jingpa, Fengyue, Duyin, Fengyu, Shibo, Zhenbei, Communication, Taixi, Beiyi, Xihan, Tairuan, Xiamen Cat, Menger, Xiyang, Jianwei, Yangming, Chaoyu, Yuanyong, Jianjing, Liangyi, Dinghe Pingyi, Nichang, Pinggu, Zhoubu, Li'an, Datian, Fuyuan, Yuelu, Meiyi, Junjiu, Yuanye, Mgpi, Longqin, Dingyou, Xianyan, Dituo, Daoyi, Zhicheng, Nengqi, Shunqing, Zhenglin, Yuedao, sailors
