China Issues First-Ever Hospice Care Standards, Highlighting End-of-Life Compassion

On February 9, the National Health and Family Planning Commission released the Basic Standards for Hospice Care Centers (Trial) and the Management Specifications for Hospice Care Centers (Trial). Hospice care centers (also known as palliative care or end-of-life care centers) are medical institutions that provide terminally ill patients with services such as pain and symptom management, as well as physical, psychological, spiritual, and humanistic care, aiming to improve quality of life and help patients pass away comfortably, peacefully, and with dignity.

The Basic Standards for Hospice Care Centers (Trial) and the Management Specifications for Hospice Care Centers (Trial) establish mandatory requirements for bed capacity, departmental configuration, staffing, facilities, and equipment, as well as management protocols.

Palliative care is a new concept in China, referring to the medical care and humanistic support provided to terminally ill patients during the final stage of their life journey. It holds significant importance for improving patients’ quality of life and demonstrating societal civilization and progress.

In 2016, there were 9.75 million deaths in China, including approximately 2.21 million due to malignant tumors. Additionally, terminally ill patients with other conditions and a life expectancy of no more than 3–6 months require palliative care services. By providing hospice care to terminally ill patients, their psychological burden can be alleviated, particularly by relieving their fear and anxiety regarding pain and death. This enables patients to spend their remaining days peacefully, calmly, painlessly, comfortably, and with dignity. Meanwhile, family members are guided to actively cooperate with physicians in providing assistance and care that addresses the patient’s physiological, psychological, and social needs.

On the other hand, for certain malignant diseases with high case fatality rates, futile and excessive treatments and resuscitation efforts are no longer necessary. However, influenced by traditional Chinese cultural norms, family members often insist that physicians spare no expense in attempting resuscitation at the end of life. Given that current medical capabilities are limited in their ability to meaningfully prolong the lives of terminally ill patients, priority should be placed on alleviating patient suffering. Therefore, the promotion of palliative care not only reflects humanistic concern but also significantly reduces unnecessary healthcare expenditures.

Currently, hospice care services have been implemented in hospitals across certain provinces and municipalities. Five years ago, the Ninth People’s Hospital of Zhengzhou, Henan Province, initiated hospice care services and established the Center for Palliative Care and Hospice Care. Since launching pilot programs for hospice care in 2012, Shanghai has designated 76 pilot institutions, opened more than 300 hospice care wards, and provided 890 hospice care beds. As of July 2016, these facilities had served 7,000 terminally ill patients, with preliminary estimates indicating a reduction of RMB 70 million in unnecessary medical expenditures. In Beijing, hospitals offering end-of-life care include Beijing Songtang Hospice Care Hospital, Beijing Deshengmen Community Health Service Center, Beijing Geriatric Hospital, and the Department of Geriatrics at Peking Union Medical College Hospital. As the first hospice care hospital in China, Beijing Songtang Hospice Care Hospital has been in operation for nearly 30 years and has cared for tens of thousands of terminally ill patients.

In VCBeat’s 2016 review, there were a total of 111 companies related to elderly care, but only one—Cikang Life—was involved in hospice care. Compared with the elderly care sector, the palliative care field has stronger medical attributes and has seen minimal involvement from private capital; most existing palliative care centers have been established by public healthcare institutions.

As China’s population aging accelerates, hospice and palliative care, as an objective livelihood need, is increasingly in demand. However, currently less than 1% of terminally ill patients have access to such services. This is partly due to inadequate public awareness, but more significantly because few medical institutions offer these services, resulting in a pronounced supply–demand mismatch. Similar to other post-acute care facilities—such as rehabilitation hospitals, nursing homes, geriatric hospitals, and sanatoriums—hospice and palliative care centers should be decentralized to primary care institutions and community health centers, aligning with the tiered diagnosis and treatment model, while large hospitals focus primarily on acute care.