Beijing Launches Pioneering COPD Community Management Program Ahead of National Graded Diagnosis and Treatment Guidelines

Currently, smog in Beijing is becoming increasingly severe, and the incidence of respiratory diseases is rising year by year. The prevalence of chronic obstructive pulmonary disease (COPD) among residents aged 40 and above in Beijing has reached as high as 13%. The World Health Organization and China’s National Health and Family Planning Commission have listed COPD as one of the “four major” chronic diseases affecting public health, alongside cardiovascular and cerebrovascular diseases, diabetes, and cancer. In 2016, the National Health and Family Planning Commission was set to release the “Technical Guidelines for Tiered Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease,” thereby incorporating COPD into the national public health service management framework. As a professional industry association, the General Practice Branch of the Beijing Medical Doctor Association collaborates with relevant departments to assist health administrative authorities in organizing and implementing prevention and control measures.

In November 2016, the General Practice Branch of the Beijing Medical Doctor Association, in collaboration with the Beijing Community Health Service Management Center, the Beijing Medical Insurance Management Center, and the Beijing Medical Insurance Association, organized renowned domestic respiratory specialists from China-Japan Friendship Hospital, Peking University First Hospital, and Xuanwu Hospital Capital Medical University, along with representative general practitioners from communities in districts such as Xicheng, Chaoyang, and Haidian, to jointly formulate the “Community Management Guidelines for Chronic Obstructive Pulmonary Disease,” thereby laying a solid foundation for family doctor contracted services.

To implement the requirements of the “Guiding Opinions on Promoting the Construction of a Tiered Diagnosis and Treatment System” (Guo Ban Fa [2015] No. 70) issued by the General Office of the State Council and the “Key Tasks for the Construction of Beijing’s Tiered Diagnosis and Treatment System in 2016–2017,” with a focus on strengthening primary care, enhancing community-based management of chronic diseases, promoting family doctor contract services, and advancing the tiered diagnosis and treatment system, we will accelerate the implementation of family doctor contract services for community patients with chronic obstructive pulmonary disease (COPD).Under the guidance of the Beijing Municipal Health and Family Planning Commission, the General Practice Branch of the Beijing Medical Doctor Association, in conjunction with the Beijing Community Health Service Management Center, the Beijing Medical Insurance Management Center, and the Beijing Medical Insurance Association, jointly launched the “Work Plan for the Implementation of the Community-Based Contracted Service Project for Chronic Obstructive Pulmonary Disease (COPD) Management in Beijing (2017–2018).”。

On the afternoon of December 13, 2016, the “Conference on Advancing Community Management and Skills Training for Chronic Obstructive Pulmonary Disease (COPD) and the Inaugural Meeting for the Establishment of Community Respiratory Medicine Specialist/General Practice Teams” was convened at the International Conference Center of Liangma River Building in Beijing. The first batch of community-based COPD management specialist/general practice teams, supported by respiratory experts from tertiary Grade A hospitals, was established. Through horizontal assistance provided by these experts, the capacity and quality of respiratory disease services at community health institutions were enhanced, resident health education on COPD was conducted, and the needs of urban and rural residents for prevention, control, and tiered diagnosis and treatment of this chronic disease were effectively met. By 2017, more than 100 community health service centers were to provide contracted management services to no fewer than 50,000 COPD patients; by the end of 2017, all community health service centers were to have established community COPD management specialist/general practice teams, with over 100,000 COPD patients under contracted care. Efforts were to be made in 2018 to extend community health service management coverage to all COPD patients.

Key Features of the Project: By uniting experts from the General Practitioner Expert Committee of the Chinese Medical Doctor Association, the Respiratory Branch of the Chinese Medical Association, and the China Primary Prevention and Control Alliance for Respiratory Diseases with general practitioners in community health centers across Beijing’s districts and counties, a novel integrated team combining specialty and general practice in respiratory medicine has been established. This team integrates tiered diagnosis and treatment with medical care, education, research, and prevention (hereinafter referred to as the “Community COPD Management Specialty/General Practice Team”). Prominent respiratory experts, including Academician Wang Chen from China-Japan Friendship Hospital, Director Chi Chunhua from the Department of Respiratory Medicine at Peking University First Hospital, and Director Nie Xiuhong from the Department of Respiratory Medicine at Xuanwu Hospital, serve as chief experts of this Specialty/General Practice Team. By the end of 2016, an expert team composed of respiratory specialists from more than 20 Grade III Class A hospitals in Beijing had formed horizontal partnerships with 100 community health service centers to provide support and assistance for contracted community management and tiered diagnosis and treatment of chronic obstructive pulmonary disease (COPD). In 2017, respiratory experts from over 50 Grade III Class A hospitals will join the Community COPD Management Specialty/General Practice Team, achieving horizontal collaborative support for all family physician teams. Between 2017 and 2018, the expert team will also lead family physician teams in conducting scientific research guidance on COPD prevention and control in communities, evaluating the effectiveness of community-based COPD management and cost control, applying internet technologies to community COPD management, and studying the impact of smog on COPD as well as community-based monitoring and management of COPD.

Furthermore, institutions such as the General Practice Branch of the Beijing Medical Doctor Association will provide gratuitous assistance to all community health service centers participating in project activities for the establishment of nebulization inhalation rooms. Additional investments will be made in basic diagnostic facilities, such as pulmonary function testers, for centers with a high demand for patient management within their jurisdictions, achieving full coverage of nebulization room construction across all community health service institutions in the city by 2018. Meanwhile, with support from medical insurance and other sources, selected patients with chronic obstructive pulmonary disease (COPD) will be enrolled in initial diagnosis and contracted management programs. Internet and mobile technologies will be adopted in tiered diagnosis and treatment and health management models, providing doctor-patient communication APP clients. Supported by internet information technology, this initiative ensures smooth information flow in tiered diagnosis and treatment and health management, enhances service capabilities, and enables online management. Through a “Public-Private Partnership” (PPP) model for public welfare services, social forces and the general public will be mobilized to participate in tiered medical services and the control and management of major chronic diseases, particularly those affecting the respiratory and digestive systems.