Special Issue / Schwerpunkt| Volume 123, P32-35, June 2017

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Call for shared decision making in China: Challenges and opportunities

  • Mi Yao
    Department of General Practice, Peking University Health Science Center, Beijing, China

    Beijing Xicheng District Xinjiekou Community Health Service Center, Beijing, China
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  • Samuel Finnikin
    Corresponding author: Dr Samuel Finnikin; Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
    Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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  • K.K. Cheng
    Department of General Practice, Peking University Health Science Center, Beijing, China

    Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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      China's healthcare system has undergone extensive changes over recent years and the most recent reforms are designed to shift the emphasis away from hospital based services towards a more primary care based system. There is an increasing recognition that shared decision making needs to play a central role in the delivery of healthcare in China, but there are several significant barriers to overcome before this aspiration becomes a reality.
      Doctor-patient relationships in China are poor, consultations are often brief transactions and levels of trust are low. Implementing a shared decision making process developed in the Western World may be hampered by cultural differences, although this remains an under-researched area. There is, however, a suggestion that the academic community is starting to take an interest in encouraging shared decision making in practice and indications that the Chinese public may be willing to consider this new approach to healthcare.


      Das chinesische Gesundheitssystem hat sich im Laufe der letzten Jahre stark gewandelt; die jüngsten Reformen sollen den Schwerpunkt von einer krankenhausbasierten Versorgung hin zu einem stärker auf dem Konzept der Primärversorgung beruhenden System verlagern. Die Erkenntnis wächst, dass partizipative Entscheidungsfindung in der chinesischen Gesundheitsversorgung eine zentrale Rolle wird spielen müssen, doch bevor sich diese Bestrebungen realisieren lassen, gilt es, einige wesentliche Hürden zu überwinden.
      Um die Arzt-Patient-Beziehung ist es in China schlecht bestellt; der Arztbesuch ist häufig eine kurze Angelegenheit mit niedrigem Vertrauensniveau. Die Implementierung des Prozesses der partizipativen Entscheidungsfindung, wie er in der westlichen Welt entwickelt wurde, könnte aufgrund der kulturellen Unterschiede auf Schwierigkeiten stoßen, wobei dieses Thema bislang allerdings noch unzureichend erforscht ist. Es gibt jedoch Hinweise darauf, dass die akademische Community sich für die Förderung von partizipativer Entscheidungsfindung in der Praxis zu interessieren beginnt, und auch Anhaltspunkte dafür, dass die chinesische Öffentlichkeit möglicherweise bereit ist, über diese neue Herangehensweise an die Gesundheitsversorgung nachzudenken.



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