First of all, it should be clear: is the medical chain service institution a chain enterprise or a private hospital/department chain?

There is a priority problem: medical priority? Or is management and operation a priority?

We can make a comparison:

The largest chain hospital in the United States is HCA (with a market value of about $43 billion), which belongs to the hospital operation organization and has a cooperative relationship with the doctor group (foreign doctors are more free to practice). Faced with a group of doctors who have more say, we can only settle for the second best and become an operating company that focuses on asset expansion. It belongs to management operation priority.

Domestic chain hospitals are first and foremost doctors' groups. Specifically, the core of chain medical service lies in doctors. Although domestic doctors can practice more, due to many reasons, such as domestic patients who recognize temples but not monks, and the strong position of public hospitals in various places, the actual group of doctors will basically become private hospitals before they can officially open. Therefore, domestic chain medical service has become a combination of chain hospitals and doctor groups. Typical China's golden mean.

Therefore, the chain medical service in China is often the instinctive expansion of doctors after their successful start-up, which naturally has the attribute of medical priority.

This is actually the thinking and market inertia under the public medical management mode, but in essence, the hospital is a special industry enterprise, which needs to pay attention to management and efficiency. While doing a good job in humanistic care, strictly abide by the quality and safety requirements, and separate basic medical care, nursing and administration, and separate medical care from management and operation. Hospital management needs professional managers to carry out professional management.

Bottom line: doctors belong to doctors and management belongs to management.

At present, the more representative chain medical service institutions in the market are:

General Hospital Chain: Hemujia

Privatization of public hospitals: general policy medical care

Eye Hospital Chain: Aier Ophthalmology

Physical examination outpatient chain: Meinianda Health, Aikang

Dental clinic chain: Happy Oral and Baibo Oral.

Chinese medicine outpatient chain: Gushengtang, Heshuntang and Yunnan Shengai.

Plastic surgery hospital chain: Meilai Medical, Huahan Plastic Surgery

Diabetes chain hospital: Ruijing

The following expert chain statistics are available for reference:

In addition, Internet-based medical service institutions have also developed rapidly. List of some well-known Internet medical companies and their representative main businesses:

Judging from the recent news events of Aier Ophthalmology and the performance of the national team in the epidemic, public hospitals are the absolute subject of domestic medical care. It is not only reflected in the degree of patients' trust reflected by the number of visits, but also in the doctor system, credibility, public resources, policies and so on.

Hospital institutions in China are mainly public hospital systems (including those directly under the Ministry of Health, government offices at all levels, major medical colleges, major state-owned enterprises, central enterprises and military institutions), including tertiary hospitals for teaching, primary and secondary hospitals, community health centers, township hospitals and other non-profit medical institutions built by the government. By the end of 20 18, there were 2340 tertiary hospitals, 8422 secondary hospitals, 50 primary hospitals 10050, 34652 community health service centers, 3655 township hospitals1home. Excluding the community health centers and township hospitals in the above statistics, the number of hospitals that can be affiliated is about 32,000, of which about 20,000 are private hospitals. In terms of the number of patients, the number of public hospitals was 2.76 billion, a year-on-year increase of 4.0%; There were 470 million person-times in private hospitals, a year-on-year increase of 13.6%. The number of patients in public hospitals is 5.87 times that in private hospitals.

Although there is competition between public hospitals, the genes of public hospitals also determine the mechanism of weak coercion. Especially on the server side, the flexibility is much worse.

Look at foreign hospitals again:

The organizational structure of hospitals in China is generally hospital+outpatient service. In foreign countries, the model of hospital management company+hospital is very common. Its advantage lies in the streamlined operation of medical services and the sharing of medical equipment and human resources, which effectively reduces medical costs and optimizes resource allocation. Two-way referral between hospitals and reasonable diversion of patients have formed a one-stop service for pre-hospital diagnosis and treatment, postoperative rehabilitation of patients and rehabilitation of patients with chronic diseases, which has shortened the hospitalization days and achieved economies of scale in management and service.

It can be seen that in addition to doctors and management, there is also a service problem, which is more important to patients than doctors. And this is the advantage of chain medical institutions.

In terms of service content and form, chain hospitals have established related disciplines independent of hospitals, such as physical examination center, rehabilitation center, nursing center, logistics center, etc., to realize resource sharing; The core medical institutions in the chain group improve the technical level and management level of chain hospitals through mobile surgery and personnel training; Chain hospital groups have greatly improved the overall brand image of hospitals, facilitated patients to seek medical treatment and saved consulting costs.

Of course, chain hospitals also have potential risks:

For example, the leverage ratio of enterprises in the industry is generally high, which affects the liquidity refinancing ability of enterprises to a certain extent and limits the adaptability of enterprises to changes in the economic environment and industry environment. For companies that issue variable interest rate securities, there is the possibility that interest rate risk will lead to bond default. In addition, the overall operating cost of fabrics in the health care industry is rising (mainly reflected in the salary of medical staff), the competitive pressure of commercial medical insurance cooperation contracts (especially private hospitals), and the restrictions of laws and regulations (bed quota and merger audit regulations).

To sum up, as a quasi-public product, medical services should be shared by the government and individuals. The opportunities for chain enterprises are service level and differentiated services. At the same time, Internet technology has brought new ways for enterprises to drain and reduce costs. Finally, in the overall medical market, under the pattern of basic physiotherapy government and high-end medical marketization, chain medical service institutions can achieve the balance between basic medical service drainage and high-end medical income, which is also the balance between public welfare and marketization of medical services.