中国医院为利滥用心脏支架

A stent is a tiny tube placed into an artery, blood vessel or other duct to hold it open. Stenting is clinically practiced to treat acute heart attacks or serious angina. The practice, however, is said to be being abused by hospitals around China.

According to rough estimates, a decade ago only 20 thousand cases of heart stent surgery were performed annually in China, but in 2011 the number reached 400 thousand each year. Official estimates put the total number of stents used in 2011 at about 650 thousand.

Hu Dayi, director of the cardiovascular disease department at Peking University People's Hospital, says that behind the surge is people's blind faith that stents to cure heart diseases permanently.

"Please note that stents are not a permanent cure. Other blood vessels without stents could still be blocked by clots after putting in the stents. And stents themselves sometimes cause clots that block vessels. There are long term risks."

Hu says some hospitals are misleading patients into building up this faith in the use of stents because of the huge profits behind stent surgery. Medical experts say that performing stent surgery can be highly profitable and patients have been known to pay as much as 30 thousand yuan for a domestically produced stent that carries a factory price of 3000 yuan. For a 6000 yuan imported stent, the surgery can cost almost 40 thousand yuan.

The Ministry of Health has taken various steps to prevent the devices from being overused. The ministry has been requiring collective assessments for surgery that uses more than three stents. However, Hu says these haven't been strictly adopted by hospitals.

"Despite the regulations already in place, we lack reinforcement and supervision. Nobody ever supervises the practice. I personally saw many violations going on."

Hu says Singapore's medical insurance office rules require that medical insurance shall reimburse no more than 3 stents for each individual, if more stents are required, doctors are to be summoned to explain why. Hu thinks China need similar regulations.

"We need more feasible measures, including adjustments in payments. For example, medical insurance should reimburse no more than 3 stents per person. And we need to crack down on violations, carry out harsh punishments on doctors and hospitals which violate the regulations."

Medical experts say that over-treatment has existed for a long time. They say it's as well established as repeated examinations and abuse of antibiotics and other medicines. This is largely due to the "drug maintaining medicine" system. One analogy has it that doctors are like cobblers who don't live by their skills, but by how many nails they can sell when repairing shoes.

The solution is the separation of medicine and pharmacies. The Beijing authorities began a pilot project in local hospitals earlier this year, where they cancelled the 15 percent drug premium taken by hospitals and also the patient registration fee. Instead, hospitals can charge an additional medical service fee, which can be reimbursed by healthcare insurance. The aim is to ensure that patients can have affordable medical treatments as well as a push for hospitals to update their price structure.

For CRI, I'm Wang Wei.