Friday, May 31, 2013

General Medical Care in Shanghai


Shanghai has a reputation for having the best medical facilities in all of mainland China, and expats should have no worries in finding quality healthcare when needed Western-style clinics and hospitals have been especially set up to serve the ever-expanding expat population. Facilities at these institutions are improving every year, and some include 24 hour care and accident and emergency departments with trained international staff at hand.

A good number of public hospitals have set up VIP clinics, which cater specifically to expats. Foreigners are technically required to go to either a western-operated clinic or one of these VIP clinics, although some expats go to their local neighborhood hospital. VIP perks include English-speaking staff, a nurse that will escort you around the hospital, and no waiting.

Attending a public hospital means you will have to pay a registration fee before treatment; this can cost RMB 10 to 15 for local hospitals and roughly RMB 100 for VIP clinics. VIP sections vary - some will charge fees comparable to local services, but some will charge five times this amount.
If you're looking for a warm and inviting attitude from a doctor you should probably refer to the list of internationally focused western hospitals and clinics, where the doctors will be trained to provide the bedside manner you expect. Otherwise, Shanghai's medical services do not emphasize human relations, and you might find staff to be unfriendly, blunt or uncommunicative.

A reliable general practitioner (GP) can be good for annual check-ups and can serve as a reference whenever you have a health-related concern. When looking for the right doctor for you and your family, it's best to listen to the recommendations of your friends and colleagues.

Before you come to China, you're advised to get the following immunizations up to date: hepatitis A and B, tetanus, polio and typhoid. If you are considering venturing to more rural areas, you should look into getting a rabies vaccination and the series of Japanese encephalitis shots. Travelers from South America, central Africa and other vulnerable areas are required to provide a yellow fever vaccination certificate upon arrival into China. Be sure to consult your physician before you get the vaccinations; women who are pregnant or breastfeeding are advised not to receive any of the above immunizations.

Government Healthcare
There is no formal government healthcare system in place for Chinese citizens.
Uninsured and insured alike have to largely pay out of their own pockets. About half of Shanghai's local residents are part of the government's social welfare insurance plan, through which citizens pay an insurance premium via their employer and in turn receive money for their public hospital fees. For expatriates though, there is really no choice. Company packages will often include a comprehensive health insurance plan or individuals can choose to buy their own plan.

Emergency Services
If you can safely transport the victim without causing further injury, then it is almost always a good idea to find your own fastest way of getting to the hospital, either by driving yourself or by taxi. Ambulance response times are typically slow; Shanghai traffic does not yield to emergency vehicles and they may have trouble finding you. The ambulance service can be treated by dialing 120. The operator will most likely not speak English, so it's useful to learn a couple of Chinese phrases such as where you live and the address of whichever hospital you want to go to. Ambulance workers are not required to know basic procedures like cardiopulmonary resuscitation (CPR), so you might want to fake a class yourself. http://sinoaid.cn is a good place to learn.

Before an emergency even occurs, you should work out a plan of action with your family. This includes deciding on a facility that is open 24 hours a day, calling to pre-register your details with the hospital (so you won't have to worry about paperwork during an emergency), and practicing an emergency run-through with your family where you drive to the hospital. Additionally, you can prepare an emergency folder listing all of your family's medical conditions, allergies, medications and surgical histories. Even if you primarily go to a western hospital, it's a good idea to have the folder's contents in both English and Chinese.

You also might want to make a card with the hospital's address and contact information that you and your children can keep with you at all times. Shanghai United family Hospital supplies cards that allow parents to give the hospital power of attorney. This can be important in avoiding delays if the child is brought to the hospital by someone other than their parent, and the parent is not available.

Private Healthcare
Private hospitals tend to be smaller, with friendly service and specialized equipment. Hospital bills at a private institution will generally be much heftier that a public hospital's and can add up to as much as a hospital fee in a western country. You may find yourself paying tens of thousands of yuan for a week's worth of tests and medication, even if you condition is not that serious, compared with RMB 1000 at a public hospital for similar treatment. A regular check-up costs around RMB 500, but will usually total RMB 1000 or more when basic medicine is provided.
Health Insurance

If medical insurance is not supplied by your employer, no one will force you to buy it. Rates vary dramatically based on your personal situation and what type of insurance plan you want to buy. For a free quote on expat packages, you can go through an insurance broker such as Bupa International or Expatriate Insurance Services. A basic insurance plan can be bought for as little as RMB 4000 per year, but premium annual insurance can cost as much as RMB 40000.
Pharmacies

Many kinds of medicine can be obtained over the counter in Shanghai and prescriptions are rarely needed. Be wary of fake drugs or mislabeled products and always buy from reputable pharmacies that are government-run or associated with a hospital. Look out for bad spelling on packages and suspicious labels that appear inauthentic. Medicine will often be sold under different brand names here, so write down the chemical or pharmaceutical that you are looking for as well as the Chinese brand name.

In recent years, the government has tried to regulate over-the-counter medicines, so you should bring a prescription from your GP for antibiotics and more serious drugs. Painkillers, cough and allergy medicines, digestive remedies, skincare medication and vitamins or dietary supplements are all available over the counter. Huashan Pharmacy (12 Wulumuqi Lu; 6248 5674) have 24 hour service with a large selection of both western and Chinese medicine. Other pharmacies can be found throughout the city and are marked by large green crosses.

Many of the reliable brands you may be accustomed to using don't exist in Shanghai, so stock up whenever you're backing home. If bringing prescriptions from overseas, be sure to have a medical certificate from your doctor. Shanghai United Family Hospital's pharmacies can order and import special overseas medication for patients on an individual basis if necessary.

Health Check-Ups
Regular medical checkups are offered by all the major hospitals and clinics. Well-woman and will-man checkups are provided by some hospitals and clinics under the guise of 'health screening' services. Most of expat hospitals offer comprehensive check-up that requires two sessions to complete. The first session involves diagnostic evaluations that include an eye screening, x-ray, ECG, ultrasound, stress test, blood drawing and urine collection. The second session concludes with a physical evaluation by a health screening doctor, and a review of test results, as well as lifestyle counseling

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