Guide: on August 19, the health and Family Planning Commission issued a document to promote the hierarchical diagnosis and treatment system. On the basis of local declarations, the national health and Family Planning Commission and the State Administration of traditional Chinese medicine identified four municipalities directly under the central government, including Beijing, and 266 prefecture level cities, including Shijiazhuang, Hebei Province, as pilot cities to carry out the pilot work of hierarchical diagnosis and treatment. In this context, what are the opportunities in each subdivided field of medical devices?

Large scale promotion of graded diagnosis and treatment

At present, nearly 20 provinces have issued guidance and detailed assessment indicators in 2017, requiring at least city residents to have 2 general practitioners. The level of basic medical treatment needs to reach 65% of the total service volume, and the coverage of telemedicine is 80%. The popularization rate of medical informatization in hospitals and grassroots organizations is 100% and 80% respectively, and the proportion of hypertension, diabetes and other diseases management reaches 40%.

As of July 25, 2016, 84 provinces and cities have issued local regulations on graded diagnosis and treatment, and the following 18 provinces or municipalities directly under the central government have issued corresponding tasks in 2017.

In addition, Zhejiang, Shaanxi, Qinghai, Tianjin, Inner Mongolia, Liaoning, Heilongjiang and Anhui have also issued provincial guidance on promoting the construction of graded diagnosis and treatment. In addition, some provinces have more precise requirements for the construction of medical insurance payment system. For example, Xinjiang requires provincial hospitals to carry out more than 50 kinds of payment tasks by disease. On the whole, all provinces have stipulated the service volume of grass-roots diagnosis and treatment, which needs to reach 65%; The coverage of telemedicine and graded diagnosis and treatment needs to reach more than 80%.

Medical device industry opportunities

The grass-roots medical institutions will undertake the task of chronic disease management. The Health Planning Commission has issued the notice of implementing the key work plan for further improving the medical service action plan in 2016, making the grading diagnosis and treatment mode based on common diseases and frequently occurring diseases. The first thing to put on the agenda is high blood pressure, diabetes, blood pressure meter and blood glucose meter. The demand for medical devices will rise sharply.

The guidance encourages the promotion of interregional resource sharing; Explore the establishment of independent regional medical testing institutions, pathological diagnosis institutions, medical imaging examination institutions, disinfection and supply institutions and blood purification institutions to realize regional resource sharing. Strengthen medical quality control and promote mutual recognition of inspection and inspection results among medical institutions at the same level and between medical institutions and independent inspection and inspection institutions.
The development of outsourcing services is mainly due to the demand for fee control. The fees of class III and class A hospitals are relatively high. Outsourcing some simple businesses can make the payer of medical insurance better control the expenses; Compared with other medical services of tertiary hospitals, the service content of medical testing institutions, pathological diagnosis institutions, medical imaging examination institutions and other institutions is not very demanding, and the service is relatively easy to provide; Each single store module is standardized, easy to copy and suitable for capital entry.

In vitro diagnostics and related industries

In 2015, the global in vitro diagnosis market was about US $63.4 billion. According to the current growth rate of the industry, it is expected to reach US $77.7 billion by 2018.

The demand for fee control also led to the outsourcing of in vitro diagnosis. Since the early 1980s, the U.S. government and commercial medical insurance institutions have begun to modify the medical insurance policy in an attempt to control medical expenditure.

Independent laboratories have lower costs and are gradually favored by medical insurance payers. By the mid-1980s, independent laboratories and private clinics had a similar market share of clinical testing, both close to 20%, and the rest were provided by hospitals. In 2013, the market share of independent medical laboratory reached 35%, about US $19 billion. In Europe and Japan, the market share of independent medical laboratory is higher, 50% and 67% respectively.

Compared with the market share of China's third-party laboratory, which is only 3%, China's third-party in vitro diagnostic institutions can provide less diagnostic items, which is far away from developed countries, and there are many contents that can be enriched. There is still great room for the development of China's third-party testing market. At present, inspection and imaging services are mainly concentrated in public hospitals, with a compound growth rate of more than 20%, indicating that the demand side of services is growing rapidly.

Similar to in vitro diagnosis, lower level hospitals and primary medical institutions need to enhance basic hardware equipment. At the same time, policies encourage the establishment of regional independent medical imaging institutions to drive the medical imaging manufacturing and service industry.

Physical examination

Preventive medicine is very common in organizations integrating medical insurance. For example, Caesar medical, a managed medical organization, provides physical examination for all insured to reduce the probability of group illness and reduce medical expenses.

1. The number of people undergoing health examination in China in 2013 was about 388 million. At present, the coverage rate of health examination is no more than 30%, which is lower than that of developed countries, so there is room for improvement.
2. Private health examination services can replace the health examination services of public hospitals.
3. At present, the market share of professional private physical examination services is about 19.6% (Analysys think tank), and the concentration of private physical examination services is not high, so there is room for further integration.

[source] Guolian securities