Hospitals need more than mortality ceilings

A recent draft of the standards on medical services capabilities issued by the National Health and Family Planning Commission has proved controversial, as the commission has set some specific "mortality ceilings" for China's Class-2 and Class-3 general hospitals.

The draft stipulates there should be no more than eight deaths for every 1,000 inpatients and no more than 1.4 deaths for every 1,000 inpatient operations in Class-3 general hospitals; while for Class-2 general hospitals, there should be no more than four for every 1,000 inpatients and no more than 0.28 deaths for every 1,000 inpatient operations.

These proposed mortality ceilings have drawn widespread suspicion and criticism as people are questioning whether the proposed limits will encourage hospitals to refuse to admit patients in a critical condition or prompt them to force patients with no hope of recovery out of hospital. Under such a rigid system, how to prevent hospital managements from fiddling the numbers is also a big problem.

In response to public queries, Zhang Gang, an official from the commission, told Beijing News that the mortality numbers are only guidelines, not compulsory assessment standards, and they will not cause hospitals to keep badly ill patients from entering their doors.

"With such non-binding standards, we are trying to remind hospitals to strengthen their manage-ment systems and ensure the quality and safety of their services. They are not meant to punish medical institutions or their practitioners should they fail to attain a specific index within a specific period," he said.

Any positive efforts from the health authorities to improve the public healthcare system should be praised. So their attempt to provide standards for the critical care provided by Class-2 and Class-3 general hospitals should be welcomed as an attempt to improve the efficiency of the management systems. Such a system is a common international practice, and similar average mortality figures are sometimes offered in relation to specific diseases or operations. According to medical experts, such reference standards can be used to urge relevant medical institutions to improve the quality of their medical services and facilities.