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Progressive payment for more than 120 varying surgical procedures will be an option for patients at the beginning of next year at a privately operated hospital in Zhengzhou, capital city of central China's Henan Province, Zhengzhou Evening News reported on December 19.

According to an implementation plan set forth by the Zhengzhou Renji Injury Microsurgery Hospital, progressive payment will apply to orthopedics, general surgery, microsurgery and surgery of the hand, as well as more than 120 normal (non-emergency) operations, including cholecystectomy, spine curvature diorthosis, surgeries for lumbar fractures, femoral head fractures, metathesis, and many more. The expense for the applicable procedures ranges from 2,000 to 60,000 yuan (US$249 to 7,436).

Under the plan, the patient will pay 50 percent of the cost upon his or her hospitalization, and another 20 percent upon checking out of the hospital. The balance of 30 percent would be paid within six months from the day the patient executed a contract with the hospital.

"Most of patients here are from rural villages or are laid-off workers in the city. Considering the interests of these socially vulnerable groups, we decided to change the charge mode," the report quoted Zhang Zhong, assistant to dean of the hospital, as saying. "We have completed an accurate computing of our cost, and set forth the ceiling for each single operation. This means no matter what the individual difference, there is a maximum limit for a person's surgical expense. If exceeded, the additional cost will be absorbed by the hospital," Zhang explained. "From January 1, 2006, the list of highest limit for each single operation will be available for the reference and choice of patients."

Patients are required by the hospital to provide their identity cards or substitute documents to prove their identity, a copy of which shall be retained by the hospital. Proof of identity and residence of their guardians may also be required. And, if needed, a list of guarantors would be presented when checking in to the hospital.

The hospital was officially approved by the Zhengzhou Health Bureau on February 2, 2003, and the facility commenced operation in its current Fenghuang Street location in September. Of the more than 80 staff people, approximately 80 percent are transferred army physicians. Half of the 30 beds in the hospital are occupied. "Our hospital is not very famous, but it is fully authorized," Zhang confirmed that the new payment policy does have some promotional purpose.

On November 1, upon learning that corrective surgery would cost 15,000 yuan (US$1859) at a large hospital, a patient with a fractured patella chose to have the procedure done at Zhengzhou Renji Injury Microsurgery Hospital, where he was cured at a cost of 4,770 yuan (US$591), according to the report.

In the in-patient department, a patient surnamed Zhou told the Zhengzhou Evening News that "the facility as well as the service of the hospital is good, and the price is reasonable."

A source with Zhengzhou Health Bureau, who declined to give his name, said during a telephone interview with the paper, "The privately-run hospitals indeed sometimes have problems in business development. The hospital's move is an active step in seeking the change of hospital charge mode, and we will be interested in the results."

There are several privately-run medical facilities in Zhengzhou City. During an interview with a representative of another hospital, a source was quoted by the paper saying "We won't follow the move, at least not now. The competitive advantage of a privately-run hospital is charging and service. If the patient doesn't pay on time, there will be bad debts. That's a big taboo for privately-run hospitals."

Renji Injury Microsurgery Hospital is not the first medical facility in China to adopt such a policy, nor even the second one. According to a previous media report, on February 16, 2003, Shanghai-based Ren'ai Hospital allowed patients to pay progressively for several surgical procedures, which costs more than 20,000 yuan. After nearly eight months, when only three patients applied for the progressive payment plan, that threshold was revised to 3,000 yuan. On March 19, 2005, a privately-run hospital in Shenyang, capital city of northeast China's Liaoning Province, announced a progressive payment plan for fee-for-service of acyesis. In early December, the Chongqing Family Planning Hospital applied the fee policy to five types of surgery, with a threshold of 3,000 yuan. Renji Injury Microsurgery Hospital is the fourth such institution to adopt the policy, the report said.

According to the report, hospital managers revealed that they are consulting the content and format of the payment contract with lawyers, and will soon officially announce the implementation of the policy at a press conference to take place around the start of the New Year.

(China.org.cn by Zhang Yunxing, December 30, 2005)