Since the reform and opening up, China's economy has begun to enter a phase of rapid development. According to the National Bureau of Statistics, GDP (gross domestic product) has been growing at a high rate since 2000, increasing from 9,921.5 billion yuan in 2000 to 39,798.3 billion yuan in 2010, with a compound annual growth rate of 14.90%. From 2005 to 2010, the total output value of the medical device industry has steadily increased year by year, with a compound growth rate of over 20%.
With the development of medical science and bio-engineering technology, hospitals are experiencing a surge in demand for high-end medical equipment, such as MRI, CT, PET, gamma knife and other high-tech imaging equipment and radiation therapy equipment; the reform of the healthcare system and the country's investment in the healthcare industry are also increasing the demand for medium- and high-end equipment in primary hospitals.
Currently, the financing methods for the introduction of domestic hospital equipment are roughly divided into the following: own funds, bank loans, foreign government loans, financial allocations, corporate investment and financial leasing. Among them, financial leasing has been gradually recognized by hospitals for its flexibility, speed, large financing amount, fast funding and other advantages, and the model has been increasingly adopted in practice.
In 2010, China's financial leasing transactions amounted to about 700 billion yuan, an increase of 89% over 2009. According to HCR (HC Research) estimates, of this amount, about 30 billion yuan was placed in medical equipment financial leasing. By the end of 2010, there were 181 financial leasing companies registered and operating in China, an increase of 17 from 2008.
According to the Administrative Measures for Financial Leasing Companies: Financial leasing business refers to the transaction in which the lessor purchases the leased object from the seller based on the lessee's choice of the seller and the leased object, provides it to the lessee for use, and collects the rent from the lessee, and it is conditioned on the lessor's retention of the ownership of the leased object and the collection of rent, so that the lessee obtains the rights of possession, use, and benefit of the leased object during the term of the leasing contract. Medical equipment financial leasing refers to the hospital to determine the appropriate medical equipment and suppliers (manufacturers), and complete the relevant medical equipment introduction and approval procedures, leasing company according to the hospital's requirements for the purchase of selected medical equipment, delivered to the hospital to use, the hospital in the use of the period of time to pay a certain amount of rent in installments, so as to obtain the right to use the equipment and the right to income, at the end of the lease period, the hospital to pay the residual value of the equipment is low, the hospital can obtain the ownership of the equipment. At the end of the lease term, the hospital pays the lower residual value of the equipment and then obtains the ownership of the equipment. According to the definition, during the financial lease period, the hospital owns the right to use and the right to income, while the leasing company owns the equipment, and at the end of the lease period, the ownership belongs to the hospital.
The reason why financial leasing is widely used is that it has the advantages of other financing methods that are incomparable: its audit conditions are relatively loose, mainly to examine the scale of the hospital, good business conditions and other indicators; financing for a longer period of time, the business process is flexible, the operation time is shorter; the repayment cycle is relatively long, the repayment method is flexible; the contract is strict, the rights and obligations of the two parties are clearly delineated, and the legal risk is low. This way is suitable for the urgent need for equipment, but the funds raised for a short period of time insufficient large and medium-sized hospitals, can make the hospital in a relatively short period of time to achieve the rolling development of the scale of operation, with the steady development of the business, the cooperation between the two sides can gradually establish a high amount of credit and strategic partnership; leasing company generally only require hospitals to carry out regular feedback, does not affect the normal operation of the hospital.
Since financial leasing mainly solves the capital needs of hospitals, there are certain shortcomings, mainly reflected in: interest rates will change with the change of bank interest rates, the lessor charges more management service fees; the lessor in the development of the contract, ignoring the quality of the equipment, service and maintenance of equipment and other responsibilities and obligations, to the hospitals to bring risks. These deficiencies are precisely the important factors for hospitals in choosing to use financial leasing or other ways to introduce equipment, but also because of the lack of clarity of responsibilities and obligations, resulting in the process of financial leasing many legal disputes.
Currently, domestic hospitals mainly use direct leaseback, vendor leasing and leaseback to finance and introduce equipment. Direct leasing refers to the lessor with its own funds or funds raised in the capital market to purchase equipment, leased directly to the lessee of the lease, vendor leasing refers to the leasing company and the suppliers and agents signed a cooperation agreement for the financing of its customers, by the suppliers and agents to recommend the customer, the leasing company to provide financial leasing services to its customers; sale and leaseback is the hospital to revitalize the assets, the ownership of the equipment will have been transferred to a third party to obtain liquidity. The sale and leaseback is a process in which the hospital revitalizes its assets, transfers ownership of existing equipment to a third party to obtain liquidity, pays rent during the lease period, and redeems the equipment at the end of the period.
Financial leasing is the innovation of the market allocation of resources, is to open up a better allocation of capital channels, to realize the innovation of investment and investment portfolio. The state as well as many local governments have introduced corresponding policies to encourage and support financial leasing companies to finance through multiple channels, and provide financial leasing industry development with financial and tax policy support, incentives and subsidies. Under the encouragement and support of the policy, this form of financial leasing will certainly be more effective in solving the needs of hospitals for equipment, thus also promoting the development process of the healthcare industry.
Domestic development
80% of China's medical resources are concentrated in 20% of the big cities, the people to see a doctor are concentrated in the big hospitals, resulting in a long waiting time to see a doctor, the acute shortage of hospital beds. Improve the community medical network, so that the masses of small illnesses into the community, the big disease into the hospital is to solve China's difficult to see the doctor, one of the main means of expensive. Major illnesses into the hospital, minor illnesses into the community is a more reasonable way to allocate medical resources, community medical institutions will become the main body of preventive health care, basic medical care, health education, disease control and other community health services.
China's community medical services are still in the initial stage. 2009, the national community health service centers and service stations accounted for only 2.98% of the total number of health institutions, and their health technicians accounted for only 4.52% of the total number of health technicians. There is still much room for improvement in the human resource situation of community medical institutions.
There is still a big gap between community medical institutions and large hospitals in terms of facilities, diagnosis and treatment level and other objective conditions. Some community medical institutions lack of hardware, obsolete equipment, and even the external environment is too poor to affect the confidence of the residents to visit the hospital, and many community medical institutions have a single business, low level of technology, and a general lack of general practitioners and senior personnel.
Introduction of equipment
1. If it is a health bureau of the institutions hospitals, need to be approved by the higher health authorities.
2. Special equipment requires approval: three ministries (Ministry of Health. Development and Reform Commission. Ministry of Finance), the purchase of large-scale medical equipment need to handle the configuration of the license, that is, approved before you can buy. Class A large medical equipment shall be approved by the Ministry of Health, Class B large medical equipment shall be approved by the provincial health department.
3. Ambulances need to be approved by the provincial and municipal health authorities, otherwise the traffic control department will not give the license.
4. Approval of the purchase, in accordance with local government requirements, in accordance with the procedures for procurement, more than 1 million yuan of equipment to enter the bidding process, the import of large-scale medical equipment category A and B must be open bidding, and through the electromechanical review process.
Professional medical equipment operation must be used by professionals, qualified to practice, with large equipment license, health regulations, financial hair [2004] No. 474 of the document, Article 21, said "large-scale medical equipment, personnel need to be trained to obtain the appropriate qualifications.