AI能解开中国医疗体系的困局吗What role can AI play in China health-care system
作者：微信文章随着老龄化程度的迅速提高，中国现行医疗系统承受的压力必将越来越大，寻求破局之道成为不可避免且迫在眉睫。那么，AI在这个领域里可以有怎样的作为呢？
With rapid increase of ageing population, the pressure on China's current healthcare system will inevitably grow, making it imperative to seek solutions. So, what role can AI play in this field?
我们来看看近期经济学人的观察和观点。
Let’s go through the observation and view from the recent issue of The Economist.
中国的公共医疗体系堪称世界一流同时也令人糟心。北京和上海最好的医院拥有顶尖的医生、最新的药物和闪亮的医疗设备。但最好的医院（三级医院）只占全国医疗机构的10%左右。在全国约3.3万个乡镇级卫生院中，只有一半的全科医生有大学学历。中国医疗支出只占GDP的7%（作为比较，英国约为11%）。
China’s public-health system is both world-class and woeful. The best hospitals in Beijing and Shanghai have top-notch doctors, the latest drugs and gleaming equipment. But such places make up only around 10% of China’s medical institutions. In the country’s 33,000-odd township-level health centres, only half of general practitioners (GPs) even have university degrees. In total China spends around 7% of its GDP on health (for comparison Britain shells out around 11%).
人们一旦生病就涌向大城市的专家，导致了一号难求、医生超负荷工作、专家将时间浪费在常见病上等系列问题。对社区基础医疗服务进行大规模投入或许能解决问题，但是高额债务使地方政府在包括医生培训和招募在内的医疗投入上很难发力。
When ill, people tend to flock to specialists in big cities. That leads to massive queues, perilously overworked doctors and experts wasting their time on common diseases. Vast investment in basic services offered near where people live might help solve the problem, and local governments want to train and hire more doctors. But they are heavily indebted.
到2050年，中国60岁以上人口将达到4.87亿，约占总人口35%，而目前这一比例为21%。人口迅速老龄化将带来一波慢性疾病浪潮，现有体系必将难以应对。
By 2050, 487m people will be over the age of 60, about 35% of China’s population, up from 21% today. Its rapidly ageing population will bring with it a wave of chronic diseases that the current system is ill-equipped to handle.
因此，让数字医疗真正运转起来的需求极为迫切。近几年，企业和政府都开始推广远程医疗和人工智能。
China has pressing reasons to make digital health care work. In recent years both private companies and government officials have started promoting telemedicine and artificial intelligence (AI).
中国远程医疗起飞是在新冠疫情期间。人们迅速使用起科技公司推出的应用程序，通过文字或视频向医生发起咨询。“京东健康”声称，截至今年6月的12个月活跃用户为2亿，平均每天有50万次线上问诊。今年6月，蚂蚁集团又推出了一款名为AQ（现已升级为“蚂蚁阿福”）的应用。据蚂蚁方面称，截至9月，该平台已服务了1.4亿名患者，在平台上提供服务的医生有近100万名。
Telemedicine only took off during the covid-19 pandemic. Chinese seized on apps launched by China’s tech companies that allowed them to consult doctors either by text or video. JD Health claimed to have 200m active users in the 12 months to June, with an average of over 500,000 online consultations a day. In June Ant Group launched another app called AQ. As of September it had served 140m patients and nearly 1m doctors had offered their services on the platform, according to Ant.
理论上，这些举措有助于加强地方医疗服务，让农村居民更方便地获得远方专家的服务。
In theory all this should help bolster local health-care offerings and give rural folk better access to faraway experts.
然而，瓶颈也很明显。一方面，远程医疗应用的典型用户是本就拥有公共医疗体系中最好就医条件的年轻城市居民。另一方面，在应用上提供咨询的医生，通常也只是利用业余时间赚取额外收入。所以，这几乎无助于缓解医生群体的工作负荷。有学者认为，让医院要求医生分配5~10%的工作时间用于远程医疗可能是一种解决方案。但这又需要调整医保制度，使医生更容易获得线上工作的报酬。
Bottlenecks remain, however. The typical users of telemedicine apps are younger urban residents—in other words, people who already have the best access to China’s public-health services. And the doctors who offer their advice on the apps usually use them to earn more money outside their regular hours. So it is hardly helping with overwork. One solution would be for hospitals to get doctors to allocate 5-10% of their daytime hours to telemedicine, argues a western professor. That in turn would require tweaks to China’s state-backed health insurance to make it easier for doctors to be paid for online work.
使用AI提供健康建议是下一步。如今，已有不少人在使用诸如DeepSeek聊天机器人寻求医疗帮助。11月，政府发布了规划，要求到2030年，在基层医疗机构实现AI辅助诊疗工具“全面覆盖”。
Accepting AI health advice is the next step. Some in China already get help via chatbots such as those made by DeepSeek, a whizzy startup. In November China government released a plan calling for “full coverage” of AI-powered diagnosis and treatment tools at grassroots health centres by 2030.
如果基层医生能利用AI模型获取最新医学建议，将有助于建立患者对这项技术的信任。这意味着更多患者会在本地接受治疗，只有复杂病例才需要转诊到大医院。而这一切还不必耗费巨资去培训大量新医生。
If local doctors could use AI models to access the latest advice, it could help build patients’ trust in the tech. In turn that would result in more local treatment; only complex cases would go to big hospitals. And it could all happen without vast sums being spent on training new doctors.
诚然，目前中国距离“由AI加持的医疗体系”仍然很远。长期以来的医疗丑闻，国人往往对医疗行业抱有戒心。一次糟糕的AI诊断就可能让公众对这项新技术也失去信任。另一个挑战是向AI模型提供的数据：目前的患者数据质量不高，而且分散在不同医院和诊所。
China still remains far from AI-supercharged health care. And thanks to a long history of scandals, Chinese tend to be suspicious of the medical profession. A bad AI powered diagnosis could cause them to lose trust in the new technology too. Another challenge will be getting enough data to feed into AI models. At the moment China’s patient data is often poor quality and fragmented between different hospitals and clinics.
不过，中国有快速适用新技术的先例。比如：当现金被弃用后，并没有转向银行卡技术，而是直接跳到了移动支付。这取决于应变灵活的科技公司、政府的鼓励态度、具备数字素养的人口，以及缺乏现成替代方案的现实这一系列因素的组合。推动医疗领域技术变革的，也可能是同样的因素组合。对于那些试图用有限预算建立基层医疗体系的国家来说，这些条件的缺失，使得中国的路径难以复制。
On the other hand, China has a history of rapid technological adoption. For instance, when Chinese people stopped using cash, they did not switch to plastic but jumped straight to mobile payments, thanks to a combination of nimble tech firms, encouraging officials, a digitally literate population and the lack of established alternatives. The same cocktail of factors may drive technological change in health care. In other countries trying to build primary health-care systems on a budget, the absence of these ingredients may also make China hard to imitate.
页:
[1]