China’s overuse of inpatient treatment and routine preoperative testing

China’s medical system is undergoing substantial reforms to improve access, efficiency, and quality of care.1 These changes have prompted recent suggestions in The BMJ on how efficiency could be further improved. Recommended reforms include reducing unnecessary use of intravenous fluid, currently estimated at eight bottles per capita annually,2 and restricting self medication with antibiotics for conditions such as flu, reported by a quarter of respondents in a recent survey by the China Food and Drug Administration.3

Another opportunity for improved efficiency is to stop admitting patients to hospital for non-invasive surgical care, which is common practice in China. Taking ophthalmology as an example, a tertiary public eye hospital in China typically has between 100 and 500 beds. By contrast, Moorfields Eye Hospital in London, one of the …