Shanghai Sixth People's Hospital: Challenges in Diabetes Care Equalization

Jia Weiping, former president of the Shanghai Sixth People's Hospital (also referred to as Sixth Hospital, or the hospital), dedicated 43 years of her medical career to advancing the precise diagnosis and treatment of diabetes. A major part of her work centered on diabetes early warning screenings; her research focused on the underlying causes of diabetes; she was also committed to formulating effective strategies for diabetes care. Jia created the "Diabetes Care System of Hospital-Community Integration" and the "Treatment-Prevention Integration System." Both systems were first applied in Shanghai and then replicated in more than 20 provinces and cities across China. In addition, she founded and led the National Office for Primary Diabetes Care, aiming to elevate diabetes care standards nationwide. The case study describes Jia's work progressing from localized initiatives to broader, national-level programs. According to the case, her career commenced with cutting-edge diabetes research. Over time, her efforts shifted from targeting individual diabetes diagnosis and treatment to focusing on prevention and control at the population level. Motivated by the goal of aiding more patients, she began her work in grassroots communities in Shanghai, expanded it citywide, and ultimately extended her impact throughout the nation. As a trailblazer in diabetes care in China, she played a critical role in bridging the gap between urban centers and rural areas, achieving standardized and integrated treatment-prevention at the primary care level. Each step of her career and each broadened responsibility was marked by adjustments in management strategies and effective use of digital technology. The case study particularly highlights how digital technology contributed to universal healthcare. In November 2021, Jia Weiping was elected as an academician of the Chinese Academy of Engineering, becoming the first person in Shanghai to earn this recognition in the field of medical and health engineering management. Attaining the highest honor in Chinese academia gave Jia a profound sense of responsibility. She began to contemplate leveraging this prestigious platform to bring the successful models she had pioneered to other grassroots regions of China, where they were urgently needed. The challenge she set for herself was to cross the "Hu Line," a boundary separating densely populated from sparsely populated areas, as well as more developed regions from those less developed. Crossing the Hu Line is pivotal for achieving balanced economic and social growth in China and ensuring equal access to healthcare services. The case study's analysis revolves around tackling this critical challenge.