4.3    Downstream

Most downstream users of IVD include medical institutions, independent medical laboratories, blood banks, physical examination centers and food testing markets. The downstream market is expected to grow by a two-digit percentage in 2021. 

4.3.1    Medical institutions

According to the statistics of the National Health Commission, as of the end of 2021, there were 1,030,935 medical and health institutions nationwide, an increase of 8,013 over the previous year. Among them were 36,570 hospitals, 977,790 primary medical and health institutions, and 13,276 professional public health institutions. Compared with the previous year, there were 1,176 more hospitals and 7,754 more primary medical and health institutions.

Person-times of diagnosis and treatment and person-times of hospitalization: In 2021, medical and health institutions nationwide had a total of 8.47 billion person-times of diagnosis and treatment, an increase of 730 million person-times over the previous year (an increase of 9.4%). In 2021, residents visited medical and health institutions 6.0 times on average. In the total amount of diagnosis and treatment in 2021, there were 3.88 billion person-times (45.8%) in hospitals, 4.25 billion person-times (50.2%) in primary medical and health institutions, and 340 million person-times (4.0%) in other medical and health institutions. Compared with the previous year, 560 million more person-times of diagnosis and treatment were in hospitals, and 130 million more person-times of diagnosis and treatment were in primary medical and health institutions. The total national health expenditure in 2021 was estimated to be 7559.36 billion CNY, including 2071.85 billion CNY of government health expenditure, accounting for 27.4%; 3392.03 billion CNY of social health expenditure, accounting for 44.9%; 2095.48 billion CNY of personal health expenditure, accounting for 27.7%. The per capita total health expenditure was 5348.1 CNY, and the proportion of total health expenditure in GDP was 6.5%.

4.3.2    Third-party medical laboratory

In 2021, the third-party independent laboratory industry achieved rapid development with significant year-on-year growth. The third-party routine testing business developed well. At the same time, as the main force of nucleic acid testing, third-party laboratories play an important role in centralized screening in various regions and individual testing for individual customers. In the first three quarters of 2021, the performance of KingMed Diagnostics, Dean, BGI, Labway, Berry, Novogene, and other listed companies focusing on third-party business increased by 33%.

4.3.3    Physical examination center

With the gradual enhancement of the health awareness of urban residents, the health consumption demand of residents has increased significantly, and the per capita health care expenditure has increased significantly, which has strongly promoted the development of the physical examination industry. In 2020, the person-times of physical examination in China was about 464 million with a year-on-year growth of 4.5%; in 2020, the market size of physical examination in China was about 190.6 billion CNY with a year-on-year growth of 11%[5]. With the increasingly close integration of artificial intelligence, big data and people's physical examination, as well as the high-tech integration of people's physical examination-related data information, the past single service treatment model may be transformed into a modern information model of integrated "Prevention - Treatment - Maintenance". The revenue of Meinian Healthcare, a listed company engaged in physical examination, increased by 32% year on year in the first three quarters of 2021.

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