"Internet plus" empowers China's home nursing services

BEIJING, May 12 (Xinhua) -- For 78-year-old Li, a Beijing resident left bedridden after a stroke, routine hospital visits for gastric tube replacement once required her son to take time off work, arrange an ambulance, carry her downstairs and wait in crowded hospital queues.

Things are much easier now with the "Internet plus" nursing services from a major hospital. Following a mobile phone booking, an experienced nurse would visit Li's home, replacing the tube in less than 30 minutes and explaining daily care procedures to family members.

"Just placing an order on the phone brings a professional nurse to the house. It's incredibly convenient," Li's son said.

Data from the National Health Commission (NHC) show that by the end of 2025, China's population aged 60 and above had reached 323 million, including more than 45 million elderly people with disabilities or cognitive impairments.

As China celebrates International Nurses Day on Tuesday, demand for home-based care has been on the rise, making Internet and nursing services a key public welfare issue in improving and upgrading healthcare services.

FROM PILOTS TO COMMON PRACTICE

China first launched a pilot program for "Internet plus" nursing services in February 2019. After that, Beijing's health authority called for applications for pilot projects under the program.

"The social demand was right in front of us. Someone had to take the first step," said Wang Xiaoying, director of the nursing department at Aviation General Hospital, who helped make her hospital among the first in Beijing to answer the call.

In the early days, Wang and her colleagues often used lunch breaks or time after work to carry medical kits to patients' homes. Nurses would first assess patients' conditions and household environments by phone before conducting on-site evaluations to ensure safe operations.

Yang Qiuxiang, one of the first participating nurses, recalls receiving her first home-care order in May 2019. The patient was a long-term bedridden elderly person, and family members lacked the manpower to transport the patient to the hospital.

Yang returned to the patient's home a number of times during her off hours over the next three months to clean wounds, change dressings, and adjust medications, as well as teach family members basic caregiving skills.

"Family members must learn the care techniques themselves to provide long-term protection for the patient's health," Yang said.

Now in her eighth year of providing home nursing services, Yang said more families are seeking in-home care, looking to improve patients' quality of life and provide them with more compassionate care.

Such services are now increasingly common among hospitals both in Beijing and across China. Apart from Aviation General Hospital, Beijing Shijitan Hospital has developed specialized home-care programs for cancer patients.

Following the launch of pilot programs in Beijing, Tianjin, Shanghai and several provinces in 2019, more and more regions have followed suit. In Nanning, capital of Guangxi Zhuang Autonomous Region, a "cloud hospital" platform had connected 82 medical institutions and 6,492 nurses by October 2025, providing home nursing services to more than 20,000 patients by the end of that year.

According to NHC data, currently, nearly 6,000 medical institutions across the country provide more than 60 types of home-based nursing services in seven categories, including maternal and infant care, geriatric care, chronic disease management, rehabilitation guidance and hospice care.

STRONG BACKUP MEASURES

For many hospitals, to advance home nursing services, professional expertise is as fundamental as safety.

At Aviation General Hospital, only nurses with at least five years of clinical experience, senior professional qualifications and strong performance records are eligible for home-care work. Candidates must also pass theoretical training, clinical examinations and comprehensive evaluations.

"Technical skills alone are not enough," Wang said. "Home environments require communication ability, adaptability and interpersonal skills. Not everyone is suited for the work."

The hospital also uses specialized authorization management. Nurses are assigned services based on their expertise. For instance, wound-care specialists would handle dressing changes, whereas diabetes specialists would handle diabetes-related cases.

Meanwhile, with more than 70 types of home-care services, Beijing Shijitan Hospital has partnered with third-party technology platforms connected to police databases to verify patient identities, provide emergency alarms for nurses and record service processes for traceability.

Hospitals are also trying to address another challenge: how to encourage nurses to participate voluntarily. Beijing Shijitan Hospital has introduced a promotion-point system linking home-care participation to professional title evaluations, while allowing nurses to receive direct compensation for services completed during off-hours.

FOR A SUSTAINABLE FUTURE

Despite the rapid expansion of home nursing services, industry observers say home nursing services still have some major problems to tackle, including inconsistent pricing standards, incomplete service regulations and limited coverage.

Hospitals have voiced similar concerns. According to a survey covering 184 public hospitals in Beijing, 85.33 percent of nursing administrators supported including home nursing services in medical insurance systems, while 87.5 percent called for stronger industry supervision and management mechanisms.

In terms of payment and insurance coverage, although 49 Chinese cities have launched pilot long-term care insurance programs, coverage and reimbursement standards vary widely across regions.

"If home nursing services can eventually be included in medical insurance reimbursement, it will significantly reduce the burden on families," Wang said.

Some regions have already begun such experiments. Ningbo in Zhejiang Province has incorporated certain home-care procedures, including nasogastric tube care and catheter replacement, into medical insurance payment systems, allowing real-time reimbursement for home nursing services.

Hospitals have also called for unified national standards for home nursing services.

"Only with unified standards can services become standardized and replicable," Wang said, expressing hope for a nationwide qualification and authorization system.

Broader participation will also be needed for the long-term development of "Internet plus" nursing services. Liu Lihui, director of the nursing department of Beijing Shijitan Hospital, proposed building a tiered service network linking major tertiary hospitals with community healthcare centers, in which large hospitals provide technical support, staff training and treatment for difficult cases, while grassroots institutions handle routine visits, basic nursing care and long-term follow-up services.

"High-quality and sustainable home-based care services are an essential public need, and we should always continue to expand this path of improving people's well-being," Wang said.