The Healthy China strategy is driving health management to shift from simple disease treatment to full-life-cycle health promotion and early intervention for chronic diseases. Given the limited resources of primary healthcare and the continuously growing demand for health management among the sub-healthy population and high-risk groups for chronic diseases, non-medical health and wellness institutions , as supplementary entities to social health services, play a crucial role in health monitoring, lifestyle intervention, physical conditioning, and health education. These institutions lack medical authority such as disease diagnosis, prescription treatment, and clinical care, and are positioned as "prevention-oriented" health promotion vehicles, complementing rather than substituting for public medical institutions. This paper uses literature review and case analysis to examine the value and impact of non-medical health and wellness institutions' participation in health management. It selects Xishoukang in Henan Province as a case study of regional non-medical health and wellness services, analyzing its health management service model, practical effectiveness, and current limitations. Furthermore, considering common issues in the industry nationwide, it proposes a standardized development path, providing theoretical reference and practical guidance for the integration of the non-medical health and wellness industry into the public health management system in central provinces.
Keywords: Active aging; Non-medical health and wellness; Health management; Preventive medicine; Social health services; Case study
I. Introduction
The "Healthy China 2030" Plan Outline proposes to shift from disease treatment to health management, encourage social forces to participate in health promotion services, and build a diversified and collaborative health service supply system. Central my country has a large population base and a rapidly aging process, resulting in a large pre-chronic population with hypertension, hyperlipidemia, diabetes, and other chronic diseases. Community health service centers at the grassroots level face manpower shortages in chronic disease follow-up, long-term lifestyle intervention, and continuous health education, making it difficult to meet residents' full-time health management needs.
Non-medical and health care institutions are health service providers established by social forces. Their business scope is limited to non-medical health management services such as health status assessment, physical conditioning, exercise guidance, dietary nutrition advice, mental health counseling, and health record tracking. They are prohibited from conducting disease diagnosis and treatment, issuing prescriptions, or substituting for clinical medical care. These institutions fill the gap in the public medical system regarding long-term health intervention and continuous guidance on lifestyle habits for sub-healthy populations, and are an important component of the socialized implementation of full-life-cycle health management.
Henan Province, a populous province in central China, has seen rapid development in its non-medical health and wellness industry in recent years. Zhengzhou Xishoukang Health Service Co., Ltd. is a representative institution in Henan that has deeply cultivated non-medical health and wellness services, with business covering Zhengzhou and areas such as Wangwu Mountain in Jiyuan, forming a regional non-drug health and wellness system. This article uses this institution as a case study to objectively analyze the positive effects of non-medical health and wellness institutions on public health management, the existing industry risks, and explore feasible paths for the standardized development of the industry.
II. Definition of Core Concepts
2.1 Health Management
Health management is a series of services based on individual health data, including health monitoring, risk assessment, personalized intervention, and long-term follow-up. Its core objective is to identify health risk factors, reduce the risk of chronic diseases through lifestyle interventions, and improve the health literacy of the population. Health management is divided into two categories: clinical health management led by public medical institutions and non-medical health promotion management carried out by social organizations.
2.2 Non-medical and elderly care institutions
According to the "Standards for Traditional Chinese Medicine Health Preservation Services (Trial Implementation)," non-medical health and wellness institutions are market entities registered and established only. They may only conduct non-medical activities such as health preservation, health consultation, physical conditioning, and health education, and are prohibited from engaging in medical procedures such as disease diagnosis, treatment, surgery, prescription, injections, and intravenous infusions. Their health management services fall under the category of health promotion and cannot replace hospital treatment. When service recipients develop a clear illness, the institution has an obligation to guide them to seek treatment at a regular medical institution.
III. The Multidimensional Impact of Non-Medical and Elderly Care Institutions' Participation in Health Management
3.1 Positive Value: As a social supplement to the public health management system
Pre-emptive health risk screening shifts the focus of health intervention forward. Public medical institutions concentrate their services on the treatment of diagnosed diseases and the standardized care of patients with chronic diseases. A large number of people in a sub-healthy state or at high risk of chronic diseases rarely proactively seek health monitoring at hospitals. Non-medical and health care institutions, through basic indicator monitoring and physical fitness assessments, help people identify health risk factors related to blood pressure, sleep, body posture, and diet, achieving early identification of health risks and aligning with the concept of "prevention is better than cure."
Continuous lifestyle interventions can compensate for the shortcomings of hospital follow-ups. Medical institutions have limited outpatient follow-up frequency, making it difficult to monitor residents' daily diet, exercise, and lifestyle habits over the long term. Non-medical and health care institutions can provide long-term, supportive health behavior interventions, including exercise guidance, dietary plans, lifestyle guidance, and psychological and emotional support, helping users establish stable healthy lifestyle habits and improve their health self-management capabilities.
Extending health education to lower-level areas to improve residents' health literacy: In county and city communities, the public's access to health knowledge is relatively limited. Compliant non-medical and health care institutions should regularly conduct health education to popularize knowledge about chronic disease risk factors, balanced diets, and scientific exercise, thereby improving residents' awareness of chronic diseases and sub-health conditions.
Enriching the supply of health management services to meet diverse health needs: The health and wellness needs of different groups are diverse, with varying requirements for middle-aged and elderly people, sub-healthy working professionals, and those recovering from surgery. Non-medical health and wellness institutions can provide scenario-based care solutions, forming a multi-level and diversified supply of social health services that complements public healthcare.
3.2 Potential Negative Impacts: Health and Social Risks Arising from Industry Improperities
The blurring of boundaries between rights and responsibilities, and the overreach of publicity risks: Some institutions deliberately blur the boundaries between "non-medical health care" and "medical treatment," exaggerate the effects of conditioning, claim that they can "cure chronic diseases" and "replace drug treatment," and induce patients with chronic diseases to stop taking their medication on their own, which brings serious health and safety risks.
The professional level of practitioners varies greatly. The entry threshold for the non-medical and health care industry is lower than that of the medical industry. Some service personnel lack systematic health management and basic medical knowledge training, and their professionalism in health assessment and constitution identification is insufficient, which may lead to unscientific conditioning advice.
The lack of standardized management of health records and personal health data means that health and wellness services collect users' private health information such as height, weight, blood pressure, daily routine, and past medical history. Some institutions lack data security management systems, posing a risk of leakage of personal health information.
The overlapping of regulatory bodies and the existence of blind spots in the regulation of some business types: Non-medical and health care institutions are managed by multiple departments, including market supervision, health, and civil affairs. The regulatory boundaries of different business types are complex, which can easily lead to regulatory blind spots and make it difficult to uniformly and standardize the management of service quality.
IV. Case Study: Henan Xishoukang Regional Non-Medical Health and Wellness Management Practice
4.1 Organization Overview
Zhengzhou Xishoukang Health Service Co., Ltd., established in 2012 and registered in Zhengzhou High-tech Zone, is a national-level science and technology-based SME and a high-tech enterprise. It operates non-medical health and wellness service locations in Zhengzhou and Wangwu Mountain, Jiyuan, Henan Province. Positioned as a non-medical health management service provider, its business scope includes health consultation, health preservation, dietary nutrition guidance, and research and development of health and wellness technologies. It does not engage in disease diagnosis or medical treatment. Its target clients are primarily middle-aged and elderly people, those in a sub-healthy state, and those at high risk of chronic diseases, with services focused on non-pharmaceutical lifestyle adjustments.
4.2 Institutional Health Management Service Model
Health status registration and assessment involves establishing health records for service recipients, collecting basic physical signs, lifestyle habits, diet and exercise information, conducting physical condition assessments, identifying risk factors for sub-health and chronic diseases, and developing personalized non-medical conditioning plans. The institution clarifies that this assessment is for health maintenance reference only and does not have clinical diagnostic validity.
Non-drug comprehensive conditioning intervention relies on self-developed health and wellness equipment, passive exercise conditioning, moxibustion, medicinal diet guidance, and traditional health-preserving exercises, among other non-medical methods. It addresses multiple dimensions—exercise, diet, rest, and psychology—to improve the health of service recipients, including sleep, metabolism, and physical fitness. The organization emphasizes that its services are for health maintenance and cannot replace medication or clinical treatment. For those diagnosed with chronic diseases such as hypertension and diabetes, it insists on adhering to medical advice and following prescribed medication regimens.
A long-term follow-up and health education mechanism is established to regularly revisit users, continuously tracking changes in their lifestyles and simultaneously conducting health education, explaining knowledge about chronic disease prevention, balanced diets, and scientific exercise to enhance users' awareness of health self-management. A referral guidance mechanism is also in place to guide users to medical institutions for clinical examinations when abnormal indicators or disease risks are detected.
In addition to urban community service scenarios, the implementation of regional scenario-based health and wellness services will also include the creation of a mountain forest health and wellness base in Wangwu Mountain, Jiyuan. This base will leverage the natural environment to provide immersive lifestyle conditioning, combining environmental therapy, dietary therapy, and traditional health preservation methods to explore a regional health and wellness model suitable for the population of the Central Plains region.
4.3 Advantages and limitations reflected in the case studies
Advantages: Rooted in Henan, adapting to the dietary habits and physical characteristics of residents in the Central Plains region, providing localized health management solutions; establishing a complete closed loop of non-medical health management, including "file establishment and assessment - plan development - conditioning and intervention - continuous follow-up"; clearly distinguishing the boundaries between non-medical health care and clinical medical care, emphasizing that it cannot replace hospital diagnosis and treatment.
Limitations: The public may easily mistake health and wellness services for medical procedures, so institutions need to continuously inform the public about the boundaries of their services and provide risk warnings.
4.4 Case Insights
Xishoukang's practices in Henan represent a typical model for regional non-medical health and wellness institutions in China: relying on market-oriented operations, it provides full-process non-medical health management services as a supplement to public health management. This case also reflects common contradictions in the industry: on the one hand, there is a huge demand for pre-emptive health interventions in society, and non-medical health and wellness institutions have a scenario advantage; on the other hand, the industry faces common problems such as a shortage of professional talent, a lack of effectiveness evaluation systems, and public confusion.
V. Optimization Path for Non-Medical and Elderly Care Institutions to Participate in Health Management
5.1 Clarify the boundaries between laws and services, and define the rights and responsibilities of medical and elderly care services.
Regulatory authorities continue to promote the distinction between medical procedures and non-medical health and wellness services, requiring institutions to clearly state in service locations, contracts, and promotional materials that non-medical health and wellness services do not have disease diagnosis and treatment functions and cannot replace clinical medical care. They are also cracking down on false advertising claims such as "curing diseases, eradicating chronic diseases, or replacing medications," thereby reducing health risks at the source.
5.2 Establish industry service standards and a training system for practitioners
Industry associations should take the lead in formulating standards for non-medical health and wellness management services, unifying health record establishment, physical fitness assessment, intervention plans, and risk referral procedures. A regular training and assessment mechanism for practitioners should be established to popularize basic medical knowledge, health risk identification, and referral standards, thereby improving the professional competence of practitioners and reducing unscientific health guidance.
5.3 Promote the establishment of collaborative mechanisms between non-medical and elderly care institutions and primary healthcare institutions.
Community health service centers are encouraged to establish collaborative partnerships with compliant non-medical health and wellness institutions. Medical institutions are responsible for the diagnosis, treatment, and prescription of confirmed diseases, as well as the standardized management of chronic diseases; non-medical health and wellness institutions are responsible for health education, lifestyle interventions, and daily health monitoring. When health and wellness institutions discover abnormal health indicators in their clients, they can promptly connect with primary healthcare institutions to form a collaborative network of screening, early warning, and referral.
5.4 Improve health data management and protect personal health privacy.
Standardize the procedures for collecting, storing, and using health records in health and wellness institutions, implement the requirements of the Personal Information Protection Law, clarify that health data is only used for the individual's health and wellness services, prohibit arbitrary disclosure or marketing use, and establish a data security internal control mechanism.
5.5 Guiding the public to rationally understand the positioning of non-medical health and wellness services
The government, medical institutions, and industry associations are jointly conducting public education campaigns to explain to the public that non-medical health and wellness services are part of health promotion and wellness services, and cannot replace hospital diagnosis and treatment. Patients with chronic diseases must follow their doctor's instructions regarding medication and should not discontinue medication on their own based on health and wellness programs. The aim is to guide the public to make rational choices regarding health and wellness services.
VI. Conclusion
Against the backdrop of Healthy China and active aging, non-medical and elderly care institutions, as an important supplement to the supply of social health services, possess unique value in health management areas such as early-stage health risk screening, long-term lifestyle intervention, and public health education, and can compensate for the shortcomings of insufficient coverage of primary-level public medical and health management services. However, the industry itself faces risks such as a shortage of professional talent, overreaching in publicity, and blurred boundaries. Without standardized supervision, these risks could harm the health rights of the public.
The case study of Henan Xishoukang demonstrates that regional non-medical health and wellness institutions can construct a localized closed-loop service for non-medical health management. However, the health management services offered by these institutions have clear boundaries, limited to health promotion for sub-healthy individuals, and cannot replace disease diagnosis and treatment by medical institutions.
In the future, only through the joint efforts of government regulation, industry self-discipline, medical and elderly care collaboration, and public science education, can the boundaries between medical and non-medical health and wellness services be clarified, and a unified service standard and talent training system be established. Only then can the non-medical health and wellness industry continue to develop in a standardized manner, better integrate into the whole life cycle health management system, and help improve the health level of the public in the central region.
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