Clinical Application and Institutional Governance of Foods for Special Medical Purposes in Medical Institutions of Eastern Coastal China: A Cross-Sectional Study

Why It Matters

The fragmented FSMP landscape hampers consistent patient outcomes and strains hospital budgets, signaling an urgent need for standardized regulation and financing within China’s health system.

Key Takeaways

• 78.7% hospitals use FSMP, but management low
• Only 43.6% have FSMP Management Committee
• Insurance covers FSMP in just 2.1% of hospitals
• Staff recognize benefits yet lack clinical confidence
• Southern Jiangsu and tertiary hospitals manage FSMP better

Pulse Analysis

China’s rapid economic growth has expanded the availability of Foods for Special Medical Purposes, yet the sector remains in a regulatory vacuum. The Jiangsu cross‑sectional study reveals that while most hospitals stock FSMP, the lack of unified protocols creates inconsistent prescribing practices. This disparity not only undermines the therapeutic potential of specialized nutrition but also generates hidden costs for patients who must shoulder expenses typically covered by insurance for conventional medical products.

Governance gaps are most evident in the absence of dedicated oversight bodies; less than half of surveyed institutions have an FSMP Management Committee. Without clear accountability, procurement pathways involve multiple departments, leading to inefficiencies and blurred responsibility. The insurance landscape is equally fragmented—only a tiny fraction of hospitals report reimbursement, forcing many to reclassify FSMP as “meal fees.” Such financial ambiguity erodes clinician confidence, as evidenced by the high proportion of staff who doubt the clinical justification for prescribing these products.

For policymakers, the findings point to a critical inflection point. Standardizing FSMP classification as a medical product, establishing independent reimbursement channels, and integrating data‑driven monitoring systems could align the sector with China’s broader health‑care reform agenda. Regional pilots in southern Jiangsu and tertiary hospitals demonstrate that targeted governance reforms yield higher adoption rates and better clinical integration. Scaling these models nationally would not only improve patient nutrition outcomes but also create a more sustainable fiscal framework for hospitals across the country.