China is shifting chronic respiratory disease management beyond hospitals toward home-based care, as policymakers, clinicians and medical-device makers promote earlier screening and long-term digital monitoring, creating new opportunities in one of the country's fastest-growing healthcare markets.
The move reflects a broader effort to address one of China's biggest chronic disease burdens while easing pressure on the country's healthcare systems as the population ages. Nearly 100 million people suffer from chronic obstructive pulmonary disease (COPD), while an estimated 176 million have obstructive sleep apnea (OSA), according to data cited in newly released recommendations jointly issued by the China-Japan Friendship Hospital, MD Weekly and a multidisciplinary expert committee.
The recommendations, based on nationwide surveys of 1,000 members of the public and 319 physicians, call for a shift from hospital-centered treatment to continuous disease management spanning public awareness, early screening, standardized diagnosis, home therapy and long-term follow-up.
The recommendations build on a series of healthcare reforms aimed at shifting chronic disease management toward primary care and community-based services. The Healthy China initiative, a comprehensive public health strategy launched in 2019, identified chronic respiratory diseases as a national public health priority, while COPD was incorporated into the national basic public health service program in 2024, further expanding community-based management and early screening.
"These diseases require lifelong management rather than one-off treatment," said Zhang Xiaolei, a senior respiratory physician at China-Japan Friendship Hospital. "Patients need continuous follow-up after leaving hospital, and digital technologies are making that increasingly feasible through remote monitoring and home-based management."
Delayed diagnosis remains a critical barrier. Many patients dismiss persistent snoring, chronic coughing or breathlessness as signs of aging rather than symptoms of chronic disease. The recommendations found that nearly half of OSA patients delayed seeking medical attention for more than one year, while many COPD patients were diagnosed only after significant lung-function impairment had already occurred.
Home-based management becomes an increasingly important part of respiratory care. The recommendations advocate integrating home monitoring devices, remote follow-up and digital health platforms into routine treatment so patients remain under medical supervision after leaving hospital rather than relying solely on periodic outpatient visits.
European sleep specialists said the direction mirrors broader international practice. "For standard cases, home monitoring will really be enough," said Raphael Heinzer, director of the Center for Investigation and Research in Sleep at Lausanne University Hospital in Switzerland.
Home sleep recordings can diagnose most routine obstructive sleep apnea cases before physicians review the results and prescribe treatment, although specialized hospital sleep laboratories remain necessary for more complex conditions, he said.
The transition is also reshaping the commercial landscape for respiratory care.
Respiratory medicines generated nearly 62 billion yuan ($9.16 billion) across hospitals, retail pharmacies and online pharmacies in China in 2024, with COPD and asthma therapies accounting for more than three-quarters of the market, according to pharmaceutical data provider Menet.
Demand is increasingly shifting toward home-use devices. China's home respiratory disease management equipment market — including non-invasive ventilators for home use, oxygen concentrators, nebulizers and portable lung-function monitors — was estimated at 8.93 billion yuan in 2025, up 14.8 percent from a year earlier, according to Frost & Sullivan and industry estimates. Non-invasive ventilators for home use accounted for about one-third of the market, while domestic manufacturers now control more than 60 percent of sales.
The industry's focus is increasingly shifting beyond hardware sales toward long-term disease management supported by cloud platforms, remote monitoring and AI-enabled software. BMC Medical, one of China's major manufacturers of respiratory health devices, has expanded cloud-based management services that allow physicians to remotely review patients' treatment data, adjust ventilation settings and conduct follow-ups outside hospitals. It is also incorporating AI into home respiratory devices to support personalized treatment and long-term patient follow-up.
European specialists suggest that China's combination of a large patient population and rapid adoption of digital healthcare could create opportunities for joint research. Frederic Gagnadoux, head of respiratory and sleep medicine at Angers University Hospital in France, said China's clinical scale offers significant potential for international multicenter studies, potentially helping researchers better understand various forms of OSA and the long-term impact of treatment on cardiovascular health and quality of life.
