Compact medical community "reshaping" county medical resources
2021-12-02
47 minutes, this is the time taken for a stroke patient in Henan from the reception of the town health center to the catheter room transferred to the county hospital to start the operation. One click call, green channel, remote ECG, remote imaging and remote consultation. On the way to the hospital, some examinations related to preoperative preparation have been done. The patient will have surgery as soon as he arrives. "County level hospitals have completed information docking with township health centers and village clinics to ensure the golden time for treatment. This year, 41 patients with myocardial infarction have been saved and the sequelae of 53 patients with stroke have been avoided." Liu Shengli, member of the Standing Committee of Zhoukou municipal Party committee, secretary general and director of the Reform Office of Henan Province, told the regular press conference of the National Health Commission on November 30 The key to "seizing time with death": by promoting the construction of compact County medical community, medical and health institutions have realized the group management and operation mode of unified management of human and property and integration of county and countryside. It is reported that since the National Health Commission launched the construction of a compact County medical and health community in 2019, all localities have started from the root. Some county medical and health institutions have been integrated into an independent legal person medical group, some have coordinated and linked through information support projects, and some have linked the assessment results of township health centers with lump sum funds, annual salary of presidents and financial subsidies It has changed the problem that the medical community was not close enough in the past, and formed a "close" structure of county chess, managing an account and serving a family. From unity to "remodeling", the system and mechanism have undergone fundamental changes The medical community has added "compact" before. What has changed? "Different from the previous county medical community, the close county medical community focuses on building a responsibility community, management community, service community and interest community." Nie Chunlei, director of the grass-roots Department of the National Health Commission, explained that in the final analysis, it is a systematic "Reconstruction" of county medical and health resources! From Union to "Reconstruction", the institutional mechanism of medical community has undergone fundamental changes. Nie Chunlei frankly said, "community of interests" It is the core of the construction of the compact County medical community. Taking the medical insurance fund as an example, the payment of the medical insurance fund is no longer based on the county hospitals, but as an important source of common income for the medical institutions within the medical community. Therefore, whether the medical insurance expenses can be saved is the common responsibility of all participating units. Can the medical community really implement the package payment of the medical insurance fund and keep the balance It is related to the participating units of each medical community. In addition, making full use of modern information technology and realizing the unified management of "human, financial, material and affairs" are the characteristics of the close medical community. Medical resources are sinking, and people see doctors at home The advantages of "tight type" are obvious. The medical resources that were difficult to sink become easier to sink with the change of the intimacy of "one game of chess", "one account" and "one family". "The integrated reform has revitalized the county's medical and health resources and optimized the allocation of resources." Zhang Bo, deputy director of Shanxi provincial health and Health Commission, said that Shanxi has integrated all county's medical and health institutions into an independent legal person medical group and implemented the "six unification" of administration, personnel, capital, business, performance and medicine and equipment Management. Under the integrated pattern, the medical staff of county-level hospitals can provide technical support for the family doctor team and promote the implementation of family doctor signing services; the two-way referral channel is more unobstructed, and it is convenient for people to see a doctor at home and refer to the superior hospital. Ningbo, Zhejiang, focuses on the "construction of digital medical community". Zhu Xiaoli, deputy head of Yinzhou District, Ningbo, introduced that the people in the district can not go out of the community to see famous doctors. Through the regional remote consultation of the General Hospital of medical community, the nearby expert consultation can be realized, the inspection results can be recognized and shared, and a new home "medicine + medicine + care" can be constructed through intelligent medicine such as Internet medicine and nursing With the integrated service system, people can have online consultation, drugs can be delivered home, and nursing can provide door-to-door services. Three level distribution and benefit sharing, so that rural doctors can be good "health gatekeepers" "We have implemented the retirement mechanism for village doctors, paid endowment insurance for village doctors, and solved the worries of village doctors." Yang Fawu, President of Suixi County People's Hospital in Huaibei City, Anhui Province, said that to play a role in the compact medical community, we must improve the enthusiasm of medical personnel in medical institutions at the county, township and village levels. In addition to the solution of the pension problem, for rural doctors, the retention of the balance of the medical insurance fund also gives them a stable income and no longer "fighting guerrillas." "we establish a three-level distribution and benefit sharing mechanism for the use of the medical insurance fund." Yang Fawu introduced that the medical insurance fund was packaged to the medical community, and the balance was distributed at three levels according to the ratio of 6:3:1. Since 2017, the balance of the packaged fund of the medical community of the county hospital has reached 94.3946 million yuan for four consecutive years. In the compact County medical community, the role of rural doctors as "health gatekeeper" is more clear, and they also play a more and more important role in chronic disease and health management. In 2021, Suixi County again piloted the new measure of "health management". It is reported that the medical insurance payment for common chronic diseases is used by the health center according to the head, and the balance is retained according to the ratio of 2:5:3 in the county and countryside. From the proportion of the balance, it is not difficult to see that the new policy is inclined to the funds of township health centers and village clinics. At the same time, the grass-roots level is thirsty for talents and pays more attention to talent training. "We encourage and fund the county and rural medical personnel to participate in or go out for further study. 249 people take turns in health centers and 101 people take turns in village doctors." Yang Fawu said that the county government has specially coordinated the overall fund for doctor training of 3.5 million yuan. When the fund is less than 500000 yuan, a new round of financing will be started. (outlook new era)
Edit：Yuanqi Tang Responsible editor：Xiao Yu
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