Recently, the Shaanxi Provincial Government issued the "Implementation Opinions on Further Promoting the Construction and Development of Medical Complexes" (hereinafter referred to as the "Opinions"). The "Opinions" clarify that by 2020, the medical association will be comprehensively promoted to form a relatively complete medical association policy. System and assessment system. All secondary public hospitals and government-run primary health care institutions are all involved in the medical association. Different levels and different types of medical institutions establish a mechanism of division of labor with clear objectives, clear rights and responsibilities, fair and effective, and establish a guiding mechanism with consistent rights and responsibilities, so that the medical association becomes a service, responsibility, interest, management community, and medical resources in the province. Effective sharing, the county's medical service capacity will be further enhanced, and promote the formation of the first-level diagnosis, two-way referral, rapid division and treatment, and the hierarchical diagnosis and treatment mode.
The "Opinions" require that all public hospitals in the province should form or join a medical association, and social medical institutions should join according to their own wishes. In cities above the city level, all medical institutions shall, in accordance with the principle of proximity and voluntariness, form a medical association that is led by a three-tier public hospital, a secondary hospital, and a community health center. Before the end of 2017, complete the various forms of medical association construction tasks, and each district city will build at least one closely-connected medical association with obvious results. Xi'an, Baoji and Yan'an should form 2-3 closely. Type medical union.
At the same time, the "Opinions" proposed that the county towns take the county-level hospitals as the leader, the township hospitals as the hub, and the village clinics as the basis, forming a division of labor coordination mechanism at the county, town and village level three medical institutions, and building a three-level county medical service system. Encourage qualified areas to implement the medical service model of “three-level hospitals + county-level hospitals + township health centersâ€, establish services, responsibilities, interests, and management communities to promote the sinking of high-quality resources.
Establish a specialist alliance across regions to enhance the diagnosis and treatment capabilities of major diseases in primary health care institutions. Develop remote telemedicine collaboration networks in remote and impoverished areas to improve the construction of telemedicine systems at various levels of medical institutions. Before the end of 2017, the medical associations leading hospitals and the three-level public hospitals that undertake urban and rural counterpart assistance must provide telemedicine, distance education, and remote training services to medical institutions in remote and impoverished areas and grassroots medical institutions supported by counterparts.
In the medical association, the results of inspection and inspection are shared and recognized, and appropriate technologies are promoted to the grassroots level to promote the sharing of technical resources. Encourage the medical institutions within the consortium to implement a unified management system, medical treatment standards and service models, establish a quality control system between members of the medical association, and improve the level of homogenization.
In addition, the "Opinions" encourage the establishment of medical imaging centers, inspection and testing centers, disinfection supply centers, logistics service centers, etc., in accordance with the conditions of the medical institutions in the medical association, to provide integrated services for medical institutions within the medical association. Exploring the unified procurement and unified distribution of medicines, consumables and equipment in various medical institutions within the medical association.
Coordinate the construction of the business information platform of medical institutions within the medical association, and realize the continuous interconnection and electronic health records and electronic medical records and information sharing among medical institutions in the medical association. Explore the implementation of telemedicine charging and payment policies to promote the sustainable development of telemedicine services.
The two-way referral green channel should be established between the medical institutions at the upper and lower levels of the medical association. According to the clinical standard of two-way referral, combined with the advice of specialist consultation, the patient should be guided by the principle of rapid division, continuous treatment, scientific order, safety and convenience. Consciously cooperate and implement a smooth two-way referral. Patients with clear diagnosis, treatment plan, stable disease, and other recovery period (recovery period) with stable disease should be transferred to the lower medical institution of the medical association for treatment and rehabilitation. All units within the medical association should clarify the two-way referral management responsibility department and responsible person, and set up a special person to ensure that the patients referred to the appointment are given priority treatment and hospitalization. Gradually provide convenient services such as volunteer guidance services at the time of admission and admission, and settlement after first treatment.
Implementation Opinions of the General Office of the Shaanxi Provincial People's Government on Further Promoting the Construction and Development of Medical Consortiums
The people's governments of all districts and cities, the working departments of the provincial people's governments, and the directly affiliated institutions:
In order to implement the "Guiding Opinions of the General Office of the State Council on Promoting the Construction and Development of Medical Complexes" (Guo Dang Fa [2017] No. 32), further promote the scientific, standardized and healthy development of the medical associations in our province, and continuously improve medical services. The overall effectiveness of the system, better implementation of grading diagnosis and treatment and meeting the health needs of the people, with the consent of the provincial government, the following implementation comments are proposed:
First, the overall requirements
(1) Guiding ideology. Fully implement the spirit of the 18th National Congress of the Communist Party of China and the 3rd, 4th, 5th, and 6th Plenary Sessions of the 18th CPC Central Committee and the National Health and Health Conference, earnestly implement the spirit of the 13th Party Congress and the provincial party committee and the provincial government. The overall deployment of medical reform will focus on implementing the functional orientation of medical institutions, improving grassroots service capabilities, and streamlining the two-way referral process, continuously improving the medical organization management system, operational mechanism and incentive mechanism, and gradually establishing and improving different levels and different categories. The division of labor between medical institutions with clear objectives, clear rights and responsibilities, fair and effective division of labor, promote the construction of a tiered diagnosis and treatment system, and achieve a development mode that shifts from treating the disease to focusing on health.
(2) Work objectives. Before the end of 2017, all kinds of medical association construction tasks will be completed in full. Each district and city will have at least one close-knit medical association with obvious results. Xi'an, Baoji and Yan'an will set up 2-3 compact models. Medical union.
By 2020, we will comprehensively promote the construction of medical associations and form a relatively complete medical association policy system and assessment system. All secondary public hospitals and government-run primary health care institutions are all involved in the medical association. Different levels and different types of medical institutions establish a mechanism of division of labor with clear objectives, clear rights and responsibilities, fair and effective, and establish a guiding mechanism with consistent rights and responsibilities, so that the medical association becomes a service, responsibility, interest, management community, and medical resources in the province. Effective sharing, the county's medical service capacity will be further enhanced, and promote the formation of the first-level diagnosis, two-way referral, rapid division and treatment, and the hierarchical diagnosis and treatment mode.
Second, the basic principles
Adhere to the government's leadership and overall planning. Implement government planning, guidance, service, supervision and other responsibilities, focusing on cities and counties, according to the regional medical resources structure and the health needs of the people, in accordance with the requirements of business-related, complementary advantages, two-way choice, sustainable development, etc., taking into account the past Cooperative relationship, overall planning for the construction of medical associations.
Adhere to the nature of public welfare and innovative mechanisms. Adhere to the government's main responsibility for medical treatment, effectively safeguard and guarantee the fairness and accessibility of basic medical and health services, adhere to medical, medical insurance, and pharmaceutical linkage reforms, and gradually remove barriers and obstacles in administrative divisions, financial input, medical insurance payment, and personnel management. Optimize the layout of resource structure to meet the multi-level medical service needs of the people.
Adhere to collaborative sharing, resources sinking. Give full play to the advantages of high-quality resources concentration in three-level public hospitals, implement the functional positioning and task division of various medical institutions at all levels within the medical association, and achieve linkage and resource subsidence. Encourage the unified management model of the medical association, give play to the advantages of intensification, promote the sharing of regional medical resources, and improve the overall capacity and performance of the medical service system.
Adhere to local conditions and benefit the masses. Based on the actual situation of each place, we will explore the establishment of the benefit distribution mechanism of the members of the medical association, and establish a medical system that meets the actual needs and is suitable for the development of hospitals. Promote the connection between medical institution construction and prevention, health care, and promote the combination of prevention, treatment and management of chronic diseases, facilitate the masses to seek medical treatment, reduce the burden of disease, and enhance the sense of gain.
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