Medical reform will strengthen the appointment of innovative treatment emergency services
The level of medical security in China has increased significantly. On February 12, the State Council held a press conference on deepening medical reform and improving medical services. Wang Hesheng, deputy director of the National Health and Family Planning Commission and director of the State Council's Medical Reform Office, said that in 2016, the number of doctors and beds per 1,000 population in the country was 2.3 and 5.4, respectively, an increase of 27.8% and 50 compared with 2010. %. Judging from the current preliminary statistics, this figure is still growing in 2017, and the efficiency of medical treatment has been improved. The number of people participating in basic medical insurance exceeded 1.35 billion, and the participation rate was stable at over 95%. According to Zhang Zongjiu, director of the Medical and Health Hospital of the National Health and Family Planning Commission, the country will increase the coverage of the appointment and treatment system in the next three years, and promote the multidisciplinary diagnosis and treatment model centered on patients. "Hospital at the door" becomes a reality In 2015, China issued a plan to further improve medical services. Between 2015 and 2017, we focused on the medical service needs of the people in the hospital and fully utilized information technology to improve the medical service process. In this context, with the medical resources going up and down, "the hospital at the doorstep of the people" has gradually become a reality. According to Wang Hesheng, as of now, the central government has arranged 47.48 billion yuan to support the infrastructure construction of 110,000 county-level hospitals and primary health care institutions. All three-level public hospitals and more than 1,000 social medical institutions participated in the construction of the medical association. In 2017, only 48,300 patients were transferred, an increase of 91.2%. The number of medical institutions carrying out telemedicine services has grown to 13,000. Zhang Zongjiu said on the 12th that the national, provincial, municipal, and county-level telemedicine service systems were gradually established, and 22 provinces established provincial telemedicine service platforms covering more than 1,800 counties, of which national poverty-stricken counties achieved full coverage. . Under the background of the sinking of resources, county-level hospitals have built 3,600 clinical specialties, and the management level has been further improved. 8400 hospitals above the second level carried out clinical pathway management, an increase of nearly 40%. Zhang Zongjiu said that starting from 2015, the nationwide implementation of the action plan for further improvement of medical services will promote the high-quality development of medical services. By optimizing service processes, using information technology, implementing daytime surgery and other measures to reduce queuing times, shortening payment and waiting time, more than 4,100 hospitals can provide information inquiry and push services for patients, four times that of three years ago, effectively reducing The patient's repeated queuing payment in the hospital and the number of round trips to the hospital. The number of medical institutions that can provide mobile payment settlement reached 2,777, three times that of three years ago. “In the past three years, the average waiting time for outpatients has been shortened by more than 10 minutes, and some hospitals have been shortened by more than one hour; the average hospitalization days have been shortened to less than 10 days.†Zhang Zongjiu said that in the next three years, he will continue to implement the action plan for further improvement of medical services throughout the country, increase the coverage of the appointment diagnosis and treatment system, and promote the multidisciplinary diagnosis and treatment model centered on patients. Innovate emergency first aid services with a focus on critically ill. In prefecture-level cities and counties, eligible medical institutions establish chest pain centers, stroke centers, trauma centers, critical maternal treatment centers, and critical care centers. It is understood that in the future, the medical association will be established as a carrier to provide continuous medical services, forming a hierarchical diagnosis and treatment pattern of orderly flow of patients, on-demand deployment of medical resources, and integration of medical services. "Less traversing less and less money" as scheduled Carry out direct settlement of medical expenses across the country across the province, so that the masses can see less errands and less money. Promote the reform of medical insurance payment methods, and the number of diseases that have been paid for by disease in more than 200 cities has reached more than 100. In fact, the Ministry of Human Resources and Social Affairs and the Ministry of Finance previously issued the "Notice on Regulating the Relevant Matters Concerning the Direct Settlement of Hospitalization Expenses for Inter-provincial Hospitalization", and accelerate the expansion of the coverage of designated medical institutions at the grassroots level. By the end of February 2018, each county will be ensured. There is at least one medical institution designated for medical treatment across the province. According to the data released by the Ministry of Human Resources and Social Security, as of December 31, 2017, on the basis of all the provincial-level platforms and all the co-ordination areas in the country have been docked with the country's remote medical treatment settlement system, there are 8,499 national cross-provincial designated medical institutions. More than 90% of the three-level fixed-point medical institutions have been connected to the network. More than 80% of the districts and counties have at least one designated medical institution that can provide direct settlement services for inpatient medical expenses across the province. Taking Gansu Province as an example, as of the end of 2017, Gansu Province has realized the comprehensive settlement of medical treatment in different places in the country, and has already paid the full amount of 57.07 million yuan for the settlement of medical treatment in 31 provinces. The province has achieved breakthroughs in medical treatment in different places. progress. The data shows that a total of 268 designated medical institutions in Gansu Province have access to the country's medical treatment and settlement platforms, and 257 medical institutions above the second level have access to the medical treatment and settlement platforms in other places. At the same time, the central government also proposed to continue to expand the scope of networked designated medical institutions, and gradually integrate more primary medical institutions into the direct settlement of medical treatment in different places. Relevant departments should speed up research and solve the problem of settlement of hospitalization expenses for more than 100 million migrant workers and the majority of “double-creative†personnel across provinces. Accelerate the sharing and integration of relevant medical insurance information systems, vigorously implement medical insurance intelligent audit and real-time monitoring, and strictly monitor the cost of medical treatment in different places. “One plus one reduction reform†aims to reduce costs In the past year, medical reform has both added and subtracted, and the increase in medical expenses has fallen sharply. Wang Hesheng said on the 12th that he insisted on the basic medical and health system as the basic concept of providing public goods to the whole people, adhered to the basic principles of safeguarding basic, strong grassroots, building mechanisms, and supplementing shortcomings, and insisted on the basic path of overall planning, highlighting key points, and advancing step by step. . At the same time, focusing on the combination of reforming institutional mechanisms and improving medical services, we will improve services as an important goal of reform and effectively improve the sense of access of the broad masses of the people. “In addition, we have established a diversified and multi-level universal health insurance system and weaved the world's largest medical insurance network.†Wang Hesheng introduced basic medical insurance, major illness insurance, medical assistance, sickness assistance, charity assistance, supplementary medical insurance and business. Health insurance is closely linked to form a multi-level, multi-level universal health insurance system. It is reported that at present, the number of people participating in basic medical insurance in China exceeds 1.35 billion, and the participation rate is stable at over 95%. In 2017, the per capita financial subsidy for basic medical insurance for urban and rural residents was raised to 450 yuan, and 375 drugs were added to the medical insurance catalogue. The scope of protection continued to expand and the proportion of reimbursement continued to increase. On the basis of basic medical insurance and general benefit, the system of urban and rural residents' major illness insurance was established, covering 1.05 billion people, and the proportion of reimbursement for compliance medical expenses for major patients increased by an average of 12 percentage points. The proportion of personal self-pay for medical expenses for poor people in rural areas has dropped from 43% in 2016 to 19% in 2017. In addition to the increase in medical insurance coverage, the subtraction is effectively eliminated by eliminating the drug addition. Wang Hesheng pointed out that it is imperative to promote the establishment of a modern hospital management system. It is strictly forbidden to link the income of medical personnel with the income from drugs, consumables, inspections, etc., scientifically control the unreasonable growth of medical expenses, and the increase in medical expenses of government-run medical institutions has decreased from 21% in 2010. About 10% by 2017. Under this effect, the high and high price of drug consumables was squeezed, the price of large medical equipment inspection and treatment was reduced, and the proportion of residents' personal health expenditure to total health expenditure fell to 28.8%, which was lower than before the new round of medical reform. 12 percentage points. In addition, in the circulation link, the “two-vote system†for drug purchase and sales was implemented in the pilot provinces of comprehensive medical reform and the first four batches of public hospital reform pilot cities to further regulate the behavior of all parties in the circulation field. In the use of links, through centralized bidding procurement, drug price negotiations, control of unreasonable use of drugs and other measures to reduce drug prices. The latest round of provincial centralized drug purchase prices fell by an average of more than 15%. 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