under the Fa 〔2009〕 12), guidance
a working idea of
in accordance with the upper and lower linkage, the increase vitality, plus the thrust of the principle, adhere to the entire areas, both near and far, focused, side push test side, the people closely around the ease medical treatment is difficult, expensive medical problems , seen in the national implementation of a number of standard and quick public hospital reform policy measures aimed at the people get benefits and medical staff encouraged to achieve a breakthrough. At the same time, vigorously promote the pilot cities in the Benefiting the convenience measures should implement institutional mechanisms to promote comprehensive reform and to establish long-term mechanism to closely combine to make it cooperate with each other and promote each other.
two major institutional mechanisms to carry out comprehensive reform
(a) promoting the separation of management from operation, to deepen public hospital management system.
1. strengthen the health administrative departments industry-wide management responsibilities. All medical and health institutions by the health administrative departments to implement a unified planning, unified access, unified supervision. Strengthen the administrative departments of health care regula
tory functions, to strengthen medical services regula
tory capacity building. Improve the organization,
China 's 100 most beautiful poem, personnel, technology, equipment, access and exit mechanisms, and improve health care standards, norms and quality evaluation system, strengthen medical services, quality, safety and health agencies monitor the operation of regulation. Health administrative departments at all levels shall not act as leadership positions in public hospitals.
2. to establish a unified, efficient and responsibilities consistent with government-run health system. Take various forms such as the establishment of specialized management agencies to determine the government run medical institutions, government-run public hospital to perform its functions, is responsible for public hospitals, asset management, financial control, performance evaluation and the person primarily responsible for hospital appointments.
(b) promote the conduct of public affairs separate, and improve corporate governance of public hospitals.
1. explore the establishment of the Council and other forms of corporate governance structure of public hospitals. Clearly the Council, the President and the hospital management, staff and other duties on behalf of the General Assembly to build decision-making, implementation, monitoring each division, operating mechanism of checks and balances of power. Council members in public hospitals should include representatives of government departments, government-run health agency representatives, hospital staff representative, on behalf of clients, experts and scholars.
2. rationalize the owners and managers of public hospitals, power and responsibility. Functional orientation of public hospitals, development planning, major investments, the President and the hospital management to develop such compensation by the government run medical institutions of power or the Council to exercise. Implementation of the independent legal status and public hospital management autonomy, strengthen management responsibilities, according to state regulations and internal management staff employed income distribution. Implementation of Opening Hospital Affairs, promoting democratic governance.
3. improve the Public Hospital appointment system and explore the open recruitment President, highlighted in the appointment or recruitment of professional management skills. Strengthen the management capacity of president of training and promoting professional president, professional building. President in accordance with national policy guidance to establish the distribution of income incentive and restraint mechanisms.
4. reasonably determine the public hospital performance appraisal system. Study the establishment of the public welfare as the core of the public hospital performance appraisal system, and gradually expand the scope of public examination results, and evaluation results with the President the appointment and removal, incentives and hospital financial assistance, staff linked to average income levels.
5. enhance the performance of public hospitals, Function and Development building, investment and financing behavior regulation, strengthen budget,
ed hardy thongs, income, assets, cost accounting and control, financial management supervision. Explore the establishment of the hospital chief accountant system, establish a sound internal control system, implementation of internal and external audit system.
(c) promote the separation of medicine and improve the compensation mechanisms in public hospitals.
1. reforms to make health system drugs. Explore a variety of specific ways to separate medicine, drug addition phasing policy, public hospitals, thereby reducing the reasonable income, to take an additional pharmaceutical service fees, some measures such as technical service fees, medical insurance fund and by increasing government investment and other channels to compensate. Pharmaceutical services Feinaruji to pay the health care range. Payment system to encourage reform of income as a starting point to solve the drugs make health problem.
2. of reasonable adjustment price of medical services. In accordance with the overall control, the principles of restructuring, rationalizing technical services reflect the value of medical personnel of medical service price; government-funded public hospitals, the purchase of large equipment cost less depreciation according to formulate check prices; plants (referred) introduced into the class of medical supplies centralized bidding and procurement, to provinces (autonomous regions and municipalities) for the unit to gradually open; to strengthen price management of medical supplies. All medical institutions should adopt appropriate methods to publicity medicines, medical supplies, prices and charges for medical services standard. Reform of health care services to develop guidance on the charging method, carried out by way of disease such fees reform, and explore will help control costs, transparency, facilitate the operation of medical services charging methods.
3. to implement on a large public hospital infrastructure and equipment procurement, the development of key disciplines, in line with state regulations and policy costs for retirees and other government subsidies to loss of investment policy.
(d) to promote and profit from nonprofit health care organizations improve the management system of classification.
establish medical institutions of different nature of the business management system, improve the non-profit medical institution's assets management system, financial and accounting systems, governance and supervision and management system. Different types of medical institutions regulate the conversion process. Held strictly defined social capital nature of the business of medical institutions, in accordance with the nature of the business standard management. The Government shall not be held for-profit medical institutions.
Third, to promote the development of public hospital services system
(a) optimize the layout and structure of public hospitals.
1. to study and formulate plans to strengthen regional health guidance, improve the regional planning guidelines for medical institutions to study the development of a national health care resources in different regions of the guiding criteria, develop the layout of public hospitals, restructuring guidance. All regions in regional health planning, regional medical institutions within the framework of planning, development of public hospital setting and development planning, to determine the function of public hospitals, type, quantity, size and layout.
2. in accordance with the volume control, structural adjustment, the modest size of the principle of strict control of public hospitals, the scale of construction, standards and lending behavior, to take the new, expansion, relocation, consolidation, restructuring, etc., to optimize the allocation of resources in public hospitals . Focus on strengthening the District, suburban, urban and other areas of satellite and pediatric, maternity, mental health, infectious disease prevention and control, aged care, rehabilitation and medical services in the areas of capacity building.
3. promoting public Chinese medicine (including national medicine) hospital reform and development. Improve the public service system of Chinese medicine hospitals, and promote Chinese medicine communities, into the grass roots, into the rural areas, give full play to the characteristics and advantages of Medicine. Focus on the strengthening of national Chinese medicine specialist, and raise the clinical efficacy of traditional Chinese medicine. Government investment in the implementation of preferential policies on the public hospital for Chinese medicine to study and formulate favorable Hosps play a dominant characteristic of Chinese medicine's economic policies.
(b) give priority to construction and development of county-level hospitals.
1. Government priorities in each county to run a county hospital. Based on the work of the previous two years, the central support 300 so again this year on the county-level hospitals (including the Chinese Medicine Hospital, the same below) standardization. More than 30 million population of the county (city) basically completed before the end of 2011, two first class of more than a public hospital, the common disease, severe, and some difficult emergency diagnosis and treatment of complex diseases can be basically solved in the county.
2. deepen their counterparts in urban tertiary hospitals support the county hospital. Continue to implement the Promoted the urban tertiary hospital doctors sent to the county hospital rotation system,
tory burch abbey flat, each county not less than one hospital, less than 5 per hospital doctors. Presence to properly resolve the city hospital staffing and benefits involved in the issue.
3. to strengthen the backbone of county hospital personnel training. Strict access to county-level hospital staff, new medical staff into the county hospital must have appropriate qualifications. Organization has not been standardized residency training graduates for New 3-year clinical standardized training. After standardized training of physicians to encourage county-level hospitals to employment, and its long-term to create conditions in the county hospital. Improve the continuing education system to encourage county hospitals through various forms of health professionals to improve operational capacity and overall quality. The selection of county hospitals around the backbone of 6,000 physicians or other health professional and technical personnel to their counterparts in the tertiary hospitals for further study. Complete title of county health personnel evaluation criteria, highlighting the clinical skills assessment, dilute the papers and foreign language requirements.
4. step by step comprehensive reform of county hospitals. Comprehensive reform program to develop county-level hospitals in the country serving a population of 300 selected more based on county-level hospitals to better personnel management and income distribution, performance assessment, quality care, payment, adjusted price of medical services, implementation of clinical path, promoting information technology as the focus of the comprehensive reform. Encouraged to expand the scope of the pilot areas where conditions permit, to increase the pilot efforts.
(c) the establishment of public hospitals and primary care health facilities division of labor cooperation mechanism.
1. sum over hospitals and primary care health facilities division of labor work experience, study and formulate the guiding document.
2. strengthen the county-level hospitals supported by the township health centers. In 20% of the county (city) to explore the vertical and technical cooperation to promote the county and township, rural health service system to improve the overall efficiency. Priorities in national poverty counties and parts of the province for the implementation of two key counties for poverty reduction than their counterparts in support of medical and health institutions of township hospitals project.
3. in urban public hospitals and community health services division of labor between the long-term stable cooperative mechanism. Take various forms such as signing long-term cooperation agreement, the integrated use of health insurance payments, medical service price adjustment, financial investment and other policies to encourage doctors to a large grass-roots visits, and gradually form a grass-roots first diagnosis, medical grade,
men gucci shoes, two-way referral pattern.
4. organize medical teams, to provide mobile medical services in remote areas.
(d) accelerating the construction of hospital information.
1. study the establishment of a unified national system of hospital information construction standards for the realization of inter-agency and inter-regional, cross-interoperability of medical information resources, shared use basis.
2. unified planning,
paul smith swirl purse Men in different age requirements for women, integration of resources, and gradually improve the convergence and regional health information systems, electronic medical records and hospital management to focus on the construction of hospital information network to support the hospital and medical staff to provide patient-centered coordinated, coherent and convenient services. Meanwhile, the public hospitals and primary health care institutions to establish collaborative division of the upper and lower linkage mechanism, the establishment of efficient medical services regula
tory system to provide technical support.
3. to promote the county-level hospitals and urban tertiary hospitals to carry out activities in telemedicine, remote consultation, remote diagnosis, remote inspection, tele-education and information sharing, give full play to the role of radiation quality medical resources. 2011 500 county hospitals in remote areas and urban tertiary hospitals, long-distance diagnosis system construction.
IV Huimin convenience measures implemented in the country
(a) improve the public medical services.
1. generally appointment to carry out treatment services. All three A-level general hospitals nationwide to implement a variety of ways appointment clinics, community treatment referral priority booking to the end of 2011, community referral clinic appointments accounted for 20% the proportion of the amount of the local patient referral appointment rate of 50% including dental, prenatal care, referral and other postoperative review appointment rate of 60%.
2. optimize the Hospital of the environment and processes. Accordance with the Peak shifting services and sub-periods to carry out treatment, simplify medical procedures and shorten the waiting time for the masses. Improve patient information management platform, public medical services information, to provide appointment register, call number, report card printing services.
3. extensively convenient outpatient services. The country generally carried out three weekends and holidays hospital outpatient clinics to enrich the power to extend the out-patient time. Through the purchase of services and other measures to encourage and support medical staff to the tertiary hospitals and health institutions to carry out primary health care practice activities.
4. the promotion of quality care. All three hospitals nationwide to carry out high-quality care, 50% of the hospitals of quality care ward covers more than 50%, 40% of the prefectural (city) level II hospital and 20% of the county hospital to carry out high-quality secondary care. Improve the preparation and implementation of professional nursing staff, medical service prices and internal distribution of income and other support policies.
(b) implementing measures to control medical costs Huimin.
1. to explore a variety of basic health care reform, payment methods, promoting the Capitation, according to DRGs, the total prepaid and other payment methods. Explore the basic health care agencies and public hospitals to determine the scope of services through the negotiation, payment, payment standards and service quality requirements. Strict examination prepared a basic medical insurance drug list drug rate, rate of utilization and control of pharmaceuticals and other indicators at their own expense.
2. to achieve basic health care costs are settled. Hospital information system to do basic health care information systems and docking, public hospitals, insurance co-ordination within the region to receive inpatient medical costs were only part of the individual pays the remaining part of the basic health care agencies and direct billing. Significantly reduced the amount of insured patients prepaid payment, health care agencies allocated a certain amount to the hospital's working capital, and time and in full settlement of health care costs.
3. promote the priority with public hospitals, the use of essential drugs, extensive use of appropriate technology. The progressive introduction of mutual recognition of test results at the same level of medical institutions.
4. improve the way drug centralized bidding, promote the general medical supplies, bidding and purchasing, in the case of quality assurance to reduce procurement costs and procurement prices.
5. strengthening hospital financial management,
custom timberland 转载：于丹――心不狠则站不稳。你, implementation of cost accounting and control, efficiency of resource use.
6. to strengthen the regula
tory control of medical costs. Around the level of economic and social development according to the basic medical insurance fund support capability, the cost of medical services, changes in the comprehensive development of medical technology to determine patient and hospital in the region are sub-cost growth, people growth rate, hospitalization rate, drug costs and drug growth accounting and other control and management objectives, management by objectives into public hospitals, the scope of accountability and performance assessment. To strengthen the medical expenses increase faster diagnosis and treatment of disease behavior regulation.
(c) strengthen the medical safety and quality supervision.
1. to study and formulate the basic medical needs to adapt to the clinical pathway, expanding the scope of hospital and disease. The end of 2011, formulated and issued to 300 the number of clinical paths, 50% of the three A-level general hospitals and 20% of the two first class general hospital management of the implementation of clinical pathways, respectively diseases hospital of not less than every 10 and 5.
2. supervision and guidance to strengthen disciplines and hospital personnel, strictly according to law practice, and strengthen the key areas and key parts of the management, ensuring the safety and quality health care.
3. to carry out medical evaluation of safety and quality control, and promote the work of the hospital management evaluation review, organize special inspection of medical safety and quality management activities. Complaint handling mechanism in patients with established, accepted in time, to seriously address patient complaints and improve public satisfaction.
five medical personnel to fully mobilize the enthusiasm of
(a) improve the public hospital personnel and income distribution system.
full implementation of the employment system, and basically complete the implementation of the Establishment and Management positions,
tory burch suede boots, the implementation of open recruitment and competition for employment, the establishment can be hired, promoted or demoted in the employment system. Improve the staff performance appraisal system, the implementation of job performance wage system, the medical staff wages and the number of medical services, quality, technical difficulty, cost control, and other people linked to satisfaction, so that hard work and excellent merit pay to improve Clinical first-line nurses and physicians salary levels.
(b) reasonably determine the staffing of public hospitals.
function according to the hospital location, workload and other factors used for the compilation of existing, reasonably determine the medical staff development, research and support to resolve the shortage of nurses in rural areas, grassroots staffing problems.
(c) create a favorable environment for medical practice.
carry out the Medical dispute mediation mechanism to establish a third party, to develop medical liability insurance and medical accident insurance, strengthen physician-patient communication, doctor-patient relationship harmonious. Strengthen the positive publicity and guidance, in the whole society to respect medical science, the social atmosphere of respect for medical personnel. Organizations or support the production of a number of typical character and reflect the medical front, the outstanding deeds of video art works.
(d) to create good conditions for career development.
establish and implement standardized general practitioners and specialists training system, improve the training modules and policy measures. Establishment of 100 standardized training bases, recruiting people to carry out a standardized training. Strengthen policy guidance, support hospitals to improve the core clinical skills medical personnel to carry out job training. Strengthen the construction of three key specialties of Clinical significantly improve the level of medical services and medical staff capacity.
(e) to promote the rational flow of medical personnel.
improve the practice of multi-point pilot practicing physicians, normative documents, we will extend to all public hospital reform in urban and other areas where conditions permit, will apply to the physician staff to relax the conditions to increase the number of multi-site practice . Encourage practitioners to public hospitals, primary care practitioners and health institutions to carry out activities.
(f) promote the highest professional integrity.
strengthen medical ethics and the ideological and political work,
lv stephen sprouse collection, attention to the quality of medical staff training and professional quality humanities education, vigorously promote the life-saving humanitarian spirit.
six doctors do to promote a diversified pattern of
(a) the refinement of social capital organized to encourage and guide the policies and measures of medical institutions.
implement the develop and improve the implementation details and supporting documents, to encourage and guide the implementation of social capital, the policy of organized medical institutions, non-public medical institutions to promote sustained and healthy development, accelerate the formation of diverse patterns of doctors do to meet people's demand for multi-level medical services.
(b) non-public medical institutions to allow a reasonable development.
1. all over the region in the formulation and adjustment of regional health planning, Medical Institutions and other medical and health resources planning, to give non-public medical institutions allow a reasonable space, clear non-public medical institutions, health personnel, beds, and proportion of the total assets of development indicators. Need to be adjusted and new medical and health resources, in line with the conditions of access standards, the priority held by the medical institutions of social capital.
2. control the scale of special needs services in public hospitals, public hospitals provide special needs services, hospital medical services shall not exceed 10% of resources.
(c) improve the social capital organized medical practice environment.
1. non-public medical institutions where the implementation of the Government provided medical services and drug price policies, in line with the relevant provisions of fixed Medicare, the program should be incorporated into urban basic medical insurance, new rural cooperative medical care, medical assistance, work injury insurance, maternity insurance and other fixed social security services, managed service agreement, and perform the same with the public sector reimbursement policy. And other measures to encourage bidding, select the eligible non-public sector commitment to public health services and government issued health in agriculture, support the border, counterpart support and other tasks.
2. to support non-public medical institutions in accordance with the approved scope of practice, hospital level services such as population size, with large medical equipment and reasonable. Encourage medical staff in public and non-rational flow between the public sector, the relevant units and departments shall, in accordance with the relevant provisions for the practice change, personnel and labor relations convergence, social insurance relationship between the transfer, file transfer and other procedures.
(d) to promote the healthy development of non-public medical institutions.
1. guide the specification of non-public medical institutions according to law practice. Range of non-super-clinic services, and severely crack down on illegal medical practice and health care fraud activities. Regulate behavior in medical advertising. Strengthen the medical safety and quality supervision and inspection, audit and evaluation.
2. promote the non-public medical institutions to carry out business activities by nature of the business. Non-public medical institutions to implement the state's financial accounting system. Income from non-profit medical institutions a reasonable addition to the provisions of expenditures can only be used for medical institutions to continue to develop.
seven, the requirements
(a) strengthen the organization and leadership. All localities and departments should fully understand the importance of reform of public hospitals, complexity and urgency, increased sense of political responsibility, to put this reform agenda, strengthen leadership, careful organization and deployment. Local government is responsible for comrades to personally attend to, work plans, break down goals and tasks, delegate responsibility, to strengthen supervision and inspection. Ministry of Health, Office of the State health care reform is the reform of public hospitals in the lead unit, the pilot reform to strengthen the work of the national co-ordination, organization and implementation and inspection guidance, the Ministry of Health to integrate the internal forces of the interim set up a special working body of public hospital reform . Central Programme Office, the Development and Reform Commission, Ministry of Finance, Human Resources and Social Security, according to the Chinese Medicine Council and other departments closely with the division of responsibilities, and strengthen guidance and supervision over the work of inspection.
(b) strengthen the support for protection. Governments at all levels to increase investment in public hospitals financial assistance to seriously implement the policy to actively support the establishment of public hospitals and primary care health facilities division of labor cooperation mechanism, the comprehensive reform of institutional mechanisms for public hospitals, residents and hospital standardized information technology training. The use of funds to strengthen financial management, improve capital efficiency. All relevant departments should further investigations and studies, closely tracking the progress of work and actively formulate and improve relevant supporting policies.
(c) actively promote the guide. Medical staff to strengthen the propaganda and mobilization work in order to support the reform of the health professionals to actively participate in reform, reform to play a dominant role. To widely publicize the policies of public hospital reform measures and the results achieved, to strengthen the policy interpretation, so that the entire social understanding, cooperation and support reforms, reform of public hospitals to create a good environment.
State Council on the issuance of 2011
2011 年 reform of public hospitals work
10
provinces, autonomous regions and municipalities, State Council department:
reform of public hospitals involved in the adjustment of various interests is the focus of medical and health system and difficult. 2011 is the completion of five key health system reform, the crucial three-year mandate, and also of public hospital reform in the crucial year. Reform of public hospitals do a good job this year, and strive to comprehensive reform of the institutional mechanisms for a breakthrough on difficult issues, will lay a solid foundation for further reform. All localities and departments should strengthen the leadership and close coordination, careful organization and deployment, to ensure the reform of public hospitals to achieve the desired results.
State Council
二 ○ 一 一年 仲春 二十 八日
SCS 〔2011〕
public hospital reform the organization of work notice
tory burch suede boots 2011 reform of public hospi
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