On April 27, the medical network influenced the good policy of the medical people!State department: all public hospitals take part in the medical community.Medical joint tendering, prescription flow and drug sharing.
▍ internal unified tender, couplet of medical prescription flow, medicines, sharing
On April 26, the general office of the state council issued a guideline on promoting the construction and development of the medical association.
"Opinion" explore: to establish a unified inside couplet of medical drug bidding procurement, management platform, forming of couplet of medical drugs prescription flow, in sharing and distribution mechanism.
"Opinions" requirement: before the end of October, the start of the third class hospitals: by the end of June 2017, the provinces (autonomous regions and municipalities) should be clear to promote the medical work plan of the construction of the couplet, all tertiary public hospital should start before the end of October of couplet of medical construction work.By 2020, all secondary public hospitals and government-run community-level medical and health institutions will participate in the medical community.
"Opinions" is clear: the unified management of the medical community and the distribution of benefits.Tertiary public hospitals are all involved and leading.To encourage the unified management model in the medical community;We will establish a mechanism for sharing responsibility and interests and mobilize the initiative of medical institutions in the medical community.
"Opinions" is released: in the medical community, doctors are free to practice.In medical couplet body (including the couplet of cross-regional medical), medical staff in helping or custody agreement signed with medical institutions in practice, does not need to go through the formalities of practicing site changes and institutions for the record.
▍ size hospital drug use, distribution and unified, drug companies benefit
The document means to establish the internal resources sharing within the medical community;In this way, we will explore the establishment of an integrated drug procurement and management platform in the medical community, and form the mechanism of prescription flow, drug sharing and distribution in the medias.This has a big impact on the pharmaceutical industry.
Provincial bidding has been greatly weakened, and the individual bargaining of the medical community has become the main purchasing mode.The prescription flow, the doctor is free to practice, must be the medicine of the medicine in the medicine of the internal medicine the catalogue of the medicine, the size hospital medicine and distribution integration.It has seized on a point at the trimejia hospital, which covers the entire medical community, and will make more breakthroughs.
As of the end of November 2016, there were 2,080 tertiary hospitals nationwide.According to the document, every tertiary hospital should have a medical association, at least 2080 medical medias.If you do a good job of buying 2080 medical medias, it means getting into all the public hospitals in the country.This is not a routine at a hospital in the past.From any point of view, the policy should be positive for the pharmaceutical industry.
▍ full impact the pharmaceutical industry
The policy is coming fast.At the state council's executive meeting on April 12th, premier li keqiang stressed that promoting the development of the medical community as a major step forward in healthcare reform.And policy briefing on April 14, the state council, reform of the state council office director, deputy director of the national health and family planning commission Wang Hesheng introduces the strengthening the construction of medical association and development guidance about it;It was officially announced yesterday (26 April).
For medical couplet body positioning, also from the earliest loose structure, to the last August 19, the national health development planning commission issued notice of the pilot "about promoting grading diagnosis and treatment, to establish" asset integrated medical couplet "encouragement, the final of the state council: medical couplet body internal unified management, profit distribution.
Grade therapy, the practice of the hospital, the size of the hospital, etc.All the changes affecting the industry have been carried by the medical association and pushed aside.In addition it is important to note that the medical couplet body construction, balance, the claims of the parties involved in this case, its implementation will be very smooth, impact would also be comprehensive.
Attached: the general office of the state council on promoting the construction and development of the medical association
The people's governments of the provinces, autonomous regions and municipalities directly under the central government, ministries of the state council, and directly affiliated institutions:
Began a new round of medical and health system reform, speed up to establish and perfect the universal health care system in China, basic medical and health institutions service conditions improved significantly, with emphasis on the general practitioner, the construction of talent team continuously strengthen, grassroots service in weak status gradually change, basic medical and health service fairness and accessibility improved significantly.But want to see, strong base is a long-term arduous task, our high quality medical resources shortage, unreasonable structure, uneven distribution, especially still faces a lack of high-quality professionals at the basic level, has become an important restriction safeguard people's health and deepen the reform.Medical association) (hereinafter referred to as the medical couplet body construction, is the important process of deepening reform and system innovation, is conducive to adjusting and optimizing the structure and layout of medical resources, promote the medical and health work center of gravity down and resource sink, promote grass-roots service ability, is advantageous to the medical resources and well versed in, promote the overall efficiency of medical service system, to better implement grading diagnosis and meet the demand of public health.In order to guide the development and development of the medical community in various regions, the following Suggestions are made by the state council.
One, the general demand
(1) guiding ideas.Fully implement the party's 18 large and 18 sixth plenary session of 3, 4, 5, and the national health and health conference spirit, earnestly implement the party central committee and state council decisions and, as a whole to promote "five one" the overall layout and coordination to promote "comprehensive" four strategic layout, firmly set up and implement the innovation, the coordination, the development of the green, open, sharing ideas, adhere to the people as the center of the development of ideas, based on China's economic and social and medical health development practice, to implement the function orientation of medical institutions, and straighten out the two-way referral service capability, process as the key point, couplet of perfecting the medical organization and management mode, operation mechanism and incentive mechanism, and gradually establish a perfect purpose between different levels, different categories of medical institution, the division of responsibilities clear, fair and effective cooperation mechanism, promote to build the classification system, way to realize development by treating centered on health as the center.
(2) basic principles.
The government is in charge of planning.To carry out government planning, guidance, coordination and supervision, propaganda and other functions, with emphasis on the city and county, according to the structure and layout of regional health resources and public health needs, in accordance with the relevant business, complementary advantages, such as two-way choice and sustainable development requirements, always give attention to two or morethings to form partnerships, overall arrangement of couplet of formation of medical institutions.
We will adhere to the public interest and innovation mechanism.We will uphold the government's responsibility for medical care, and earnestly safeguard and guarantee the public welfare of basic medical and health care.Insist on medical, health care, medicine, linkage reform, innovation mechanism, gradually to break the administrative area, financial investment, health care payment, barriers and obstacles in aspects of personnel management, optimize resource structure layout, combining with the reform of medical insurance payment advance, gradually establish a perfect mechanism of collaboration between medical institutions.
Resource sinking, ability to ascend.Using the advantages of high quality resource concentration in the tertiary public hospitals, the technical radiation and the driving effect of the basic level of public hospitals are carried out by means of technical assistance and personnel training.Encourage medical couplet of unified management mode, giving full play to the advantages of intensive, promote regional medical resource sharing, give play to the role of lead and support of science and technology, improve the medical service system overall capacity and performance.
The people benefit the people and the people benefit.Adhere to people's health as the center, and gradually realize the management of medical quality homogeneity, strengthening basic medical and health institutions of residents' health "gatekeeper" ability, promote the combination of chronic disease prevention, treatment and management, promote the construction of medical conjoined cohesion and prevention, health care, convenient to the masses, to the nearest lighten the burden of disease, prevent because of sickness poor Chinese, promoting health and economic transformation and upgrading of industrial development, enhance the masses get feeling.
(3) work objectives.In 2017, the basic structures of couplet of medical system framework, the comprehensive start construction experimental unit of couplet of various kinds of medical, tertiary public hospital to participate in and all play a role of leading, comprehensive reform pilot provinces each cities and grading treatment pilot cities built at least one has obvious effect of medicine.Exploration of couplet of longitudinal cooperative medical collaboration mode such as total medicare pay for a variety of ways, such as direct medical couplet of preliminary form relatively scientific collaboration mechanism and internal referral mechanism of relatively smooth.
By 2020, we will comprehensively promote the establishment of the medical community and form a more comprehensive policy system for the medical community by summarizing the pilot experience.All secondary public hospitals and government-run community-level medical and health institutions are all involved in the medical community.Between different levels and different categories of medical institutions to establish specific goals and responsibilities clear, fair and effective collaboration mechanism, establish their consistent leading mechanism, make of couplet of medical service, responsibility, interests and community management, regional medical resource sharing, to further enhance grass-roots service ability, promoted the formation of first option at the grass-roots level, two-way referral, acute slow partition, the upper and lower linkage of hierarchical diagnosis model.
Two, gradually form various forms of medical association organization pattern
According to the region around the hierarchical diagnostic system construction actual situation, adjust measures to local conditions, classification guidance, give full consideration to the geographical distribution of medical institutions, function orientation, service ability, business relations and cooperation intention, give full play to the central and local governments, military, social all kinds of medical resources, respect the initiative at the grassroots level exploration area, couplet of layer to form various kinds of medical, promote high quality medical resources to the basic flow and outlying and poverty-stricken areas.According to the will of the social medical establishment, it can be incorporated into the medical community.
(1) major medical groups in cities are formed.In above the level of district-constituted municipalities cities, by the tertiary public hospital or hospital led business ability strong, united community health service institutions, nursing homes, rehabilitation institutions, such as resource sharing and collaboration management mode.We will cooperate with the medical community in terms of talents sharing, technical support, mutual recognition, prescription flow and service cohesion.
(2) major medical community in county area.Focus on exploring the county hospital as the bibcock, towns and townships as hub, based on village clinics and township integration management, effective connection and integration of rural management.Give full play to the link role in county hospital and rural county leading role, and formed the county rural tertiary healthcare agency collaboration mechanism, constructing three-level linkage county medical service system.
(3) forming specialist alliances across regions.Medical institutions specialized resources according to different area, according to a number of characteristic specialized subject of medical institutions to support technical force, give full play to the national medical center, the national center for clinical medical research and collaborative network, with specialized cooperation as a link, several characteristic specialized subject to form a regional alliance, form a development mode, focus on improving the capacity of major disease treatment.
(4) developing telemedicine networks in remote and poverty-stricken areas.Vigorously develop oriented, remote and undeveloped areas at the grass-roots level of telemedicine network, encourage public hospitals to basic medical and health institutions to provide remote medical treatment, remote teaching, remote training and other services, USES the means of information technology to promote resources longitudinal flow, improve the high quality medical resources availability and efficiency of medical service as a whole.
Between urban and rural to urban tertiary public hospital as the main unit, in the established relationship, based on the long-term stable partnerships through hosting area county hospital medical couplet body, a variety of forms, including tertiary public hospital to county-level hospitals in the management team and expert team, helping to focus on increasing the county hospital medical service ability and level.National and provincial public hospital in addition to the couplet of dependency in the medical, can establish cooperative relations with several medical couplet body to different regions, couplet of medical form a high-level, complementary advantages, develop innovative collaborative research, technology popularization promotion and personnel training, radiation to drive regional health service ability to ascend.
Third, improve the internal division of labor in the medical community
(1) improve the system of organizational management and cooperation.To formulate the constitution of the medical association, stipulate the responsibilities, rights and obligations of the entity and other member units, improve the system of medical quality management, and improve the management efficiency.The medic can explore the establishment of the council at the hospital level.
(2) to implement the functional orientation of medical institutions.The medical association establishes the responsibility Shared responsibility and the benefit allocation mechanism, mobilizing the various medical institutions in the medias to the initiative, the implementation of the function localization.The tertiary hospital gradually reduced the proportion of patients with chronic disease, morbidity, and stable disease.Grassroots medical institutions and professional to clear diagnosis, rehabilitation institutions, nursing homes in a stable condition of patients with chronic disease, rehabilitation period, geriatrics patients and patients with adanced tumor treatment, rehabilitation and nursing service.We will encourage village health clinics to strengthen public health and health management services according to the needs of local residents, and do a good job in preventing and controlling disease.
(3) we made steady efforts to promote the signing of family doctors.Strengthen the training of general practitioners.Focused on chronic diseases such as hypertension, diabetes, and accelerate the family doctor within the couplet of the medical contract signing, priority to cover the old key crowd, maternal and children, the disabled, demand oriented old-age signing the family doctor service, to incorporate all the people living in poverty in 2017 signing service scope.By signing service, encourage and guide the residents within the medical conjoined to the first option at the grass-roots level, the higher hospital signed a contract to provide priority accepts, priority examination, priority in the hospital, etc.Sign for exploration of some chronic diseases patients less than 2 months dose strengths party service, conditional place can, according to the requirements of two-way referral of patients go to a doctor, by extending the prescription, concentrated distribution form of strengthen cohesion at the grass-roots level and the superior hospital drug use, convenient patient to the nearest hospital get medicine.
(4) providing the patient with continuous care.We will encourage nursing homes and professional rehabilitation institutions to join the medical community.Establish medical couplet body internal referral mechanism, focus on clear downward referral channel, the acute recovery, recovery and critically ill patients with postoperative period in patients timely referral to medical institutions at a lower level to continue treatment and rehabilitation, strengthen health care and pension service, provide patients with integration and facilitation of disease diagnosis and treatment, rehabilitation, long-term care service continuity.
Fourth, promote the quality and quality medical resources of the medical community
Encourage medical couplet of medical institutions in the administrative subordination relations and financial investment channels unchanged under the premise of overall staffing, compensation allocation, resource sharing, etc., high quality medical resources up and down through the channels and mechanisms.
(1) promoting the orderly flow of human resources.We will make use of resources such as medical skills to maximize the efficiency of existing resources.The medical staff should be fully engaged in the distribution of remuneration and the initiative of the medical staff.We will encourage more than two secondary medical institutions in the medical community to send professional technical and managerial personnel to the community-level medical and health institutions.In medical couplet body (including the couplet of cross-regional medical), medical staff in helping or custody agreement signed with medical institutions in practice, does not need to go through the formalities of practicing site changes and institutions for the record.
Improving the ability of community-level medical services.Tertiary public hospital, leading role into full play, in view of the disease and priority diseases diagnosis and treatment needs, send medical personnel through the guidance of specialized subject to build, clinical teaching, business, teaching rounds, scientific research and project cooperation of a variety of ways, such as promoting high-quality medical resources sharing and sink at the grass-roots level.
(3) unified information platform.Strengthen the planning and design, give full play to the information system of couplet of medical support, the combination of establishing provincial, city and county levels population health information platform, and overall consideration of couplet of medical related to hospital management, medical services, such as information platform construction, implementing electronic health records and electronic medical records of continuous recording and information sharing, information connectivity in the couplet of medical diagnosis and treatment.The medical |
