2. Establishment of a resource ****sharing mechanism with complementary advantages. Implementation of regional health planning, rational allocation of health resources. Advantageous health resources within the county *** enjoy *** use, maximize the use of resources, and improve the efficiency of resource use. Under the premise of guaranteeing medical quality and medical safety, the items for mutual recognition of medical tests and medical imaging examinations between medical institutions are reasonably determined according to the level of medical institutions within the county, and mutual recognition of examinations is implemented within the county. Gradually implement the centralized supply of all kinds of materials and logistical support services to reduce costs.
3. Establishment of a hierarchical and rational business cooperation mechanism. In accordance with the functional positioning of the three-tier institutions and the service capacity of each medical and health institution, the service scope of the cooperative parties is reasonably determined, and a two-way referral system is formulated to clarify the referral procedures, standards and technical specifications for the timely upward and downward referral of patients. Give full play to the role of the new rural cooperative medical system in regulating the flow of patients, and guide patients to reasonably choose the medical institutions they will visit. Establishing a system of consultation between cooperative units, mutual assignment of doctors, guided room visits, joint surgeries, joint emergency treatment and first aid. A county-wide unified system for continuous improvement of medical quality and a medical quality control system has been formulated, with higher-level medical institutions guiding the implementation of lower-level cooperative units. Preventive health care institutions at the county level give technical support and operational guidance to township health centers, and township health centers to village health offices in disease prevention and control, maternal and child health care, and health education. The preventive health care personnel of township health centers supervise village-level public **** health work in sections.
4. Establishment of a mechanism for business guidance and personnel training for counterpart support. Establishment of county-to-township and township-to-village business guidance and personnel training system, and promotion of inter-unit technical exchanges and technical support. The business level of rural health organizations is upgraded in various ways, such as through medical rounds, consultations, training courses, mutual assignment of business personnel, and further training. Higher-level medical institutions should uniformly arrange for personnel from lower-level cooperative units to participate in clinical staff departmental rotations, give priority to arranging further training for personnel from cooperative units, absorb personnel from lower-level cooperative units to participate in training courses on continuing medical education, and encourage the joint declaration of scientific research topics and the development of scientific research.
5. Establish a reasonable compensation and distribution mechanism. County governments should set up special funds to compensate and reward units that pay more and make outstanding contributions in vertical cooperation. Playing the role of government guidance, it encourages higher-level organizations to give support and assistance to lower-level organizations. Reasonable distribution of *** same proceeds incurred in business cooperation, on-time reconciliation and handling of acceptance and payment procedures.
1. Reasonable preparation of the township health centers of all income and expenditure. Pilot counties (cities and districts) should take into account the public *** health and basic medical tasks undertaken by the township health centers, staffing, scope of services, business development and other factors, in accordance with the balance of income and expenditure, the principle of income and expenditure, scientifically and reasonably determine the income and expenditure items of the township health centers, and to approve the revenue and expenditure. Township health centers in accordance with the approved annual budget organization income, arrangement of expenditure, of which the government subsidy income in accordance with the "Shandong Province, rural health care subsidy policy of a number of opinions" (Lu CaiShe [2003] No. 3) of the relevant provisions of the implementation. Township health centers within the scope of the state personnel salaries, allowances and other personnel expenses, to carry out the work necessary materials, instruments, drugs, transportation, water and electricity consumption and other operational expenses, infrastructure repairs, equipment renewal and configuration, as well as personnel training and other project expenditures, retired personnel costs, and the handling of sudden public **** health incidents and other necessary expenses in accordance with the relevant policies to ensure the implementation of.
2. Standardize the township health center revenue and expenditure management. County-level departments should develop a county-wide unified township health center financial income and expenditure management system for each health center to set up an independent account for the health center's income and expenditure on the implementation of centralized sub-account management. Pilot counties may adopt the method of managing revenues against expenditures and subsidizing the difference; they may also explore the method of paying the full amount of revenues and then centralizing payments on a monthly basis. Capital construction and equipment purchases are implemented according to the approved annual plan. In order to ensure the normal operation of health centers, a certain amount of working capital can be issued to health centers.
3. Reasonable disposal of the township health center income and expenditure difference. Township health center business income and expenditure balance of part of the funds should be transferred to the township health center business development funds, mainly by the county-level health administrative department for the county township health center personnel training, end-of-year assessment and incentives and other work. Part of the funds can be returned to the health center, the specific proportion is determined by the pilot counties (cities and districts).
4. Reform of township health center income distribution mechanism. County-level health administration departments manage the personnel and funding of township health centers in accordance with their responsibilities, and establish performance evaluation mechanisms for township health centers and health personnel. The business volume, service quality, completion of public **** health tasks, satisfaction of the service population, and improvement of the health status of the service population of township health centers are included in the scope of the assessment, and are used as the main basis for returning the income of the township health centers and for the assessment of incentives. Strengthening the management of the selection and appointment of township health center directors, and implementing the director appointment system and the tenure target responsibility system. Reform the internal distribution of township health centers, expand the unit distribution autonomy, according to the principle of post, task, performance pay, comprehensive health personnel skills, quality and other factors, reasonable determination of performance pay, shall not be medical personnel business income and service charges directly linked.
A strengthened organizational leadership. Pilot work involves a variety of interests, is a complex and arduous task. To be under the leadership of the local government, carefully organized, improve measures, and actively promote the implementation of the pilot tasks. Pilot counties (cities, districts) health administrative departments to set up specialized institutions, respectively, to undertake vertical cooperation and township health hospitals financial management of the business work. The medical and health units to implement the "hand" system of responsibility and target management to ensure the smooth implementation of the pilot work.
Two develop and improve policy measures. Pilot counties (cities, districts) in the county health resources and health services on the basis of baseline surveys, the development of the implementation of the program, a clear vertical cooperation and township health centers to carry out two-line management of income and expenditure policies and measures, the unit's responsibilities and tasks, work procedures, incentives and penalties, etc. to make provisions. To comprehensively use administrative and economic means to guide the units to consciously fulfill their responsibilities and obligations.
Three strengthen supervision and assessment. The establishment of the pilot evaluation system, the establishment of assessment and supervision and reward mechanism, clear participation in the pilot units of responsibility and obligation, the task will be decomposed and implemented to the unit, section, responsibility. County-level health administrative departments should regularly organize supervision and inspection, and municipal health administrative departments should regularly organize stage-by-stage assessment, and our office will also organize annual work assessment before the end of the year. The focus of the assessment includes whether a long-term mechanism has been established and effectively implemented, whether the health service capacity of grass-roots organizations has been improved, whether the burden of farmers in seeking medical treatment has been reduced, and whether rural grass-roots health care services have been implemented. Through the inspection and evaluation, constantly summarize experience, analyze problems, and promote the healthy development of the two reforms.