To further deepen the comprehensive reform of the medical and health system in our county, accelerate the realization of ? The primary first diagnosis, two-way referral, emergency and slow treatment, up and down linkage? The hierarchical diagnosis and treatment mechanism, so that the masses close to enjoy quality medical services, according to the "Fujian Province to promote the construction of medical consortium guidance (for trial implementation)" of the spirit of the notice, combined with the actual situation in our county, the development of this program.
First, the general idea
Medical consortium refers to different levels, categories, regions, affiliated health care institutions, according to the need for synergistic development of medical services, voluntary negotiation and combination of vertical collaboration organization. Zhenghe County regional medical consortium? (hereinafter referred to as the medical consortium), in accordance with the grass-roots first diagnosis, two-way referral, acute and chronic treatment, up and down linkage, resource **** enjoyment, mutual benefit, the principle of Zhenghe County General Hospital (County Hospital, County Hospital of Traditional Chinese Medicine, the County Maternity and Childhood Hospital) as the lead unit, combined with eight township health centers and two community health service centers composed of the county medical consortium. Medical consortium in accordance with the members of the administrative affiliation remains unchanged, the unit legal person remains unchanged, property rights belonging to unchanged, legal responsibility remains unchanged, the basic functions remain unchanged, the identity of employees remain unchanged, the principle of unchanged regulatory mechanism, give full play to the advantages of the county hospitals diagnostic and treatment technology to synergistic services as the core, technical support for the support of the integrated management of medical services as the focus of the rational use of existing health care resources as the center, and gradually achieve a more Close human, financial and material integration management form, maximize the benefits of county and township medical resources.
Second, the objectives and tasks
2017 first to carry out a pilot, the county hospital and the Iron Mountain Health Center to explore the establishment of technology, talent, management, interests as a link to the loose medical consortium, the county hospital and the ridge waist health center to establish personnel, assets, technology, services, information, management integration of the close-type (hosting) medical consortium. By 2017, the gradual formation of clear powers and responsibilities, clear functions, effective operation, the masses benefit from the operation of the medical consortium system, to promote the development of the county, township level linkage, the overall increase in the allocation and utilization of medical resources in the county, and constantly improve the level of medical technology and service capacity, reduce the outflow of hospitalized patients, accelerate the realization of the ? The goal of medical reform is to keep minor illnesses out of the townships and major illnesses out of the counties, and to summarize the medical reform goals in a timely manner. The goal of the medical reform, timely summary of the experience of the medical association to gradually expand the coverage.
Third, the organizational structure and form of governance
Medical consortium to implement the leadership of the Council's management system, the main person in charge of the lead hospital as chairman, the main person in charge of the members of the unit for the vice-chairman, the Council office in the lead hospital. The council should formulate the constitution of the medical consortium, specifying the nature of the organization, purpose, mission, institutional members, management system, scope of responsibilities, rights and obligations, work rules and other provisions. The close-knit medical association should establish a corporate governance structure, stipulate the rights and obligations of the council, management, medical institutions and other relevant parties through the formulation of the statute, coordinate the allocation and integration of resources within the medical association, and promote the vertical flow of high-quality resources.
(a) Council Office Responsibilities:
1. Specifically responsible for the implementation of the work, do a good job in the hospital branch of the medical association guidance, supervision, assessment, evaluation and other work. The two sides of the unit is the first person in charge, the department heads strongly support, fully grasp the medical association work to promote, to ensure that the expected results.
2. The medical association office held a monthly medical association work meeting to summarize the problems in this month's work, study the solutions, and arrange the next month's work tasks.
(ii) awarding:
The original institutional setup and administrative affiliation of the township health centers (community health service centers) in the members of the medical consortium will remain unchanged, and the first name of the unit will remain unchanged, plus the ? Zhenghe County General Hospital medical consortium? Branch hospital? Brand.
Fourth, the operation and management
(a) the establishment and improvement of hierarchical diagnosis and treatment, two-way referral system
1. The members of the CMC to establish and improve the relevant system, to explore the introduction of various measures to facilitate access to health care for the benefit of the people, to guide the masses in the CMC branch of the first diagnosis. For patients who need to be transferred up or down, both sides establish a contact person system, designate a person in charge, and provide? One-stop? The first step in the process is to establish a system of contacts for patients who need to be referred up and down the line.
2. The establishment of a two-way referral system between the consortium, the establishment of referral files, in accordance with the principles of patient voluntariness, hierarchical diagnosis and treatment, continuous treatment, safety and convenience, and minimize the burden of the patient's medical expenses, the development of a reasonable, convenient, smooth two-way referral rules, in the context of the two-way referral, in order to enjoy the health care insurance tilt policy.
3. In line with the principle of being responsible for the patient and gradually improving the diagnosis and treatment level of physicians in lower hospitals, physicians in higher hospitals are obliged to follow up and guide the patients transferred within the medical association; physicians in lower hospitals have the right to participate in the checkups of the patients transferred within the medical association.
4. Specific referral requirements in accordance with the two-way referral system and process regulations.
(B) resource **** enjoy
1. To realize the unified deployment and use of the bed resources of the member units of the medical association.
2. Free distribution of resuscitation medicines (epinephrine, norepinephrine, isoprenaline, lobeline, niclosamide, cediran, etc.) for the branch hospitals.
3. The implementation of banded purchasing of medicines and consumables to solve the problem of distribution difficulties in primary health centers due to low usage.
4. Provide technical support for equipment maintenance.
5. Responsible for the quality control of testing, imaging, pathology, etc. in the branch hospitals of the medical consortium, and to guide and supervise the testing and imaging work of the member units.
6. Undertake the work of disinfection and supply of the center of the hospital branch of the consortium, the hospital branch of the consortium in accordance with the specific circumstances of each hospital agreed to by the general hospital commercial disinfection and supply center unified distribution.
7. In the unified quality control standards, to ensure medical safety on the premise of expanding the scope of mutual recognition of test results in the hospital cluster, to reduce the duplication of tests and inspections, inspection and mutual recognition must be carried out in line with the premise of medical safety norms, and can be gradually mutual recognition of the project, the implementation of step-by-step.
8. Make full use of the General Hospital continuing education resources to achieve the purpose of *** with the learning. The monthly continuing education training to notify the hospital branch of the relevant personnel to participate.
9. Actively carry out the emergency and urgent care joint mechanism. Relying on the political and health information cloud platform in the medical association to build emergency medical management information system, the establishment of emergency and first aid coordination and linkage mechanism, the realization of emergency information sharing and communication in a timely manner, the centralized allocation of emergency resources and the use.
(C) personnel exchanges
1. Provide free further training for medical staff of the hospital branch of the medical association, using? One-on-one teaching model, for primary care institutions to train a group of health care personnel who can diagnose and treat common diseases, multiple diseases and clear diagnosis of chronic diseases.
2. Actively explore the establishment of county-level public hospitals and primary health care institutions of medical personnel exchange rotation mechanism, the implementation of a unified recruitment, unified management, unified use of personnel management system, unified training.
(D) technical guidance
1. To help hospitals establish and improve the internal management, public **** health, medical services, medical safety and other related work systems, to further optimize the workflow, to improve the hospital hospitals ability to provide medical services and management level.
2. Explore clinical path management, electronic medical records and other means of service within the medical association. Accelerate the promotion of clinical path management, and gradually realize the standardized treatment of single diseases.
3. According to the needs of the hospitals at any time to arrange for the appropriate specialists to the hospital branch of the consortium to carry out consultations, difficult case discussions, teaching room, appropriate technology guidance and other collaborative services.
4. To build a remote diagnosis and treatment platform among the members of the consortium, using information technology to improve the quality and efficiency of medical services; and to gradually realize the functions of remote consultation, remote specialist diagnosis (pathology, testing, imaging, etc.), bidirectional referral, and emergency command.
5. Establishment of the WeChat group and QQ group of the medical association to build an information platform for learning and exchange.
(E) Improve the performance allocation mechanism of the member units of the medical association
According to the member units of the two-way referral situation, the number of services, quality and patient satisfaction, etc. to implement the performance assessment, to fully mobilize the enthusiasm of the county and township medical personnel, to establish and improve the performance allocation mechanism of the internal member units. The specific implementation rules are separately formulated by the member units of the medical association.
(F) carry out health service management
Accelerate the promotion of information technology construction of the members of the medical association, as soon as possible to realize the effective connection between the residents' health records and diagnostic and treatment information, and to realize the security of medical service information interconnection between the members of the medical association. Focusing on the combination of general practice and specialization, specialists from second-level hospitals and general practitioners from the branch hospitals of the medical consortium can jointly conduct diagnosis and treatment of related diseases in order to improve the health management level of the residents.
(VII) related policy support
1. Two-way referral of patients within the medical association, and gradually simplify the referral and reimbursement procedures for the New Agricultural Cooperative Medical Insurance (medical insurance) according to the policy of hospital referral, and abolish the two-way referral of the New Agricultural Cooperative Medical Insurance (medical insurance) within the medical association, and cancel the second starting line. Relax the scope of use of clinical drugs in primary health care institutions, the medical insurance (new rural cooperative) drug reimbursement catalog as a primary drug catalog to adapt to the two-way referral needs.
2. Not within the scope of the primary health care institutions diagnosis and treatment subjects or emergency, critical, difficult, major disease patients, by the grass-roots health centers (community health service centers) first referral to the higher hospitals in the county for treatment, the new rural cooperative reimbursement rate in accordance with the township health centers (community health service centers) policy implementation.
3. In order to promote the sinking of high-quality medical resources at the county level, the medical staff of the higher hospitals in the medical association to the township health centers for more than six consecutive months is regarded as a pre-promotion to the countryside, and as the main basis for the evaluation of the title. Medical personnel of primary health centers (community health service centers) working in higher-level hospitals are considered to be in advanced training. Encourage the medical association within the higher hospital medical personnel, management personnel in primary health care institutions as deans, subject leaders, management department heads, two-way referral work to be the gatekeeper and guidance to improve the grass-roots management level, outstanding performance to be prioritized for promotion and reappointment.
4. In order to accelerate the pace of the construction of the medical consortium, under the premise of not increasing the financial expenditure of primary health care institutions, and taking into account the higher hospital medical personnel to the grass-roots level to serve at ease, the personnel relations of the higher hospital medical personnel assigned to remain unchanged, the wages and salaries issued by the original unit (not lower than the original unit at the same level). The establishment of a medical association of the lead pilot unit, the completion of the established assessment indicators, the county medical management committee from the county public hospitals comprehensive reform of the central financial subsidies to extract a certain percentage to be subsidized, the establishment of a close medical association of the unit of 200,000 yuan per year, the establishment of a loose medical association of 100,000 yuan per year, the funds are mainly used for the dispatch of medical personnel transportation, room and board subsidies and incentives.
(H) Establishment of a sound assessment mechanism
1. Establishment of a sound internal assessment mechanism for the medical association. The council of the medical association shall establish an assessment mechanism for the operation of the medical association, and shall take the performance of the member units of the medical association in fulfilling the responsibilities of functional positioning, division of labor and collaboration, capacity enhancement, and compliance with the statute as the assessment index. In the assessment of the members found to be contrary to the requirements of the objectives and the basic principles, the lead hospital may require them to rectify the situation, and if they do not rectify the situation or the rectification is not in place, terminate their membership.
2. Strengthen industry supervision and management functions. The health care administration is responsible for the guidance of the construction of the medical association, regular or irregular inspection of the operation of the medical association, and timely correction of the members of the medical association in violation of the objectives of the requirements and basic principles of behavior. There is a serious violation of the objectives and basic principles of the medical association, the health planning administrative department ordered the lead hospital to dissolve the medical association, and the lead hospital and the relevant member units of the main person in charge of responsibility.
3. Improve the performance evaluation mechanism of the medical association. The health care administration should take the responsibilities and tasks of the medical institutions at all levels within the medical association, improve the talent structure and service capacity of the grassroots, implement the two-way referral system, the implementation of grassroots first aid and the implementation of hierarchical diagnosis and treatment system as the main content of the performance appraisal. The results of the assessment are linked to the evaluation of the hospital level, the approval of the total amount of hospital performance pay, financial allocations, the appointment and dismissal of the director, and the payment of medical insurance.
V. Organization and implementation
(a) Strengthen organizational leadership. The implementation of vertical integration of medical resources, promote the construction of medical consortium is the comprehensive pilot health care reform ` important goals and tasks. The medical and health units should effectively strengthen the organizational leadership, the implementation of the responsibility, in accordance with the requirements of this implementation plan, unified planning for the construction of medical consortiums, clear construction goals and sequential progress, actively and steadily promote the implementation.
(ii) Strengthen supervision and guidance. To carry out regular supervision, to understand the construction of the medical association, to summarize the experience of different modes of medical association construction in a timely manner, to understand the work of the new situation, new problems, targeted to put forward proposals for improvement, to enhance the work of the initiative, foresight and creativity.
(C) actively publicize and guide. To effectively strengthen the public opinion propaganda, to strive for all walks of life on the construction of the medical association understanding and support, the formation of a social atmosphere to promote the reform. Guiding patients to gradually change the habit of medical treatment, the formation of the basis of the first diagnosis, level by level referral, two-way referral medical behavior, laying the foundation for the formation of hierarchical diagnosis and treatment pattern.
2017 County Medical Union Implementation Program 2In order to comprehensively implement the municipal party committee and municipal government to deepen the spirit of the reform of the medical and health system, give full play to the overall effectiveness of the county medical and health resources, accelerate the promotion of the county, townships and villages close medical consortium, so that the masses can enjoy high-quality medical and health services close to the city, according to the Office of the Municipal Party Committee of China*** Xining Municipal Party Committee Office, Municipal Government General Office of China, "on the issuance of the formation of the Xining City Guiding Opinions on Close Integrated Medical Consortium" (Ningbanfa [2017] No. 13), the development of this program.
First, the overall requirements
Adhere to ? Basic protection, strengthening the grassroots, building mechanisms? principle, adhere to the direction of the people's health services, integration and optimization of health care resources within the county, the formation of county hospitals as the core, by the township health centers (including community health service centers, hereinafter referred to as the same) and the village health room composed of close integration of health care consortium (hereinafter referred to as health care consortium), health care consortium within the play of the county core hospitals of the county? The medical association plays the role of the county-level core hospital. The role of the county-level core hospital, the implementation of management, operation, personnel distribution rights, to promote the center of gravity of health care work and quality medical resources sinking, improve the comprehensive service capacity of medical and health institutions, service efficiency, technical level, management level, and strive to make more than 90% of the patients in the county within the clinic.
Second, the formation of the way
Based on the principle of administrative division and the convenience of the masses to the principle of access to health care to the county first, second people's hospital and county hospital of traditional Chinese medicine as the core hospital, the formation of three close integration of medical care consortium, the specific formation of the way is as follows:
(a) Huangshuzhong County, the first medical care consortium. By the county's first people's hospital as the core hospital, on the new Zhuang, Tianjiazhai, West Fort, Tumen Pass, Ganheitan, Qunjia, Danyuan 7 townships (centers) health centers and belonging to the 152 village health room composition.
(ii) Huangshuzhong County second medical consortium. By the county's second people's hospital as the core, stop Lungkou, **** and, Lijiashan, on the five Zhuang, Haizigou, Handong, Dacai 7 townships (centers) health centers and the Doba Community Health Service Center and its 224 village health room composition.
(C) Huangshuzhong County third medical consortium. By the county hospital of traditional Chinese medicine as the core, the county Tibetan medicine hospital, Rushal community health service center and belongs to the 20 village health room composition. Huangzhong County first people's hospital, Huangzhong County second people's hospital, Huangzhong County hospital of traditional Chinese medicine were added? Huangzhong County first medical consortium core hospital, Huangzhong County second medical consortium core hospital, Huangzhong County third medical consortium core hospital? The sign, the township health centers, community health service centers to hang the medical consortium core hospital branch of the sign, the administrative village health center to hang the medical consortium of the village health center of the sign of the branch.
Third, the management of the medical consortium
Medical consortium in the body of the medical institutions to adhere to the legal personality, financial compensation policies and channels, the total number of authorized personnel, functional positioning and public **** health responsibilities? Five unchanged? Under the principle of the establishment of the county public hospital management committee under the leadership of the medical association council, supervisory board system, build decision-making, implementation, supervision of mutual division of labor, mutual checks and balances of power operation mechanism.
(a) management mode. Administrative management, the establishment of Huanghuanzhong County Public Hospital Management Committee (hereinafter referred to as ? Medical Management Committee?) (Annex 1), medical management committee director by the county government in charge of the county governor, deputy director by the health and family planning bureau director, members of the development and reform, finance, human resources, civil affairs, supervision, audit, editorial office departments. The MMC is mainly responsible for the development planning, implementation of major projects, financial input, operation supervision, performance evaluation and other duties of the medical association. Business management, innovation of modern hospital management system, the establishment of medical consortium council, the council consists of the core hospital director, vice president, chief accountant, the township health hospitals, the main person in charge of the medical consortium, the chairman of the board of directors, vice chairman of the core hospital director, vice president also served as the core hospital director, vice president. The president and vice president of the core hospital of the medical association are managed in accordance with the principle of party-controlled cadres, and are studied and decided by the county party committee. The chief accountant is appointed by the party committee of the county health and family planning bureau. The heads of township health hospitals and community health service centers are appointed by the directors of the core hospitals of the medical consortium and reported to the county health and family planning department for the record. In terms of supervision and management, the Supervisory Council of the medical consortium (hereinafter referred to as ? Supervisory Council?) , the chairman of the supervisory board in accordance with the principle of party management cadres management, by the county party committee to study the decision, the supervisory board members of the core hospitals of the discipline inspection members, trade union chairman and affiliated member units of the staff representatives of the 5-7 people, to fulfill the supervision of the work of the Council of the medical alliance power. The medical consortium implements the core hospital director's responsibility system under the unified leadership of the council, and implements the term target responsibility system and accountability. The Council should rationalize the relationship between the responsibilities, rights and benefits of various medical and health institutions, exercise unified management of personnel deployment and assessment, finance, equipment, drugs and business, and implement the system of collective discussion of financial budgets, salary allocation, appointment and dismissal of cadres, decision-making on major issues, implementation of major projects, and use of large funds; unify the rules and regulations, service standards, and technical norms of medical institutions within the medical consortium to promote the scientific, standardization and modernization of the management of medical institutions. The Council shall build an internal organizational and management structure, and set up functional departments for administrative management, business management, financial management, etc. The functional departments shall be located in the core hospitals, and their specific duties shall be determined by the Council. The township health centers are responsible for the management of their own units and village health centers in the region according to the current management model.
(C) division of responsibilities. 1, health planning administration. On behalf of the government to fulfill the responsibilities of the funder, is responsible for the setup of the county health care system planning, technical access, quality supervision and performance assessment, and the development of the health care system planning, financial input, major projects to implement the work of guidance and services; actively coordinate with the relevant departments to provide a variety of policy support for the health care system, and timely resolution of health care system difficulties and problems.
2, the core hospital. Mainly responsible for the day-to-day operation of the medical association, supervision and inspection work, build the medical association within the division of labor mechanism; responsible for the development of two-way referral, key specialties, counterpart support, personnel teaching and training, green channel and remote consultation and other work rules; undertake the county general difficult complex critical diseases diagnosis and treatment, referral and other work.
Among them, the county hospital of traditional Chinese medicine in the fulfillment of the core hospital duties on the basis of the establishment of technical cooperation mode with the provincial hospital of traditional Chinese medicine and Tibetan medicine, to the county primary health care institutions to promote the appropriate technology of traditional Chinese and Tibetan medicine, and guidance to carry out the work of traditional Chinese and Tibetan medicine services.
3, township health centers and community health service centers. Undertake the diagnosis and treatment of common and frequent diseases and referral, basic public **** health, health supervision and co-management, family planning technical services and other work under their jurisdiction; be responsible for the training of rural doctors under their jurisdiction, the guidance, inspection, assessment and other business management work of the village health office; and complete the corresponding work issued by the council of the medical association.
4, village health center. Undertake the village's basic medical, basic public **** health services and other work, according to the content of the family doctor contracted services, fulfill the duties of the family doctor, guide the patient referral; complete the medical association council and the township health center rules issued by the other work tasks.
Fourth, the work of the task
(a) the reform of financial subsidies accounting method, the establishment of a unified financial management operation mechanism. The medical association set up a financial management center, strictly according to the "Huangzhong County close medical consortium financial management methods (for trial implementation)" (Annex 2), to strengthen the costing and control of the cost of each member unit. Financial management center unified management, issued all kinds of special and subsidized funds, the implementation of hierarchical accounting, according to the corresponding financial management system and accounting system to set up detailed accounts, accounting for all assets, liabilities, income, expenditure and revenue. Improve the system of medical service charges, establish a system of publicizing medical charges, an inquiry system, and a cost list system, and improve the transparency of charges. It has established a sound internal financial and asset management system, unified deployment and use of funds and assets, and ensured personnel salaries and normal operating expenses for each member unit. Establishment of a sound internal audit system, improve internal supervision and control mechanisms, standardize the management of income and expenditure, and rationalize the debt.
(ii) Reform of the personnel allocation system, the establishment of a unified personnel management system. Medical association council in the total number of approved positions, duties and responsibilities within the scope of the exercise of unified management of talent and rational allocation of autonomy. Strictly implement the Huanghuangzhong County close medical consortium personnel management methods (for trial implementation) "(Annex 3), to maintain the relative stability of the primary health care personnel team, the establishment of a dynamic adjustment mechanism, innovative personnel management methods, and the gradual implementation of the preparation of the filing system. In terms of job setting, income distribution, title evaluation, management and utilization, in accordance with the ? Old man old ways, new man new ways? , in accordance with the relevant provisions of the State. A full employment system, a job management system and a job performance pay system have been implemented, forming a flexible employment mechanism that allows for entry and exit, as well as upward and downward mobility. The medical association will train a group of medical and nursing personnel who can diagnose and treat common and frequent diseases for primary medical institutions through various ways. To establish the treatment of medical personnel working at the grassroots level is higher than the original treatment policy, and gradually realize the standardization of various types of talent, institutionalized management.
(C) Reform of health insurance payment methods to ensure standardized management of funds. County Social Security Bureau in the designated medical and health institutions, designated retail pharmacies on the basis of the existing management and settlement methods, the three medical associations as employee health insurance, urban and rural residents of the main health insurance designated medical institutions, the total amount of health insurance payment according to the previous year's urban and rural residents of the increase in per capita disposable income of a moderate upward trend, and a unified package to pay for the establishment of the negotiation and reasonable adjustment mechanism. In accordance with the "Xining City Basic Medical Insurance Single Disease Payment Implementation Opinions" and the "Xining City Urban and Rural Residents Basic Medical Insurance Outpatient Coordination Implementation Plan (for Trial Implementation)", the total amount of control under the implementation of the second-level hospitals by disease (group) and per bed day payment method, primary health care institutions according to the volume of services, per head and other composite payment. The gap between the starting payment line and the payment ratio of county and township healthcare organizations within the healthcare consortium has been appropriately widened. The healthcare consortium and each healthcare organization will determine the way and method of distributing the health insurance fund according to their functional position, service population and service volume. The medical association will actively support the urban and rural residents to carry out disease prevention and health management work, give full play to the overall orientation and cost control of medical insurance, and improve the efficiency of the use of medical insurance funds.
(d) Establish and improve the centralized procurement system for medicines and consumables to ensure the quality of medicines. The medical institutions to establish drugs and medical supplies sunshine procurement mechanism, the implementation of the provincial drug centralized purchasing platform for procurement, distribution, the village health clinic drugs and medical supplies by the township health hospitals are responsible for the unified online procurement. On the basis of the county-based quantity-bargaining procurement, it is actively exploring the centralized bidding, joint procurement and unified distribution mechanism for medicines and consumables in the form of a medical consortium. The medical association council is responsible for supervising the procurement of drugs and medical consumables of each member unit, allowing drugs to circulate among each other within the medical association, further improving the new mechanism of centralized procurement of drugs, and guaranteeing the supply and distribution of drugs and quality and safety.
(5) Establish a unified business and equipment management system to improve the quality of grassroots services. The medical association council is responsible for the business management of each member unit, strengthening the quality control of healthcare for primary healthcare organizations, and carrying out regular training and guidance, supervision and evaluation, and performance appraisal. It provides medical, public **** health and family planning services to the public in accordance with functional positioning and technical requirements. Strengthen the unified management and deployment of equipment, establish and improve the management system for medical equipment, and improve the utilization and intactness rates of equipment. Strengthen the integration of village health office management, focusing on regulating the basic public **** health, medical services and drug procurement and use behavior, improve the village performance evaluation and compensation mechanism, and gradually enhance the service capacity of the village health office.
(F) Strengthen performance evaluation and establish a reasonable distribution mechanism. Strengthen the supervision and assessment of the medical consortium, based on the "Huangzhong County close medical consortium performance appraisal management approach (for trial implementation)" (see Annex 3), the county health planning, human resources, finance and other relevant departments to develop performance appraisal indicators and scores, 1 performance appraisal per year, the results of the assessment in a timely manner and public, and with the performance of the total amount of payroll, dean's salary, appointment, dismissal, rewards and punishments are linked to establish incentives and constraints mechanism. The medical association develops and improves the internal performance appraisal methods of each member unit and institution, strengthens the supervision and performance appraisal system, establishes a salary distribution system in line with the characteristics of the medical industry, focuses on reflecting the value of medical personnel's technical labor, and fully mobilizes the enthusiasm of medical personnel.
(VII) Strengthen the construction of information technology to realize the resources **** enjoy. Accelerating the construction of the rural three-tier health service network information technology, open up the vertical and horizontal link channels of the county, township and village levels, and build a medical management, financial management, personnel management, public **** health service management, drug management and performance management of the content of the ? Intelligent Health? system, and implement the? Internet+basic public ****health services+chronic disease management. model. A unified health database for urban and rural residents has been established, realizing the enjoyment of medical and health information*** within the county. Taking the remote medical consultation system as a means, establish clinical examination, imaging, remote consultation, pathology testing and sterilization supply in core hospitals? Five ****sharing centers? , realizing the transmission and *** enjoyment of information and data, providing relevant technical support and services to primary medical institutions, and enabling patients to receive diagnosis from experts of higher-level hospitals at the grassroots level. The implementation of the same level of medical institutions, test and examination results mutual recognition system and the lower member units of the higher hospitals of the test and examination results of the recognition system, to reduce the duplication of inspection and testing, reduce the burden of patients to medical care.
(H) the establishment of a comprehensive system of hierarchical diagnosis and treatment, in terms of mass access to health care. The medical institutions within the medical association further improve the system of graded diagnosis and treatment and two-way referral according to the policy provisions and their respective functional positioning and diagnosis and treatment scope. Primary medical institutions give priority to the core hospitals within the medical association referral, the core hospitals to establish a two-way referral of patients? The core hospitals should establish a green channel for two-way referral of patients. , which should give priority to the upward referral of patients in arranging for their reception, examination and hospitalization, and refer patients with clear diagnosis and stable conditions down to primary medical institutions, and instruct primary doctors in follow-up treatment and rehabilitation work. The medical association has formulated reasonable, convenient and smooth graded diagnosis and treatment, two-way referral specific implementation rules.
(ix) Implement measures to facilitate and benefit the public, and highlight the public welfare of medical institutions. Consolidate and innovate family contracting service, family responsibility doctor, family people's medicine box? Three? service model, the implementation of common, frequent, chronic diseases, family doctors responsible for the full management of services, the need to go to higher hospitals for treatment of patients, grass-roots general practitioners take the initiative to get in touch with the core hospitals of the medical consortium, and timely referral to the treatment. Seriously implement the "five free and ten reduced" program for patients with special needs. Five exemptions and ten reductions for special-needs patients. The company's first step was to create a new, more efficient, and more effective way to improve the quality of life of the people who live there.
V. Work requirements
(a) Strengthen organizational leadership. Formation of close medical work is a very complex systematic project, involving a series of institutions, mechanisms for the establishment and improvement of the need for multi-sectoral and social **** with the participation. The medical management committee should effectively strengthen the organizational leadership, coordinate and promote the construction of the medical association, coordinate and solve the difficulties and problems arising in the operation.
(ii) strengthen communication and coordination work. County financial, social, editorial office, health planning and other departments in accordance with their respective responsibilities to actively cooperate with the formation of a close-knit health care system to give the appropriate policy support, the formation of synergies to promote the formation of the work of the smooth progress. The council and members of the medical association should actively communicate with each other, each in their own way, each responsible for their own responsibilities, **** with the promotion of the management of the medical association to achieve practical results.
(C) increase supervision. The county public hospital management committee to strengthen the formation of medical association work guidance, coordination and supervision, timely reflection and solve the difficulties and problems in the formation of work, seriously summarize the work experience, and constantly improve the policy measures, urge the medical association according to the node of time to promote steadily and orderly.
(d) Strengthen public opinion propaganda. County Health and Family Planning Bureau, Broadcasting Bureau, the medical and health institutions to organize and carry out a good set of medical association work purpose, significance and policy measures of the publicity work, fully mobilize the majority of medical personnel to participate in the formation of medical association work enthusiasm and initiative, for the smooth formation of medical associations and effective operation of the public opinion to create a good atmosphere.