--------------------------------------------------------------------------------Investigation report on the county's rural health care situation --October 18, 2004 County People's Congress Standing Committee of the 22nd meeting of the County People's Congress Standing Committee of the County People's Congress investigation group in order to improve the level of rural health care services in the county, to meet the farmers to solve the basic health care and medical needs, recently, the County People's Congress Standing Committee to set up an investigation group, the county's rural health care situation of the investigation. Investigation group in the county government after listening to the county's rural health care work report, focusing on time were in-depth to the North Dahu Town, Xiyang Township, Chundeng Township and other health centers and community health service stations, by taking the form of holding symposiums, on-site visits to the farmers, focusing on the county's farmers to enjoy the level of primary health care, the situation of the farmers' basic health care needs and the construction of the rural health care system and so on. Research, now the research situation to the county people's congress director meeting to report: First, the basic situation of rural health care in the county I county **** there are 15 townships (districts), 139 administrative villages, with a total population of 404,400 people, of which 311,400 agricultural population, the per capita net income of farmers 2503 yuan, the per capita consumption expenditure on health is about 165 yuan. At present, there are 22 government-established non-profit medical and health institutions in our county, including 11 county-level medical and health institutions and 11 township health centers. *** There are 58 social medical institutions and 244 urban and rural community health service stations. There are 1,830 health technicians on duty in the county, and the ratio of health technicians to the population served is 1:220, higher than the national average. The construction area of the county's medical and health institutions is 30,869 square meters, the actual opening of 708 beds, beds and services to the population ratio of 1:571. Over the past few years, the county is committed to improving the quality of health of the majority of rural residents and to make it one of the goals of the comprehensive construction of a well-off society, the establishment of a rural health service system and preventive health care services system to adapt to the requirements of the development of new situations in the health sector, and the formation of a strong county health service system. Service system, the formation of a strong county, townships, villages, three-level medical and health care network, to protect the people's health, promote the county's economic development and social progress has played a positive role. 1, improve the medical and health infrastructure. First, strengthen the medical and health institutions housing construction. Over the past few years, the county health administration department invested more than 15 million yuan, the county CDC, county maternal and child health center, county hospital, county hospital, county hospital branch, Beidahu Township, Wanchang Township, Shuanghe Township and other central health centers, Dagangzi Township, Guanting Township, Yilaxi Township, Sanjiajia Township and other general health centers of the business premises for the renovation or new construction, with a total construction area of 20,000 square meters. Secondly, additional and updated medical equipment has been installed. Over the past few years, the county and township levels of medical and health institutions*** purchased 170 units of large-scale medical equipment, with a total investment of more than 12.5 million yuan. Among them, the county hospital invested 9 million yuan in four years, the acquisition of spiral ct machine, automatic biochemical analyzer, color ultrasound, automatic blood cell counter, microwave therapy instrument and other large-scale medical equipment 34 pieces. Township health centers are all equipped with more than 100ma x-ray machine, b ultrasound, cardiology and biochemistry testing equipment, to provide a scientific clinical testing and diagnostic basis. 2, the establishment of a well-functioning rural health service system. In order to meet the needs of rural medical and health care, and further improve the rural health service system, in 2001, the county government issued the "Yongji County Rural Community Health Service Work Implementation Program". Under the guidance of the program, in accordance with the "two network level one office" model, the county reform township, village two health institutions management system, the township health centers set up community health service centers, responsible for the management of the jurisdiction of the day-to-day management of the rural community health service station, and will be the original village health institutions reformed for the community health service station. After four years of construction, at present, the county's rural community health service stations have reached 244 (including township community medical and health service stations 8), the coverage rate of 100%, the construction of the qualified rate of 80%. Over the years, the county's rural community medical and health service stations have combined paid and voluntary services, and have integrated medical care, prevention, health care, rehabilitation, hygiene promotion, health education, and planned immunization in the community, on a household basis, to provide farmers with proactive, convenient, fast, high-quality, and low-priced comprehensive services.3. Prevention and treatment of infectious and chronic diseases have been strengthened. In order to strengthen the management of planned immunization, in 2003, the county will be hepatitis B vaccination into the children's planned immunization procedures, the county financial annual investment of 40,000 yuan of special funds, free of charge for the newborn vaccination of hepatitis B. At the same time, the county health department in-depth 6 township survey points on the status of human parasitic diseases such as schistosomiasis, liver fluke, trichinella investigation, *** investigation of 4,500 people, to do a good job in the prevention and treatment of other epidemics provides the basis. In order to effectively prevent and control tuberculosis, the county tuberculosis control center implemented the World Bank loan/UK grant tuberculosis control project in July 2003, and carried out DOTS treatment for tuberculosis patients found in our county, and strengthened the training of anti-TB doctors and BCG vaccinators in tuberculosis prevention and control knowledge, and carried out tuberculin monitoring for 30,000 primary and secondary school students in the county. At present, the incidence rate of infectious diseases in the county is 254.23 per 100,000 people, which is at the middle level of the region, and the inoculation rate of the "four vaccines" has been maintained at over 98%. In order to prevent and control AIDS, in the first half of this year, the whole region held an AIDS comprehensive prevention and treatment demonstration area work conference in our county, introducing the construction of our county's AIDS comprehensive prevention and treatment demonstration community and the experience of AIDS prevention and treatment. At the beginning of the year, our county completed the construction of the primary screening laboratory for AIDS in the county CDC. In May, our county held a teacher training course on AIDS prevention knowledge, and trained more than 60 people, including the director of the township health center, the chief of the medical section, the chief of the prevention and protection section, and the person in charge of some community health service stations. Meanwhile, the results of the county's endemic disease prevention and control work have been consolidated. To control iodine deficiency disease as the focus of the first half of this year, the county completed 60 copies of maternal urine samples and maternal family salt sampling, 27 food wholesale department of the county, 64 households with salt and pouring salt sampling and monitoring, its test samples of 288, the pass rate of 100%. At present, the county's prevention and control of macrosomia, Crohn's disease, brucellosis, iodine deficiency disease reached the national control standards
Through the microcomputer programmed management, a detailed grasp of the total number of women of childbearing age within the jurisdiction of the county, affecting women's health status of the disease and the cis position. Mastered the number of newly married pairs, the number of pregnant women, the number of high-risk pregnancies, the number of maternal deaths, etc., for the better implementation of maternal and child health care management provides a reliable basis. In carrying out the work of maternal system management, the focus has been on screening high-risk pregnancies, and management measures have been improved, so that the rate of maternal system management has reached 90 per cent, and the coverage of maternal health care has reached 95 per cent. The rate of hospitalized deliveries has reached 75 per cent, meeting the targets set in the initial insurance plan. In order to further improve the service function of women's insurance work, since 2003, our county has strengthened the construction of obstetrics and gynecology departments in medical institutions at county and township levels by selecting and sending obstetrics and gynecology technicians for further training and installing additional necessary equipment, and further improved the service level of obstetrics and gynecology departments in health centers, so that general health centers are able to undertake physiological obstetrics and general gynecological surgeries, and medical units above the level of the central health centers have the level of pathologic obstetrics and difficult The level of gynecological surgery has been improved. At present, medical units above the county's central health centers have carried out the construction of baby-friendly hospitals, and all the work indexes have reached the standards required by the primary insurance, and will pass the municipal acceptance by the end of 2004. The coverage rate of children's health care in the county has reached 100%. The incidence rate of neonatal tetanus is zero. The incidence of neonatal asphyxia and neonatal intracranial hemorrhage has been significantly reduced. The mortality rate of newborns and children under 5 years of age has been reduced by 20% compared with the previous five years, and the popularization rate of scientific feeding and health care knowledge among infants and young children has reached over 65%, reducing the occurrence of malnutrition diseases among children.5. Law enforcement in the health industry has been intensified. In order to adapt to the needs of the new situation of health industry-wide management, the county has established a new system of health supervision and disease prevention and control, withdrawn the former Yongji County Public **** Health Supervision and Yongji County Health Epidemiological Prevention Station, and reorganized the Yongji County Health Bureau Health Supervision and Yongji County Disease Prevention and Control Center. In terms of health supervision, the year insisted on the social health counterfeiting activities, and to do with the daily health supervision work. Food hygiene, school health industry regularly carry out special rectification, standardize the food hygiene "three certificates" issued and management work, improve the "three certificates" of the issuance procedures and management methods, the development of a system of accountability, the illegal operators are dealt with seriously in accordance with the law, standardize the market economic order, and protect the general public. The market economic order has been standardized, and the health of the general public has been protected. In the medical industry law enforcement, the Health Bureau of the Medical Affairs Section of all levels and types of medical institutions, beauty salons, pharmacies, morning market law enforcement inspections, over the past two years to crack down on the illegal practice of medicine in 36 cases, banned 28 illegal medical institutions, clean up the illegal medical beauty 2, pharmacies, 6 seat medical, confiscation of 10 units of medicines and equipment, penalties of 38,000 yuan, standardize the medical market to ensure that the people's health and safety of life. 6, strengthened the government's construction of rural health and management functions. Adhere to often carry out patriotic health campaigns, improve environmental health, and constantly improve the living environment of the residents. Through the establishment of a permanent organization, on behalf of the county government is responsible for the management and supervision of environmental sanitation. Every year, the county puts the environmental sanitation work as one of the county's spiritual civilization construction target responsibility together with the assessment. Starting from last year, the management has been intensified, and the county government has formulated a patriotic hygiene target responsibility assessment program, and signed target responsibility books with township governments and relevant departments, and implemented reward and punishment measures. By carrying out civilized village and township activities, one existing township has reached the standard of municipal sanitary township. Through the rural water and toilet construction, by the first half of this year, there have been 6 townships to carry out some of the villages and townships to change the water, running water benefited population 162,700 people, the cumulative total of water benefited 265,500 people, 8 townships to carry out toilet, 35,000 households built sanitary latrines, the prevalence rate of 34%. Second, the county's rural health care problems that need to be solved although the county's health care with the county's economic and social development has made some achievements, in accordance with the requirements of primary health care, basically able to meet the needs of the masses of farmers, but there are still such and such a problem, focusing on the following aspects: 1, medical equipment, facilities are old and aging. In this survey, we see that some rural township health
Health hospitals and community health service stations in dilapidated housing, poor facilities, medical equipment, broken not supplemented and improved, it is difficult to achieve the goal of normal health care. Chundeng Township Health Center and Beidahu Township Sanjiajia Village Community Health Service Station housing is simple, dilapidated, still using the 1960s and 1970s old bungalows, urgently need to be rebuilt. Survey we also saw some township health centers and community health service station health care infrastructure is weak, a considerable part of the rural community health service station only "old three things", a stethoscope, a blood pressure device, a thermometer. The pace of health care reform is slow, the development of health care is lagging behind, and the people's demand for health care does not match. 2, the lack of health care personnel. Because of the backwardness of the material conditions in rural areas, therefore, most of the county's medical professionals and technicians are concentrated in the towns, resulting in a relatively low proportion of rural medical personnel, the problem of difficult to see a doctor is more prominent. The community health service station in Sodenggou Village, Xiyang Township, has only one township doctor, but serves the preventive health care of nearly 1,000 people in the village. In Beidahu Township Health Center and the county CDC survey learned that the lack of talent leads to the shortage of health care workers, "can not get out, can not get in" phenomenon is a serious constraint on the development of the cause. Training of existing health care personnel in place to improve the measures are not in place, the lack of health care personnel has not been improved. 3, village-level health care institutions and the burden of village doctors. In Beidahu Township, three children's village and Xiyang Township, Hongshi Village Community Health Service Station to understand that, at present, the county village-level medical institutions have a heavy burden. The three sub-village health service station a cumulative total of more than 7,000 yuan a year to the higher-ups, where the price department of the annual inspection, every month to the town health center to pay the career development fund, every year to the Drug Administration, health and other departments as well as Quality and Technical Supervision Bureau to pay a variety of fees, not counting the relevant departments from time to time each year to organize various types of training courses issued by various types of qualification fees charged. Village health institutions do not have the village collective economic input, housing, drugs, facilities are village doctors personal investment, but also to pay staff salaries, while the government at all levels of the village doctors engaged in public **** health and preventive health care work without any subsidies, to a certain extent, affecting the village doctors to carry out preventive health care work motivation. 4, the phenomenon of illegal practice of medicine occurs from time to time. From the survey, we learned that, at present, the illegal practice of medicine in some parts of the countryside is repeated, a serious threat to the safety of life and health of farmers, these people under the brand of a medical institution or medical college, under the guise of a charity clinic, the purpose is to promote drugs, cheating money. Illegal medical organizations have also established closer ties with local village committees. According to a township doctor in Chundeng Township, in April this year, the County Tuberculosis Prevention and Control Office went to a village in the township to volunteer to check the bodies of farmers, while the village committee of the village only summoned 50 or 60 people. On the contrary, an illegal medical institutions to the village "clinic", stationed directly to the home of a village cadres, and the village cadres but spared no effort to facilitate its. 5, farmers due to poverty and poverty is serious. After investigation, in rural areas, a part of the farmers are "anti-disease", there is no treatment; a part of the farmers are no money to see a doctor, looking at the disease; there is also a part of the debt to see a doctor, but because of the delay in the best time to treat the disease has not been good, the people and the money is empty. Chundeng Township held in the township doctor symposium learned that farmers to the village community health service station to see a considerable part of the credit, to the end of the year after the total account, and every year the township doctor to the end of the year, there are always thousands of accounts can not be honored. A farmer said to the investigation team, was flooded, or the house was burned, suffering for a few years may still be able to turn around, but really want to get a serious illness, the final result is often the family's assets. Third, the development of rural health care in our county recommendations of the party's 16th National Congress report pointed out that in our country to establish health services and health care system, efforts to improve rural health care, improve the level of urban and rural residents of health care. Combined with the survey, on the county's rural health care work, now puts forward the following suggestions. 1, effectively put the rural health care on a more important position. Rural health care is related to the lives and health of the masses of farmers, no farmers' health, there is no rural well-being. In the face of the new situation, to accelerate the development of rural health care into the county's national economic and social development priorities, on the important work of the government at all levels and departments of the agenda, according to the new situation of the formulation of long-term, medium- and short-term development planning, improve the policy measures. Townships to implement the relevant departments and part-time cadres responsible for this work, we must effectively incorporate health education, patriotic health work into the government's work agenda, we must adhere to the unremitting efforts to change the township government on the "big health" work "no one to do the job, no one to manage things," the situation. The situation. In the county primary and secondary school students to continue to carry out good health education classes in the farmers to do a good job in the publicity of health care knowledge, and further promote the improvement of the awareness of self-care of the whole population. 2, to promote the township (township) health centers to promote the reform of the operating mechanism. Efforts to explore the township (township) health centers in a variety of operating methods, not to engage in one-size-fits-all, not to force a business model. To seriously summarize the reform experience of Dagangzi Township Health Center, to further deepen the reform of the operating mechanism and personnel system, and actively implement the personnel employment system, focusing on the introduction of talent, the introduction of funds, as a way to improve the medical conditions and raise the level of medical care, to better meet the medical needs of the rural population, and strive to achieve significant results in three years. 3, the establishment of a mechanism for the inflow of talent, and to grasp the training of practitioners. To speed up the pace of reform of the personnel system within the health system, activate the employment mechanism, the development of a liberal talent policy, and actively create an environment conducive to the inflow of talent, and solicit technical personnel. To continue to strengthen the training of rural health personnel, the annual training of rural doctors, accelerating the pace of rural doctors to update their knowledge. Further improve the medical group operation mechanism, medical technology sinking level, the implementation of technical cooperation and guidance to help local improve the level of medical care, and further improve the overall quality of the county's rural health team. 4, to strengthen the construction of the soft environment of medical and health care. Supervision, price and other departments should strengthen the relevant departments for the village-level community health service stations set up by the inspection of the charges, resolutely cancel the unreasonable charges, the unreasonable part of the reasonable charges should also be resolutely canceled, and re-establish the standard for the village-level medical and health institutions to reduce the burden. At the same time, to further increase the illegal practice of medicine to punish the phenomenon, thoroughly purify the rural health care market, so that the phenomenon of illegal practice of medicine in rural areas have no soil for survival. 5, and actively create the conditions for the establishment of farmers as soon as possible medical insurance system. In the rural areas of the full implementation of the new cooperative medical system is the general trend, to seize the province in 2008 the full implementation of the new cooperative medical system this opportunity to seize the county to implement this system to make all the preparations. In the temporary absence of the system, all levels of government and relevant departments to carry out poverty alleviation work and solve the medical needs of the rural masses in need of integration, the masses of poverty due to disease as the focus of poverty alleviation, to take a variety of measures to effectively solve the problem of poor people difficult to get medical care.