20 12 notice of major work arrangements
Guo ban fa [2012] No.20
People's governments of all provinces, autonomous regions and municipalities directly under the Central Government and relevant departments of the State Council:
The main work arrangement for deepening the reform of medical and health system for 20 12 years has been approved by the State Council and is hereby printed and distributed to you. Please carefully organize the implementation according to the actual situation.
the General Office of the State Council
April 20 12 14
Deepening the reform of medical and health system: 20 12 main work arrangements
20 12 is a crucial year to deepen the reform of medical and health system (hereinafter referred to as medical reform), and it is also the first year to fully implement the planning and implementation plan for deepening the reform of medical and health system during the Twelfth Five-Year Plan period. In order to clarify the task objectives, implement the work responsibilities, consolidate and expand the achievements of medical reform, and continue to further promote medical reform, we now put forward the following opinions on the main work arrangements of medical reform in 20 12:
I. General requirements
Thoroughly implement the spirit of the Opinions of the Central Committee of the State Council on Deepening the Reform of Medical and Health System (Zhong Fa [2009] No.6) and the Notice of the State Council on Printing and Distributing the Planning and Implementation Plan for Deepening the Reform of Medical and Health System during the Twelfth Five-Year Plan (Guo Fa [2012]1KLOC-0/No.0) to make the construction conform to China. Adhere to the basic medical and health system as the core concept of providing public goods to the whole people, adhere to the basic principles of ensuring basics, strengthening grassroots units and building mechanisms, adhere to the policy of giving priority to prevention, focusing on rural areas and paying equal attention to Chinese and Western medicine, maintain the continuity and stability of the basic medical reform policies, make efforts to speed up the improvement of the universal medical insurance system, consolidate and improve the basic drug system and the new mechanism for the operation of primary medical and health institutions, actively promote the reform of public hospitals, and make overall plans to promote reforms in related fields to maintain a good medical reform situation.
Second, the task
(1) Accelerate the improvement of the universal medical insurance system.
1. Consolidate and expand the coverage of basic medical insurance.
The participation rate of basic medical insurance for employees (hereinafter referred to as employee medical insurance), basic medical insurance for urban residents (hereinafter referred to as urban medical insurance) and new rural cooperative medical system (hereinafter referred to as new rural cooperative medical system) is stable at 95%. Focus on the management of migrant workers, employees of non-public economic organizations, flexible employees, students, preschool children and newborns. Continue to promote the closure of retirees from bankrupt enterprises and employees of difficult enterprises to participate in insurance. (Ministry of Human Resources and Social Security and the Ministry of Health are responsible respectively)
2. Continue to improve the level of basic medical security.
(1) The government's medical insurance subsidy standard for the new rural cooperative medical system and urban residents has been raised to 240 yuan per person per year, and the level of individual contributions has also increased accordingly, and the per capita financing has reached about 300 yuan. (Ministry of Finance, Ministry of Health and Ministry of Human Resources and Social Security are responsible)
(2) The maximum payment limit of the overall fund within the scope of employee medical insurance, urban residents' medical insurance and the new rural cooperative medical system shall be raised to more than 6 times of the annual average wage of local employees, more than 6 times of the annual per capita disposable income of local residents and more than 8 times of the annual per capita net income of farmers nationwide, all of which shall not be less than 60,000 yuan. Within the scope of urban residents' medical insurance and the new rural cooperative medical system, the payment ratio of hospitalization expenses reached 70% and 75% respectively, gradually narrowing the gap with the actual payment ratio of hospitalization expenses, and further improving the proportion of outpatient co-ordination payment. Explore the gradual establishment of employee medical insurance outpatient co-ordination through personal account adjustment. (Ministry of Human Resources and Social Security and the Ministry of Health are responsible respectively)
3. Reform the medical insurance payment system.
(1) Actively promote the reform of payment methods such as paying by head, paying by disease type, paying by bed day, and prepaying the total amount, and gradually cover the designated medical institutions of medical insurance in the overall planning area. Strengthen the control of total payment, establish the restraint mechanism of medical insurance for the growth of medical expenses in the overall planning area, formulate the overall control target of medical insurance fund expenditure and decompose it into designated medical institutions, and link it with payment standards. Actively promote the establishment of a negotiation mechanism between medical insurance agencies and medical institutions and a payment mechanism for purchasing services, and determine the scope of services, payment methods, payment standards and service quality requirements through negotiations. Combined with the reform of payment methods, explore ways to control personal burden. Gradually control the total cost of medical institutions and the growth of medical expenses and personal burden, as well as the quality of medical services into the medical insurance evaluation system. (Ministry of Human Resources and Social Security and the Ministry of Health are responsible respectively)
(2) Improve the differentiated payment mechanism, further tilt the payment ratio to the primary medical and health institutions, encourage the use of Chinese medicine services, and guide the masses to tilt to the primary level. Non-public medical institutions and retail pharmacies such as qualified private clinics will be included in the designated scope of medical insurance. (Ministry of Human Resources and Social Security and the Ministry of Health are responsible respectively)
(3) Strengthen the supervision of medical insurance on medical service behavior, improve the monitoring and management mechanism, gradually establish a real-time monitoring system of medical insurance on medical services, and gradually extend the supervision of medical insurance on medical services in medical institutions to the supervision of medical service behavior of medical personnel. Establish a joint anti-fraud mechanism, increase penalties for fraudulent insurance fraud, and disclose relevant information in a timely manner. (Ministry of Human Resources and Social Security and the Ministry of Health are responsible respectively)
4. Further intensify medical assistance.
(1) Increase the input of relief funds and build a solid medical security bottom line. The scope of assistance has been extended from family members of low-income and five-guarantee households to poor groups such as seriously ill patients with low income, severely disabled people and elderly people from low-income families, and they are funded to participate in urban residents' medical insurance or the new rural cooperative medical system. Improve the level of assistance, cancel the deductible line of medical assistance, steadily increase the capping line, and further increase the self-funded proportion of hospitalization medical expenses within the scope of the aid target policy. (Ministry of Civil Affairs and Ministry of Finance are responsible)
(2) To study the establishment of emergency relief fund for diseases. Establish a fund through multi-channel financing such as government investment and social donation to solve the emergency medical treatment expenses of patients who cannot afford the expenses and have no owners. Pay close attention to the formulation of fund management measures. (Responsible for Development and Reform Commission and Ministry of Finance)
5. Explore the establishment of a serious illness protection mechanism.
(1) Study and formulate measures for the protection of critical illness, actively explore ways to use the basic medical insurance fund to purchase commercial critical illness insurance or establish supplementary insurance, effectively improve the level of critical illness protection, and effectively solve the problem of poverty caused by patients with critical illness. Do a good job in connecting basic medical insurance, medical assistance and commercial insurance. (Development and Reform Commission, Ministry of Finance, Ministry of Human Resources and Social Security, Ministry of Health, China Insurance Regulatory Commission and Ministry of Civil Affairs are responsible)
(2) We will comprehensively promote the protection of eight serious diseases, such as uremia, childhood leukemia, congenital heart disease in children, breast cancer, cervical cancer, severe mental illness, multidrug-resistant tuberculosis and opportunistic infection of AIDS, and include lung cancer, esophageal cancer, gastric cancer, colon cancer, rectal cancer, chronic myeloid leukemia, acute myocardial infarction, cerebral infarction, hemophilia, type I diabetes, hyperthyroidism and cleft lip and palate 12. (Ministry of Health, Ministry of Civil Affairs and Ministry of Finance are responsible)
6. Improve the management level of basic medical insurance.
(1) Actively promote the medical insurance "one card" to facilitate the insured to seek medical treatment. Basically realize the immediate settlement of medical expenses in the insured areas and in different places in the province, and accelerate the immediate settlement of medical expenses in different provinces with the focus on resettling retirees in different places. We will steadily push forward the trans-regional transfer of the employee medical insurance system and strengthen the connection of various basic medical insurance systems. (Ministry of Human Resources and Social Security and the Ministry of Health are responsible respectively)
(2) strengthen the management of medical insurance fund revenue and expenditure. The new rural cooperative medical insurance fund and urban residents' medical insurance fund adhere to the principle of balance of payments in the current year, and the excessive balance is combined with the actual focus to improve the payment level of high medical expenses, so that the fund neither precipitates too much nor overdraws; Where there is too much medical insurance balance for employees, effective measures should be taken to gradually reduce the balance to a reasonable level. (Ministry of Human Resources and Social Security and the Ministry of Health are responsible respectively)
(3) Explore and integrate the management functions and handling resources of employee medical insurance, urban residents medical insurance and the new rural cooperative medical system, and improve the management and handling operation mechanism of basic medical insurance. Conditional areas to explore the establishment of basic medical insurance system for urban and rural residents. (The Central Organizing Committee, the Development and Reform Commission, Ministry of Human Resources and Social Security and the Ministry of Health are responsible)
(4) On the premise of ensuring the safety and effective supervision of the fund, we encourage qualified commercial insurance institutions to handle all kinds of medical security management services in the form of government purchase services. (The Ministry of Health, Ministry of Human Resources and Social Security and the China Insurance Regulatory Commission are responsible)
7. Vigorously develop commercial health insurance.
Improve the industrial policy of commercial health insurance, and encourage commercial insurance institutions to develop health insurance products other than basic medical insurance to meet diversified health needs. Encourage enterprises and individuals to participate in commercial health insurance and various forms of supplementary insurance, and formulate and implement relevant preferential policies such as taxation. (Responsible for Development and Reform Commission, China Insurance Regulatory Commission and Ministry of Finance)
(two) to consolidate and improve the basic drug system and the new mechanism for the operation of primary medical and health institutions.
8. Consolidate and improve the basic drug system.
(1) Expand the scope of implementation of the essential drug system. Consolidate the achievements of government-run primary medical and health institutions in implementing the basic drug system, and implement the policy of all essential drugs equipped and used and medical insurance payment. Orderly promote the implementation of the basic drug system in village clinics, and simultaneously implement various subsidy support policies for rural doctors. For private primary medical and health institutions, all localities can combine the actual situation and bring them into the scope of implementation of the basic drug system by purchasing services. Encourage public hospitals and other medical institutions to give priority to the use of essential drugs. (Development and Reform Commission, Ministry of Health, Ministry of Finance and Ministry of Human Resources and Social Security are responsible)
(2) Standardize the purchasing mechanism of essential drugs. We will fully implement the Notice of the General Office of the State Council on Printing and Distributing the Guiding Opinions on Establishing and Standardizing the Procurement Mechanism of Essential Drugs in Government-run Primary Medical and Health Institutions (Guo Ban Fa [2065438+00] No.56), and adhere to the policies of combining recruitment with procurement, linking quantity with price, double envelope system, centralized payment and full-process monitoring. Improve the comprehensive evaluation index system of essential drug quality. For the exclusive varieties of essential drugs whose prices have been basically stable and the market supply is sufficient after many centralized purchases, the national unified pricing will be tried out. Explore the establishment of a monitoring mechanism for drugs in short supply, and ensure the supply of short-term varieties with small dosage and clinical necessity through bidding and fixed-point production. Establish a provincial centralized procurement and use management information system for essential drugs, implement centralized payment and supply distribution policies, and improve the timely delivery rate. (Development and Reform Commission, Ministry of Health, Ministry of Industry and Information Technology and US Food and Drug Administration are responsible)
(3) Improve the national list of essential drugs. Seriously sum up the use of essential drugs in various places, study, adjust and optimize the national list of essential drugs, and better meet the people's demand for essential drugs. Gradually standardize the dosage forms, specifications and packaging of essential drugs. Standardize the local replenishment of essential drugs and strictly implement the relevant policies of the essential drug system. (Ministry of Health, Ministry of Human Resources and Social Security, Chinese Medicine Bureau and US Food and Drug Administration are responsible)
(four) to strengthen the quality supervision of essential drugs. We will continue to improve the quality standards of essential drugs, implement sampling inspection and electronic supervision of all varieties of essential drugs, and improve the supervision ability of essential drugs from production to use. (Responsible by the US Food and Drug Administration)
9. Deepen the comprehensive reform of primary health care institutions.
(1) Establish and improve a stable and long-term multi-channel compensation mechanism to ensure the normal operation of primary medical and health institutions. After the national essential drug system is fully implemented, the central government will establish a regular subsidy mechanism for local governments, which will be included in the budget. Local governments should include special subsidies for primary medical and health institutions and regular international payments subsidies in their financial budgets and make them available in full and on time, and implement pre-allocation before settlement. Full implementation of general medical expenses and medical insurance payment policies. Implement basic medical and health institutions to undertake basic public health service funds. (Ministry of Finance, Development and Reform Commission, Ministry of Health and Ministry of Human Resources and Social Security are responsible)
(2) Deepening the reform of the establishment and personnel system. Reasonably determine the total staffing of primary medical and health institutions in the county, and implement dynamic adjustment according to the service function orientation and development needs of primary medical and health institutions. We will implement the autonomy of legal persons in primary medical and health institutions, fully implement the appointment system and post management system, focus on selecting and appointing good presidents, and establish a target responsibility system for term of office. (Central Organizing Committee, Ministry of Health and Ministry of Human Resources and Social Security are responsible)
(3) Improve the performance distribution mechanism. Adhere to more pay for more work, excellent performance and excellent remuneration, and tilt the focus of income distribution to key positions, business backbones and people who have made outstanding contributions. On the basis of the smooth implementation of performance pay, where conditions permit, the proportion of incentive performance pay can be appropriately increased and the income gap can be widened reasonably. Pay performance pay in full and on time. The balance of income and expenditure of primary medical and health institutions can be used to improve welfare benefits and mobilize the enthusiasm of medical staff. (Responsible by Ministry of Human Resources and Social Security, Ministry of Health and Ministry of Finance)
(4) Accelerate the liquidation of debts of primary medical and health institutions. Do a good job in debt verification and locking, raise and implement debt-to-equity swap funds through multiple channels, complete debt stripping and debt resolution on time, and resolutely stop the occurrence of new debts. (Ministry of Finance, Ministry of Health and Development and Reform Commission are responsible)
10. improve the service capacity of primary health care institutions.
(1) According to the principle of filling vacancies, continue to increase efforts to support the standardization construction of township hospitals. (Responsible by Development and Reform Commission and Ministry of Health)
(2) Accelerate the informatization construction of primary medical and health institutions, establish a primary medical and health information system covering basic functions such as the supply and use of essential drugs, residents' health management, basic medical services and performance appraisal, unify technical information standards, realize interconnection with basic medical insurance and other information, and improve the standardization level of primary medical and health services. (Responsible by Development and Reform Commission, Ministry of Health and Ministry of Human Resources and Social Security)
(3) Strengthen the construction of grass-roots talent team focusing on general practitioners. Actively promote the construction of the general practitioner system, carry out standardized training for general practitioners, continue to recruit more than 5,000 directional free medical students for township health centers and grass-roots units in the central and western regions, arrange10.5 million on-the-job training for general practitioners in grass-roots medical and health institutions, implement the special post project for 20,000 general practitioners, improve and implement the policy of encouraging general practitioners to serve at the grass-roots units for a long time, and strive to realize that every urban community health service institution and township health center has qualified general practitioners. Support the construction of 100 clinical training bases for general practitioners. The central government continued to support the central and western regions in strengthening the on-the-job training of primary medical and health personnel, focusing on targeted and practical training with general medical characteristics and promoting the use of essential drugs, training 620,000 people. (The Ministry of Health, the Ministry of Health of the General Logistics Department, the Development and Reform Commission, the Ministry of Education, the Ministry of Finance, Ministry of Human Resources and Social Security and the Central Organizing Office are responsible)
(four) to encourage qualified places to carry out the pilot reform of the practice mode and service mode of general practitioners, and to promote the establishment of a stable contractual service relationship between general practitioners (teams) and residents. Encourage primary medical and health institutions to provide appropriate technologies and services such as Chinese medicine. Establish and improve the grading diagnosis and treatment, two-way referral system, and actively promote the pilot of the first diagnosis responsibility system. (Ministry of Health, Development and Reform Commission, Ministry of Finance, Ministry of Human Resources and Social Security, Chinese Medicine Bureau are responsible)
1 1. Build a solid rural medical and health service network.
(1) Support the housing construction and equipment purchase of village clinics in various ways, such as public construction and private operation and government subsidies. Incorporate village clinics into the information construction and management scope of primary medical and health institutions. Implement multi-channel compensation and pension policies for rural doctors. (Ministry of Health, Development and Reform Commission, Ministry of Finance and Ministry of Human Resources and Social Security are responsible)
(2) Strengthen the training of rural doctors and the construction of reserve forces. Free training for rural doctors practicing in village clinics is not less than twice a year, and the cumulative training time is not less than two weeks. Enrich the team of rural doctors through targeted training of local personnel to ensure that there are rural doctors in every village clinic. (Ministry of Health and Ministry of Finance are responsible)
(3) County-level health administrative departments should strengthen the industry management of rural doctors and village clinics, focusing on strengthening the supervision of service behavior. Actively promote the integrated management of township hospitals and village clinics. (Ministry of Health, Development and Reform Commission and Ministry of Human Resources and Social Security are responsible)
(3) Actively promote the reform of public hospitals.
Focusing on county-level hospitals, we will promote the comprehensive reform of public hospitals in management system, compensation mechanism, personnel distribution, drug supply and price mechanism, select about 300 counties (cities) to carry out comprehensive reform of county-level hospitals, and encourage local governments to explore specific models according to local conditions. Expand and deepen the pilot reform of urban public hospitals.
12. accelerate the reform of county-level public hospitals.
(1) Reform the compensation mechanism. Take comprehensive measures and linkage policies such as adjusting drug prices, reforming medical insurance payment methods, and implementing the government's responsibility for running medical care, and break the mechanism of "supplementing medical care with medicine". The compensation of public hospitals will be changed from three channels of service charges, drug bonus income and financial subsidies to two channels of service charges and financial subsidies. Reasonable gains or losses caused to hospitals can be compensated by adjusting the price of medical technical services and increasing government investment. The adjusted medical technical service charges are included in the scope of medical insurance payment according to regulations. The increased government input will be subsidized by the central government, and the local finance should adjust the expenditure structure according to the actual situation and effectively increase the input. (Ministry of Health, Development and Reform Commission, Ministry of Finance and Ministry of Human Resources and Social Security are responsible)
(2) Adjust drug prices. Cancel the drug addition policy. Increase the price of medical technical services such as medical treatment fees, operation fees and nursing fees. Reduce the inspection price of large-scale equipment, and set the inspection price of large-scale equipment in public hospitals invested by the government as the cost after depreciation. (Responsible by Development and Reform Commission and Ministry of Health)
Improve the centralized online procurement of drugs in county-level public hospitals, actively promote the centralized procurement of medical consumables with quantity and high value, reduce intermediate links and costs, and strive to reduce the inflated price. (Ministry of Health and Ministry of Supervision are responsible)
(3) Give play to the compensation and supervision role of medical insurance. At the same time, we will promote composite payment methods such as total prepayment, per capita payment, and payment by disease, and give timely and reasonable compensation to medical institutions by purchasing services, so as to guide medical institutions to actively control costs, standardize diagnosis and treatment behavior, and improve service quality. Strict assessment of the basic medical insurance drug list utilization rate and self-funded drug control rate and other indicators to control or reduce the personal burden of the masses. (The Ministry of Health and Ministry of Human Resources and Social Security are responsible respectively)
(four) the implementation of the government's medical responsibility. We will implement the government's investment policies in public hospitals' capital construction and equipment purchase, the development of key disciplines, public health services, retirees' expenses in line with state regulations, and policy loss subsidies. (Ministry of Finance, Development and Reform Commission and Ministry of Health are responsible)
Reasonably determine the number and layout of public hospitals (including state-owned enterprise hospitals), and strictly control the construction standards, scale and equipment. It is forbidden for public hospitals to borrow money for construction. (Ministry of Health, Development and Reform Commission, Ministry of Finance and State-owned Assets Supervision and Administration Commission are responsible)
(5) Accelerate the establishment of modern hospital management system. In accordance with the requirements of separating government from business, the management and employment autonomy of county-level public hospitals should be implemented. Explore the establishment of various forms of corporate governance structure of public hospitals such as the board of directors. The functions, development planning, major investment and other powers of public hospitals are exercised by the government medical subject or the board of directors. (The Ministry of Health, the Development and Reform Commission and the Central Organizing Office are responsible)
Establish and improve the dean responsibility system and the term target responsibility system assessment system. The heads of health administrative departments at all levels shall not concurrently hold the leadership positions of public hospitals. We will continue to deepen the reform of the personnel system and gradually promote the socialization of social security services such as pension for medical staff in public hospitals. (Ministry of Health and Ministry of Human Resources and Social Security are responsible)
(6) Improve the internal distribution incentive mechanism of the hospital. Improve the internal distribution mechanism with service quality, quantity and patient satisfaction as the core, reflecting more work and more pay. Increase the proportion of personnel expenditure to business expenditure and improve the treatment of medical personnel. The remuneration of directors and hospital administrators shall be decided by the medical disciplines organized by the government or the authorized Council. It is strictly forbidden to link the personal income of medical staff with the income of hospital drugs and examinations. (Ministry of Health, Ministry of Human Resources and Social Security and Ministry of Finance are responsible)
13. Expand and deepen the pilot reform of urban public hospitals.
Focusing on the separation of government affairs, management and administration, medicine, for-profit and non-profit, focusing on breaking the mechanism of "supplementing medicine with medicine", focusing on reforming the compensation mechanism and establishing a modern hospital management system, deepening institutional innovation, improving service quality and operational efficiency, and forming the basic path of reform as soon as possible. Study and explore the establishment of specialized management institutions and other forms to determine the government-run medical institutions and perform the functions of government-run hospitals. According to the needs of reform, the pilot areas will be given some autonomy in performance wage distribution, pricing and drug procurement. (Ministry of Health, Development and Reform Commission, Ministry of Human Resources and Social Security, Ministry of Finance, Ministry of Education and State-owned Assets Supervision and Administration Commission are responsible)
14. Vigorously develop non-public medical institutions.
(1) All localities should issue detailed implementation rules to encourage social capital to set up and develop medical institutions as soon as possible, implement policies to encourage social capital to run medical institutions in detail, and support the establishment and development of a number of non-public medical institutions. Health and other relevant departments should clean up and revise relevant policy documents within a time limit. Further open the medical service market, relax the access scope of social capital to set up medical institutions, actively introduce powerful enterprises, overseas high-quality medical resources, social charity forces, foundations, commercial insurance institutions and other medical institutions, and give priority to supporting the establishment and development of non-profit medical institutions. Expand the pilot scope of overseas wholly-owned medical institutions. Encourage qualified personnel (including those from Hong Kong, Macao and Taiwan) to set up clinics according to law. Further improve the practice environment and implement policies such as price, tax, designated medical insurance, land, construction of key disciplines, and evaluation of professional titles. Conditional places can subsidize social capital to set up non-profit medical institutions. Actively develop medical service industry and encourage non-public medical institutions to develop into high-level, large-scale medical groups and rehabilitation medical institutions. (Development and Reform Commission, Ministry of Finance, Ministry of Health, Ministry of Commerce and Ministry of Human Resources and Social Security are responsible)
(2) Encourage areas with rich resources of public hospitals and guide social capital to participate in the restructuring and reorganization of some public hospitals, including hospitals run by state-owned enterprises, in various ways. Encourage social capital to provide various forms of public welfare support to some public hospitals. (Ministry of Health, Development and Reform Commission, Ministry of Finance and State-owned Assets Supervision and Administration Commission are responsible)
15. Carry out all-round convenience and benefit services.
(1) patient-centered, service-oriented, simplifying medical service processes such as registration, consultation, examination, charging and taking medicine, actively promoting the construction of a unified regional appointment registration platform, generally implementing appointment diagnosis and treatment, and carrying out "diagnosis and treatment first, then settlement" to improve the medical environment, significantly shorten the waiting time of patients and facilitate the people to seek medical treatment. Vigorously promote quality nursing and advocate voluntary service. (Ministry of Health is responsible)
(2) Popularize clinical pathway and strengthen quality control. Carry out quality control of single disease and standardize medical behavior. Continue to carry out special rectification activities for clinical application of antibacterial drugs. Taking electronic medical records and hospital management as the core, we will promote the informatization construction of public hospitals. The inspection of medical institutions is open to the public, and the inspection equipment and technicians shall meet the statutory requirements or have statutory qualifications to realize mutual recognition of inspection results. (Ministry of Health is responsible)
16. Improve the service capacity of county hospitals.
Strengthen the capacity building of county-level hospitals with talents, technology and key specialties as the core, and focus on running 1-2 county-level hospitals (including county traditional Chinese medicine hospitals) in each county, so as to improve the medical treatment rate in the county and reduce the transfer rate outside the county. Start the implementation of special posts in county-level hospitals and introduce urgently needed high-level talents. Consolidate and deepen the long-term cooperation and assistance mechanism for municipal hospitals to support county-level hospitals, arrange 6,000 key personnel of county-level hospitals to study in tertiary hospitals, and develop remote diagnosis and treatment systems for rural and remote areas. (Ministry of Health, Development and Reform Commission, Central Organization Establishment Committee, Ministry of Human Resources and Social Security and Ministry of Finance are responsible)
(4) Make overall plans to promote reforms in related fields.
17. improve the level of equalization of basic public health services.
(1) Continue to do a good job in the 10 national basic public health service project, and strive to improve the service quality, residents' awareness rate and satisfaction. The standardized electronic filing rate of health records of urban and rural residents reached over 60%, and the number of patients with hypertension and diabetes reached 65 million and180,000 respectively. All patients with severe mental illness found in the investigation are included in the management scope. Strengthen the vaccination work of the national immunization program. Improve the accessibility of public health services for floating population and rural left-behind children and the elderly. Strengthen health promotion and education, advocate a healthy lifestyle, and guide scientific medical treatment and safe and rational drug use. (Ministry of Health and Ministry of Finance are responsible)
(two) continue to implement major public health projects, do a good job in the prevention and control of infectious diseases, chronic diseases, occupational diseases, severe mental illness, major endemic diseases and other diseases that seriously endanger people's health. Improve the professional public health service network, continue to support the rural pre-hospital emergency system and the construction of county-level health supervision institutions, and strengthen the capacity building of major disease prevention and control and food safety risk monitoring. (Ministry of Health, Development and Reform Commission and Ministry of Finance are responsible)
18. Promote the structural optimization and layout adjustment of medical resources.
(1) Formulate regional health planning, clarify the allocation standards of health resources at the provincial, municipal and county levels, and give priority to social capital when adding medical and health resources. If the number of beds in medical and health institutions per thousand permanent residents reaches 4, the scale of public hospitals will not be expanded in principle. (Ministry of Health, Development and Reform Commission and Ministry of Finance are responsible)
(2) Strengthen the construction of weak links in the medical service system and support the construction of key clinical specialties in medical institutions. Strengthen the construction of pediatrics in provincial children's specialized hospitals and general hospitals at city and county levels. Start the construction of municipal general hospitals in remote areas. Strengthen the standardization of medical and health information technology, and promote the effective integration of information technology and management, diagnosis and treatment norms and daily supervision. (Development and Reform Commission, Ministry of Health and Ministry of Finance are responsible)
19. innovate the system of training and using health talents.
(1) Strengthen the training of nurses, elderly nurses, pharmacists, pediatricians, as well as the shortage and high-level talents in mental health, pre-hospital first aid, health emergency, health supervision, hospitals and medical insurance management. We will issue guidance on the standardized training system for residents and accelerate the establishment of the standardized training system for residents. (Ministry of Health, Ministry of Education, Ministry of Human Resources and Social Security and Ministry of Finance are responsible)
(2) Promote doctors to practice more. All localities should introduce detailed rules for the implementation of doctors' multi-point practice, encourage people with doctor qualifications to apply for practice, improve the registration, filing, assessment, evaluation and supervision policies of practicing doctors, and establish doctors' management files. Establish and improve the medical practice insurance and medical dispute handling mechanism. (Ministry of Health is responsible)
20. Promote the reform in the field of drug production and circulation.
(1) Reform the drug price formation mechanism, select drugs with large clinical use, and set the highest retail guidance price according to the cost of leading enterprises and market transaction prices such as centralized drug purchase price and retail pharmacy sales price. Improve the price management of imported drugs and high-value medical consumables. (Responsible by the Development and Reform Commission)
(2) Improve the development policy of pharmaceutical industry and standardize the order of production and circulation. Promote pharmaceutical enterprises to improve their independent innovation ability and optimize and upgrade the pharmaceutical industrial structure. Develop modern drug logistics and chain operation, and improve the drug distribution capacity in rural and remote areas. Promote cross-regional and cross-ownership mergers and acquisitions and joint restructuring of pharmaceutical production and circulation enterprises. Encourage the development of retail pharmacies and equip licensed pharmacists according to regulations. (Ministry of Industry and Information Technology, Ministry of Commerce and US Food and Drug Administration are responsible)
(3) Improve drug quality standards and improve the quality level of generic drugs. Good manufacturing practice has implemented the new revision, revised and published the Quality Management Standard for Pharmaceutical Trading, and regularly published drug quality announcements. Strictly investigate and deal with illegal activities such as manufacturing and selling counterfeit drugs, and severely crack down on illegal activities such as renting and lending licenses such as "linking" and "walking tickets", buying and selling tax tickets, and publishing false drug advertisements. (The US Food and Drug Administration and the Ministry of Industry and Information Technology are responsible)
Third, safeguard measures.
(1) Strengthen the target responsibility system.
(2) Strengthen financial guarantee measures.
(3) Strengthen performance appraisal.
(4) Strengthen publicity and guidance.