With the deployment of health poverty alleviation as an important hand in precise poverty alleviation and precise poverty alleviation, closely focusing on the poor masses "affordable, good, sick, less sick," these key links, focusing on the solidarity, solid work, to maximize the prevention of the masses of poverty due to disease, disease return to poverty.
I. Progress of work
(I) Basic work status. According to the poverty alleviation department's 2018 statistics, at the beginning of 2014, the city*** had a documented poverty population of 395,000 people, with a poverty incidence rate of 31.8%. After the fight against poverty in recent years, at the end of 2017, the remaining poor population was 27,000 households and 96,000 people, of which 6,056 households were impoverished due to illness, accounting for 22.5% of the poor population.In 2017, 752 households and 2,931 people were returned to poverty, of which 496 households were returned to poverty due to illness, accounting for 66% of the population returned to poverty. As of May 2018, the city still had 18,592 poor patients in need of treatment, accounting for 39.4 percent of the region.
(ii) Conducting convenient services. It has formulated three working initiatives: first diagnosis and treatment and then payment, one-card visit, and one-stop billing, implemented the "six-one, two-push, and five-understand" working method, and established a green channel for poor patients to receive treatment and a system of follow-up visits. It has also established a green channel for poor patients to receive treatment and a system of follow-up visits. It has set up health records for the poor and implemented dynamic management.
Promoting family doctor contracting service, the poor population health file rate and contracting service rate have reached 100%; preparation of health manuals, the issuance of "medical services for poor patients preferential card", pushing health knowledge, poverty alleviation policies, so that the poor people of their own health status, disease conditions, treatment costs, the person responsible for underwriting, The reasons for poverty are clearly understood. Comprehensively carrying out "one-stop" settlement of hospitalization expenses for impoverished patients, in particular introducing third-party payment for financial underwriting funds, realizing the service requirement of "no meeting, immediate handling, and one trip at most" for the settlement of expenses for patients and medical institutions; carrying out the "Internet+Medical and Healthcare" program; and providing "one-stop" settlement of hospitalization expenses for impoverished patients, in particular introducing third-party settlement of financial underwriting funds. "Internet + medical health". Part of the city's counties and districts to fully apply the "Internet + family doctor service platform", and gradually solve the problem of the people difficult to see a doctor.
(C) improve and perfect the guarantee mechanism.
One is the strict implementation of the autonomous region of rural poor patients medical government policy. By the autonomous region financial subsidies, local financial support, the government set up a medical aid fund, in accordance with the principle of first insurance, then aid, after the bottom, through the urban and rural residents medical insurance reimbursement, civil medical aid, government medical insurance policy system of eight protection, so that poor patients to achieve the actual reimbursement of hospitalization medical expenses within the year not less than 90% or the year the cumulative total of out-of-pocket hospitalization costs of not more than 5,000 yuan The goal is to benefit 188,000 rural poor people.
The second is the development of a general rural residents' healthcare inclusive policy. A commercial health insurance mechanism has been introduced for general rural residents with illnesses, establishing a method of purchasing commercial health insurance for major illnesses based on individual contributions from rural residents, appropriate government subsidies, and the assumption of risk by commercial insurance companies, raising the level of medical protection and benefiting 1,079,000 general rural residents.
Thirdly, the establishment of a supplementary medical insurance system for serious illnesses. All urban workers and urban and rural residents in the city who participate in basic medical insurance are covered for diseases that are seriously life-threatening and costly to treat. The number of reimbursable diseases of serious and major illnesses has been expanded to 36, covering 1.312 million people in the city.
(4) health poverty alleviation has achieved results
The city has set up a medical insurance system for different groups of people, carried out a variety of convenient services, and adopted "targeted treatment" measures to solve the problem of poverty caused by illness and returning to poverty due to illness. The results have been achieved at a stage.
1, the effectiveness of work innovation. In practice, we have explored the health of poverty alleviation government guarantee funds entrusted to a third party management (the use of commercial insurance company agencies, personnel and payment process, to realize the medical patients, medical institutions, medical expenses settlement "do not meet, immediately do, the most run a trip" service requirements) and" Internet + medical health" model, a better solution to the rural poor population can afford to see the disease, see the disease, see a good disease, less sick, and promote the exchange of the whole region. The National Health Commission, after evaluation in 2017 and assessment in 2018, identified Panyang County of our city as a national "advanced county (demonstration county) for health poverty alleviation"; Panyang County's application of "Internet+Medicine and Health" to help health poverty alleviation was recognized by Vice Premier Sun Chunlan of the State Council, Comrade Sun Chunlan. Mr. Sun Chunlan, Vice Premier of the State Council, recognized this work.
2, accurate treatment effectiveness. 2017 city **** approved 12553 poor patients, of which 1802 patients with major diseases (9 major diseases diagnosed 319 people), 1229 patients with serious illnesses, 9522 patients with chronic diseases. By the end of 2017, the "three batch" categorized treatment was implemented for 12,459 people, with a treatment rate of 99.25%, of which 1,768 people were centrally treated for major diseases (309 people were treated for 9 major diseases, with a treatment rate of 96.87%). , the treatment rate is 98.1%; 1207 people are treated for serious diseases, the treatment rate is 98.2%; 9484 people are treated for chronic diseases, the treatment rate is 99.6%, as of the end of June 2018, 329,049 filed card holders were verified for their diseases,*** approved 24,369 filed card holders, the approval rate is 93.65%. Among them, 2,803 patients with major diseases, 2,706 patients with serious diseases and 11,960 patients with chronic diseases were approved. The cumulative number of treatments for patients with major diseases is 5,436, for patients with serious diseases is 5,298, and for patients with chronic diseases is 16,309. The average treatment rate is 74.11%.
3, the effectiveness of medical protection. First, the effectiveness of the city's rural poor patients government guarantee. 2017 settlement of poor hospitalized patients 5572 times, reimbursement of financial subsidies for major disease insurance and government guarantee pocket funds 15.97 million yuan, the reimbursement of all accounted for 93.2% of the total hospitalization costs, the average individual hospitalization out-of-pocket payment of 963 yuan. The reimbursement ratio of hospitalization expenses for poor patients has reached the target of not less than 90% and out-of-pocket expenses of not more than 5,000 yuan as required by the autonomous region. Second, the city's urban and rural residents benefit the effectiveness of the policy. in 2017, the city's urban and rural residents were hospitalized 171,600 times, with a total hospitalization cost of 1090,460,000 yuan, and the reimbursement ratio of major disease insurance reached 8.68%, of which the reimbursement ratio of the major disease insurance Goodyear tilted policy was 4.28%, and the reimbursement ratio of the commercial health insurance touting was 13.49%. The number of other rural residents in the city enjoying the two policies reached 85,000, accounting for 49.5% of the total number of hospitalizations in 2017. The per capita reimbursement of the major disease insurance Guyuan tilt policy amounted to 269 yuan, and the per capita reimbursement of the commercial health insurance touting reimbursement amounted to 848 yuan, and the two combined per capita reimbursement was 1,117 yuan more. Third, the effectiveness of government peddling in 2018. As of the end of June 2018, the city's Dong*** reimbursed 3,518,600 yuan of government touting funds, enjoying the government touting policy for 3,230 people, with an average personal out-of-pocket payment of 725 yuan, and a reimbursement ratio of 91%.
4, poverty alleviation to promote the effectiveness. Since the launch of health poverty alleviation, the city's residents' participation rate has increased from 95.4% in 2014 to ?98.2 % in 2018, an increase of 2.8 %, and life expectancy is expected to be extended by 1.5 years per capita during the five-year period. As of the end of June 2018, the city had 3,849 households in the population not out of poverty due to illness, and the rate of poverty due to illness fell to 7.66 %. The people's health concept has changed dramatically, and gradually formed the habit of everyone talking about hygiene, everyone grasping health, suffering from a major disease can be hospitalized in a timely manner, outpatient treatment of minor diseases, chronic disease family contracting management, no disease in advance to prevent the habits of life, and improve the awareness of health.?
Third, the current problems(a) shortage of medical resources in the city. Medical resources are equipped with less than the national average standard, the educational structure of the medical team is unreasonable, low level, the discipline leader and practical talents are few, the rural health team is unstable, the lack of general practitioners.
(2) The structure of health resources is uneven. Medical resources between urban and rural areas are unevenly equipped, and the total amount of medical and health resources at the rural level is seriously insufficient. The development of Chinese and Western medicine is unbalanced, with the development of Chinese medicine lagging behind. The development of specialized hospitals has been slow, especially in the areas of obstetrics and gynecology, pediatrics, and geriatrics, where service capacity is relatively weak.
(3) There are still problems of difficulty in accessing medical care. The cost of medical assistance cannot be solved. Poor patients seeking medical treatment outside the city after the major disease assistance, government pockets and other reimbursement of the remaining medical costs, transportation costs, accommodation costs, escort costs, food expenses are very large; the cost of medication during the recovery period can not be reimbursed; outpatient costs are not supported by the policy; patients up and down the referral of duplicate "threshold fee" is difficult to solve the problem; the work of controlling the irrational increase in medical costs is difficult. The situation is grim.
Four, the next step in the work plan?
(A) the implementation of medical personnel "return to the six pan" project. The state invested in the establishment of an incentive fund, the return of high-end medical professionals and make a greater contribution to the local medical workers to give heavy awards to encourage and attract medical personnel outside the Guyuan nationality. Strive for the state in the college recruitment, training, job placement and other aspects of the policy tilt given to the city of Guyuan.?(ii) the formation of specialized medical teams. Strive for the state to set up a special local medical service fund, support Guyuan City to cultivate the formation of various types of excellent medical teams at all levels, to build a "minor illnesses at the grassroots level, major illnesses do not go out of the county, difficult and complicated diseases do not go out of the city," the pattern of access to medical care.
(3) to create high-end specialized medical departments. Strive for national investment in the construction of municipal people's hospital urology, stroke center, orthopedics, general surgery, ophthalmology, municipal hospital of traditional Chinese medicine, internal medicine, spine health centers, to create municipal maternal and child health care and family planning service center (municipal children's hospital) obstetrics, neonatology, and other nine key departments and advantageous departments, to drive the city's level of medical care and treatment and scientific research capacity to enhance the city's overall level of health care across the city to achieve the development of the city.
(4) increase the construction of basic medical equipment and medical conditions at the grassroots level. Strive for the state of the city in the development of "Internet + medical health" project infrastructure, to give financial tilt support.
(5) Grasp the signing service. The implementation of good chronic disease contracting service management, the realization of the establishment of poor patients signing rate of 100%, the general residents signing rate to meet the national requirements, and the realization of the signing of a case, the management of a case, the signing of the service to the letter.