In accordance with the requirements to further optimize the implementation of preventive and control measures for the new coronavirus pneumonia epidemic, the State Council's Integrated Group on Response to the New Coronavirus Pneumonia Epidemic has formulated the "New Crown Key Population Health Service Work Program". Now issued to you, please combine with the actual implementation.
State Council Response to New Coronavirus Pneumonia
Epidemic Joint Prevention and Control Mechanism Comprehensive Group
December 9, 2022
New Coronavirus Key Population Health Service Work Program
According to the State Council Joint Prevention and Control Mechanism Comprehensive Group's Notice on the Health Survey of New Coronavirus Key Population Groups, a survey on the elderly's comorbid underlying diseases and their New Crown virus vaccination survey and categorized registration. Now on the registration of key populations to do a good job of health services to develop this program.
I, clear principles of health services
Adhering to the principle of classification and grading, highlighting the key, according to the situation of suffering from the underlying diseases, the new coronavirus vaccination, the degree of risk of infection is divided into three categories: the key populations, the sub-priority populations, the general population, respectively, marked in red, yellow, green, color, the service content of the different colors.
II. Carrying out categorized and graded services
The first level of services.
1. Service population. General population.
2. Service content.
Communities are responsible for mobilizing, publicizing, and guiding those who have not completed the booster immunization and are eligible for vaccination after the doctor's assessment to be vaccinated as soon as possible.
To play the role of streets, community residents' committees and their public **** health committees, primary health care institutions, family doctors, to strengthen health education, advocate a healthy lifestyle, and do a good job of personal health protection.
Provide counseling services related to new crown pneumonia. The community publicizes the current policies on prevention and control of new crown pneumonia through loudspeakers, a letter, micro-letters, SMS, APP, etc., notifies every key population family of the duty phone number of the primary health care institution or the phone number of the family doctor, and assists in health education.
Second-level services.
1. Service population. Sub-focused population.
2. Service content. Secondary services based on primary services.
The asymptomatic or mildly symptomatic infected people who are treated at home take the initiative to report to the community and contact the primary health care institutions under their jurisdiction, which will guide the antigen testing, health monitoring, health counseling, and medication guidance in conjunction with the practice of primary health care institutions through the Internet, video, telephone, remote or offline. After assessment for the need of infected people to provide wearable health monitoring equipment, finger-clip pulse oximeter to carry out health monitoring, such as the emergence of persistent high fever, respiratory distress, finger oxygen saturation
Community assistance in the implementation of home treatment of infected people's management, the need for regular medical care to guide and assist in medical care, and assistance in the provision of drug purchase and delivery of medication and other services.
Tertiary services.
1. Service population.
Key populations.
Key populations with emergency medical needs.
Other populations with emergency medical needs such as infants, children, pregnant women and other populations.
2. Service content. Tertiary services are carried out on the basis of secondary services.
Disabled elderly or senior mobility-impaired infected people, after the county health department to determine the team of experts or higher-level hospitals to decide the mode of admission after assessment. For those who are assessed to be homebound, under the guidance of higher-level hospitals, primary health care institutions provide health counseling, health guidance, health monitoring, antigen testing and other necessary services. For those who are assessed to be unsuitable for home stay, primary health care organizations will provide guidance and assistance in referral.
The key groups of infected people and people with urgent medical needs, the community and primary health care institutions to assist in the referral of urgent medical needs can also be accessed through the emergency room.
Three, strengthen the organizational security
Clear division of responsibilities. Local joint prevention and control mechanism to take the lead in charge, the relevant departments in accordance with the responsibilities of the respective implementation. To the municipal level as a unit, the health sector to determine the fixed-point medical institutions, the formation of technical support for grass-roots medical and health institutions to provide technical support for the parent organization and professional team, to guide the medical and health institutions in accordance with the division of labor to provide the key populations of health management and medical treatment, and to strengthen the training of the various relevant institutions to carry out classification and grading of the service. Civil affairs departments are responsible for guiding nursing homes, children's welfare institutions and other key places to strengthen their management, mobilizing communities to provide management services for key populations under the unified leadership of the local epidemic prevention and control mechanism, and guiding residents' committees to cooperate with primary healthcare institutions in the provision of medicines, antigen testing, and contacting higher-level hospitals around the elderly and other high-risk populations. The relevant departments should implement the financial guarantee for the survey of key populations, graded health services and the necessary equipment.
Strengthening the stockpile of medicines and antigen detection kits for primary healthcare organizations. All localities should increase the supply guarantee to ensure that primary healthcare institutions dynamically stock Chinese medicine, symptomatic therapeutic drugs such as antipyretic and cough suppressant drugs, and antigen detection reagents according to the list of Chinese medicines recommended by the state and the province and according to the total number of the population they serve by 15-20%, and the number can be increased as appropriate in densely populated areas. County-level health and wellness departments should organize teams of pharmacists to provide patients with medication guidance on contraindications, compounding, precautions and other aspects of drug use.
Improving the service level of primary health care organizations.
One is to strengthen the equipping and upgrading of primary healthcare institutions. Accelerate the construction progress of fever clinics in township health centers and community health centers, and strive to increase the coverage rate to about 90% by the end of March 2023. Improve equipment configuration, including oxygen therapy equipment, portable lung function instruments, finger-clip pulse oximeters, wearable health monitoring equipment, etc.; upgrade the electronic health record information system, and encourage those in a position to do so to equip densely populated communities or remote villages with smart health stations.
The second is to effectively increase the manpower of primary health care organizations. A system should be established for physicians from relevant departments of urban second- and third-tier hospitals to visit the grassroots level, and the lead hospitals of the medical consortiums should send physicians to sink to the grassroots level. The staffing of primary healthcare organizations should be strengthened in accordance with the increase in the service population and the volume of services provided, and retired medical personnel and health professionals and technicians in other positions may be temporarily rehired to fill primary healthcare organizations within the past five years. Township health centers and community health service centers are permitted to hire personnel or assign non-medical health service tasks to them by way of third-party services. A telemedicine service network should be established and improved, and high-quality medical services from second- and third-tier hospitals should be extended to the grassroots level by means of telemedicine.
Thirdly, the family doctor contracting service for key populations should be realized. Accelerating the improvement of the coverage of contracted services for the elderly over 65 years of age, realizing the full coverage of contracted services for the elderly with combined basic diseases, and doing a good job of health management and health monitoring in accordance with the principle of classification and grading. Strengthening the contact between family doctors and contracted elderly people to ensure that they or their families can contact their family doctors in a timely manner when they have a need for medical care.
Implementing the community's responsibility for the management of key populations. The active roles of grass-roots governments and residents' committees and their public **** health committees are fully utilized to assist in the daily publicity, education and service work for key populations. Direct hotlines between communities and medical institutions and pharmacies have been established, and medical vehicles have been deployed or upgraded on a street-by-street basis in urban areas and on a township-by-township basis in rural areas, to provide guidance and assistance in making referrals.
Strengthening health management for key populations in rural areas. Each region should strengthen the guidance, support and scheduling of health surveys and management of key populations in rural areas. Determine fixed-point medical institutions at the prefecture and municipal levels, and clarify the process and path of referral from township health centers to fixed-point medical institutions. The lead hospital of the county medical **** body implements a person or a specialized team to provide manpower, technology, equipment and other necessary support to the township health centers and village health offices under its jurisdiction in carrying out services for key populations. The villagers' committees and their public **** health committees coordinate and link up well with the village health offices, mobilizing social organizations, social workers, volunteers, and social charitable resources to assist in purchasing and delivering medicines and assisting in medical referrals for key populations under their jurisdictions; and guiding the villagers to improve their personal health awareness and to do a good job of self-protection.
Strengthening the management of nursing homes, children's welfare institutions and other key institutions. Localities should guide nursing homes and child welfare institutions to develop in-hospital categorization and grading service programs with reference to this program, establish collaboration mechanisms with jurisdictional medical and health institutions and pharmacies, and clarify the referral process. Medical staff of nursing homes and child welfare institutions' internal medical institutions or medical and health institutions with which they have established a collaborative relationship provide categorized and graded services for key personnel. Nursing homes and child welfare institutions should dynamically stock Chinese medicine, symptomatic treatment drugs such as antipyretics and cough suppressants, and antigen detection reagents.
To play the role of the medical consortium. Actively play the role of the medical consortium medical **** body lead hospitals to strengthen the technical guidance on the construction and operation of fever clinics of its members. Coordinate the deployment of personnel within the medical consortium, send professional forces to guide and support the daily diagnosis and treatment work of the fever clinic of the primary medical and health care institutions. Smooth the two-way referral channel, do a good job of hierarchical diagnosis and treatment convergence, the lead hospital to set up by the respiratory, pediatrics, critical care, traditional Chinese medicine and other related departments of the specialty treatment team, strengthen the grassroots technical support, training, guidance and quality control.
Encourage the participation of social forces. Co-ordinate the efforts of all parties, encourage and guide the participation of social forces in the primary health care services to ensure that the growth of medical service resources to meet the needs of the masses of health care services.