Basic medical care is guaranteed with three one-three qualifications and three lines.

In order to implement the decision-making deployment of the CPC Central Committee and the State Council to solve the outstanding problems of "two no worries and three guarantees", according to the Notice of the Leading Group of Poverty Alleviation and Development of the State Council on the Guiding Opinions on Solving the Outstanding Problems of "Two No Worries and Three Guarantees" (Guoda [ 2019] No. 15), to promote a comprehensive solution to the outstanding problems of basic medical care security, and to promote the implementation of the health poverty alleviation project, the National Health Commission, the National Development and Reform Commission, the Ministry of Finance, the National Health Insurance Bureau, the State Administration of Traditional Chinese Medicine, and the Poverty Alleviation Office of the State Council have jointly formulated a "Work Program for Solving the Outstanding Problems of the Poor Population's Basic Medical Care Security". It is now issued to you (downloadable from the website of the National Health Commission), please implement it seriously. Work Program for Solving the Outstanding Problems of Providing Basic Medical Care for the Poor Population

In order to implement the decision-making and deployment of the CPC Central Committee and the State Council to solve the outstanding problems of "two no worries and three guarantees", and to promote the implementation of the project of poverty alleviation through health care, we will take the capacity building of the county hospitals, the construction of the mechanism of "county and township as one, country as one "The main direction of the project is to build the capacity of county hospitals, "county and township as a whole, village as a whole" mechanism, and the standardization of rural medical and health institutions, so as to comprehensively solve the outstanding problems of basic medical care for the poor population, and ensure that the task of poverty alleviation in health will be completed comprehensively by 2020. According to the "Leading Group of the State Council on Poverty Alleviation and Development on solving the outstanding problems of "two no worries and three guarantees" of the guiding opinions", the formulation of this work program.

First, accurately grasp the standards and requirements of basic medical security

The basic medical security of the poor population, mainly refers to the poor population into the basic medical insurance, major illness insurance and medical assistance system to protect the scope of common diseases, chronic diseases in the county and rural three-tier health care institutions in a timely manner to diagnose and treat the major diseases, serious illnesses, the basic life of the basic life is still guaranteed. The establishment of a sound basic medical security system, strengthening the construction of county and village medical and health institutions, equipped with qualified medical personnel, eliminating the "blank spots" in rural and village institutions, so that the poor people have a place to see a doctor, a doctor, and a system of protection.

The guiding work standards include: medical and health institutions "three one", medical and health personnel "three qualified", medical service capacity "three lines", medical security system full coverage. (See the annex for details).

Second, strengthen the county hospital capacity building

(a) increase support. Further increase the central budget investment support, urge the local will be eligible for poverty-stricken counties (national poverty alleviation and development work focus on counties and contiguous areas of special hardship counties, hereinafter the same) county hospitals (including traditional Chinese medicine hospitals, hereinafter the same) into the scope of support for universal health protection project. Localities should implement the responsibility to invest in the transformation and improvement of county hospital facilities, equipped with basic equipment, to ensure the normal operation of county hospitals.

(ii) strengthen the counterpart help. Further clarification of the three hospitals to help goals, tasks and assessment indicators. Organization of the three hospitals to increase the depth of poverty in the county to help. Take "group" support, select and send management and technical personnel to serve as the recipient hospital president or vice president, director of nursing and discipline leaders, help team of no less than 5 people (Chinese medicine hospitals can be sent 3 people), each batch of personnel to work for a period of not less than 6 months. To help county hospitals in poor counties to strengthen the construction of clinical specialties for the local disease spectrum, to enhance the internal medicine, surgery, obstetrics and gynecology, pediatrics, emergency departments of common diseases, common diseases and some of the diagnosis and treatment of acute and critical illnesses.

(C) Promote telemedicine. To achieve full coverage of telemedicine in county hospitals in poor counties, expand the service connotation, enrich the content of the service, and effectively promote the sinking of high-quality medical resources through remote consultation, room visits, demonstration teaching, training and other forms. Further standardize telemedicine services, and gradually improve telemedicine fees and reimbursement policies.

(3) Strengthening the mechanism of "one county, one village, one country"

(4) Strengthening the training of county and village personnel. Continuing to carry out standardized training of general practitioners, assistant general practitioner training, transfer training, etc., and increase the training of free medical students in rural areas. It will continue to recruit special general practitioners for impoverished areas, and comprehensively solve the problem of the lack of practicing physicians in township health centers. Localities are being encouraged to continue the training of free medical students for village health centers. Continuing to carry out practical skills and appropriate technology training for rural doctors, and improve the ability of rural doctors to diagnose and treat common and frequent diseases and traditional Chinese medicine services.

(E) integrated use of county health human resources. Encourage the implementation of the "county hired by the county management township with" and "township hired by the village with", for township health centers and village health offices to employ qualified medical personnel. A sound system has been established for selecting and dispatching qualified medical personnel, and the problem of the lack of qualified doctors in village health units is being solved by selecting and dispatching doctors from township health centers to carry out medical rounds and stationing them there. Explore the development of provincial non-poor county hospitals to support the poverty-stricken areas of township health centers, and regularly send physicians to township health centers to practice.

(F) promote the construction of county medical **** body. Conditional places, further development of close-knit county medical **** body construction, promote medical **** in the administration, medical business, information systems and other unified operation, improve the overall performance of the county medical and health services, and gradually use the regional medical insurance fund total control instead of the total control of the specific medical institutions.

Fourth, strengthen the standardization of rural medical and health institutions

(g) Eliminate the "blank spot". Promote the local government to implement the main responsibility, increase investment, in accordance with the principle of filling in the blanks, in the period of poverty alleviation, comprehensively complete the township health centers and village health room infrastructure construction, reasonable allocation of township health centers, village health room medical equipment. The construction of Chinese medicine departments in township health centers and the allocation of Chinese medicine equipment in village health rooms will be strengthened. For poverty alleviation relocation after the formation of new administrative villages, in the local government water, electricity, network and other infrastructure construction in place before, can be set up through the temporary medical point, to provide services for the masses.

V. Strengthening the comprehensive prevention and control of diseases in poverty-stricken areas

(8) Fully implement the three-year action plan for the comprehensive prevention and control of key infectious and endemic diseases. In accordance with the "Health Poverty Alleviation Three-Year Action Plan" (State Health Financial Development [2018] No. 38), do a good job in the comprehensive prevention and control of AIDS, tuberculosis, schistosomiasis, schistosomiasis and endemic diseases such as macrosomia, and carry out the classification of patients with symptoms of life-saving treatment.

Six, safeguards

(ix) clear division of labor. Adhere to the central coordination, the province is responsible for the overall responsibility, the city and county to implement the management system, the central department is responsible for the top-level design of health policy to alleviate poverty, improve the working mechanism, clear responsibility requirements; local governments are responsible for combining the local poverty alleviation actual, formulate policies, clear standards and promote the implementation. Health administrative departments take the lead in implementing health poverty alleviation, strengthening the capacity building of county and village medical and health services, and carrying out categorized treatment, poverty alleviation departments are responsible for integrating health poverty alleviation into the overall deployment of poverty alleviation and work assessment, medical insurance departments are responsible for implementing medical insurance to alleviate poverty, and integrating the poor into the scope of coverage of the medical insurance system, and the departments of development, reform and finance are responsible for strengthening the input guarantee for health poverty alleviation.

(J) the development of implementation programs. Localities should take into account the actual situation, in accordance with the ability to solve practical problems, the poor population generally recognized, and quantifiable, realizable, assessable principles, to develop specific work standards and implementation programs, against the standards to carry out investigation, clear the bottom line, the establishment of accounts, a clear timetable, roadmap, and by the end of July 2019 will be the local specific work standards and the results of the investigation of the National Health Commission, the National Health Insurance Bureau for the preparation of the report. In principle, the province will not develop separate standards.

(xi) Increase investment support. The central financial sector to coordinate the existing funding channels in the field of health, in the distribution of health transfer funds, the "three regions and three states" and other y impoverished areas to be appropriate. Provincial and municipal-level finances will provide support for solving the outstanding problems of basic medical care. County-level finances should implement subsidies for township health centers and rural doctors in accordance with the regulations. For village health centers that serve a small population and are not sufficient to maintain normal operation according to the existing channels and subsidy standards, county-level finances will provide appropriate subsidies. Poverty-stricken counties are making good use of existing policies to support eligible projects that address the outstanding problems of basic medical care. The East-West Poverty Alleviation Collaboration, counterpart support, and targeted poverty alleviation should support the solution of the outstanding problems of basic medical care in impoverished areas. Encourage all kinds of public welfare funds, enterprises and other social forces to support the capacity building of medical and health institutions in poor areas.

Annex: basic medical care is guaranteed work standards

I. Guarantee the accessibility of basic medical care

(a) medical and health institutions "three one".

1. Each poor county to build a good county-level public hospital (including hospitals), with the appropriate functional rooms and facilities and equipment. Near or under the municipal administrative districts of poor counties, municipal public hospitals can meet the needs of the local reality can not set up a separate county hospital.

2. Each township built a government-run health centers, with the appropriate functional rooms and facilities and equipment, able to undertake the diagnosis and treatment of common diseases, acute and critical patients initial on-site first aid and referrals and other duties.

3. Each administrative village to build a health room, with the appropriate functional rooms and facilities and equipment, able to carry out basic medical and health services. Smaller populations or smaller administrative villages can be set up jointly with neighboring administrative villages village health room, township health centers located in administrative villages may not set up village health room.

(B) medical technicians "three qualified".

1. Each county hospital has at least one qualified medical practitioner for each specialized department.

2. Each township health center has at least one qualified licensed (assistant) physician or general practitioner.

3. Each village health center has at least 1 qualified village doctor or licensed (assistant) physician.

(C) medical service capacity "three lines".

1. Poor counties with a resident population of more than 100,000 people have a county hospital (Chinese medicine hospital) to reach the second level of hospital medical service capacity.

2. Resident population of more than 10,000 township health centers to meet the "township health center management approach (for trial implementation)" (Wei Nongwei Fa [2011] No. 61) requirements.

3. The administrative village health center with a resident population of more than 800 people meets the requirements of the "Management Measures for Village Health Centers (Trial)" (State Health Grassroots Development [2014] No. 33).

Second, to ensure full coverage of the medical security system

The rural population of poor people with established records are all included in the coverage of basic medical insurance, major disease insurance, medical assistance.