Payment for the implementation of the program (for trial)
In order to further improve the province's new rural cooperative end-stage renal disease and other six kinds of major diseases, medical security work, in the summary evaluation of rural children's leukemia, congenital heart disease on the basis of payment for the pilot work, combined with the actuality of the province, decided to carry out the new rural cooperative in the province. Hop end-stage renal disease and other six kinds of major diseases and improve the level of medical protection, specially formulated this implementation program.
I, the new rural cooperative pay per case major disease disease range
1, end-stage renal disease: specific reimbursement for the disease: chronic renal failure (uremia).
2. Women's "two cancers": breast cancer and cervical cancer.
3. Severe mental illness: including schizophrenia, manic psychosis, bipolar disorder, paranoid psychosis, epilepsy with mental disorder, mental retardation with mental disorder.
4. Multidrug-resistant tuberculosis.
5. AIDS opportunistic infection. Specific reimbursement categories are:
(1) Bacterial infections. Bacterial pneumonia, bacterial enteritis, sepsis, bacterial meningitis.
(2) Viral infections. cmv retinitis, herpes simplex virus infection, herpes zoster virus infection.
(3) Parasitic infections. Toxoplasmic encephalitis, cryptosporidiosis.
(4) Fungal infections. Pneumocystis carinii pneumonia (PCP), oral and esophageal Candida infections, cryptococcal meningitis.
Two, designated treatment hospitals
The provincial Department of Health selects the New Rural Cooperative designated hospitals with strong service capacity, good diagnostic and treatment conditions, and high technical level as the designated treatment hospitals for major diseases in Guizhou Province, to ensure the medical safety and quality of medical treatment for patients with major diseases.
The way of determining the designated treatment hospitals for major diseases in Guizhou Province: all the designated medical institutions of the New Rural Cooperative at all levels that meet the conditions of the designated treatment hospitals for relevant major diseases (Attachment 1) shall, according to the principle of voluntary declaration, apply to their respective administrative departments of health or the management institutions of the New Rural Cooperative, and then report to the Provincial Department of Health at all levels after the initial examination by their respective administrative departments of health or the management institutions of the New Rural Cooperative, which shall, according to the principles of voluntary declaration, report to the provincial department of health. According to the relevant major diseases designated treatment hospital conditions and take into account the actual capacity of the hospital to determine the list of major diseases designated treatment hospitals in Guizhou Province.
The first batch of hospitals designated for treatment of end-stage renal disease and other six major diseases under the New Rural Cooperative is shown in Appendix 2.
Three, the scope of compensation, methods and compensation standards
(a) Patients who meet the following conditions are included in the scope of payment for major diseases
1, the patient must participate in the New Rural Cooperative.
2, the patient's diagnosis of disease and the main treatment must also meet the scope of major diseases under this program.
3. The patients shall be treated in the hospitals designated for the treatment of the relevant major diseases.
4. The current hospitalization (or outpatient) medical expenses incurred by the patient in accordance with the prescribed treatment methods.
(2) The following medical expenses of patients with major diseases are not included in the scope of payment for major diseases
1. The medical expenses incurred by patients with major diseases who are not treated in the relevant hospitals designated for the treatment of major diseases, or who are not treated according to the provisions of this program, or who are hospitalized again (or on an outpatient basis) because of intensive maintenance treatment, are not included in the scope of payment for major diseases, and are compensated according to the original compensation plan of the New Rural Cooperative Coordination Area. The original compensation program in the region will be compensated.
2. Within one year of participation, patients with major diseases can only enjoy the compensation policy of this program once for the same disease process (referring to the same diagnosis and the same treatment), and the medical expenses incurred for re-hospitalization will be compensated in accordance with the original compensation program of the New Rural Cooperative Coordination Area.
3. Patients with major diseases whose main costs have been reduced or exempted by other programs are no longer entitled to the compensation policies stipulated in this program, and the remaining costs are compensated in accordance with the original compensation program of the New Rural Cooperative Coordination Area.
(C) average medical cost of major diseases fixed standard and payment
1, based on "Guizhou Province, end-stage renal disease and other six major diseases standardized diagnosis and treatment program (2012 version)" (issued in a separate document) and the level of medical costs in recent years, to determine the average cost of major diseases of the fixed standard of medical costs (hereinafter referred to as the fixed standard), and the implementation of instant settlement.
(1) End-stage renal disease.
Patients diagnosed with chronic renal failure (uremia) who are suitable for peritoneal dialysis or hemodialysis treatment, on the premise of voluntariness, and with indications for surgery, will undergo "autologous arterial-venous endovascular fistulas" to establish peritoneal dialysis or hemodialysis access, and the outpatient medical cost will be 0.3 million yuan per case, and the inpatient medical cost will be 1.5 million yuan per case. The cost of hospitalization is RMB 15,000 per case, and the cost of peritoneal dialysis or hemodialysis treatment during hospitalization shall be included.
The maximum price of medical expenses for continuing hemodialysis or peritoneal dialysis, medication, examination and other treatments after discharge from the hospital is as follows:
Method of dialysis
Limit price
Number of sessions
Remarks
Hemodialysis
Below RMB 480 yuan (with a disposable hemodialysis device)
No more than 9 sessions per month.
The reimbursement includes 1 set of tubing and dialyzer (disposable), 1 person's portion of dialysis solution, 2 puncture needles, 6 bottles of saline (500 ml), anticoagulant, disinfectant consumables, and hemodialysis operation, medicine fee, and monitoring fee (including oral medicines, excluding the cost of transfusion, etc.).
Hemofiltration
Under $1000
No more than 4 times per month
Hemoperfusion
Under $1900
No more than 1 time per month
Peritoneal dialysis
Peritoneal dialysis solution $34.6/bag
4-5 bags per day
Reimbursement The cost includes: external short tubing and iodine solution mini-cap (4-5/day), sterilizing consumables, peritoneal dialysis operation, medication fee, monitoring fee (including each follow up lab fee, treatment fee, consumables 10 empty needles, 2 blood collection needles, 5 sterile culture flasks, excluding blood transfusion and other fees).
Peritoneal equilibrium test
RMB500/trip
No more than 5 times per year
Kt/V measurement
RMB500/trip
No more than 5 times per year
Replacement of short peritoneal dialysis tubing
RMB340/trip
No more than 3 times per year
Hemodialysis is RMB 95,000 per case per year and peritoneal dialysis is RMB 90,000 per case per year. Medicines include: medicines for the treatment of uremic cardiomyopathy: nitroglycerin, levocanidin, trimetazidine, isosorbide nitrate extended-release tablets; medicines for the treatment of renal anemia: erythropoietin, iron, folic acid; Vitamin B12; medicines for the treatment of renal hypertension: nifedipine tablets, captopril tablets, amlodipine benzenesulphonate extended-release tablets, nifedipine controlled-release tablets, felodipine extended-release tablets, levosulphonate amlodipine tablets, Carvedilol, Betaloc, Irbesartan, Chlorosartan; renal bone disease treatment drugs: calcium carbonate, aluminum hydroxide, alpha-osteol; uremic gastrointestinal mucosal lesions treatment drugs: Ralitidine, Omeprazole, Pantoprazole, thioglycollate aluminum preparation; hemodialysis anticoagulant and thrombolytic drugs: low molecular heparin calcium, low molecular heparin sodium, sodium heparin, urokinase.
(2) Breast cancer.
For diagnosed patients, under the premise of voluntariness, those who have surgical indications will be treated with mastectomy (including breast conserving surgery, radical mastectomy, modified radical mastectomy, etc.) (including pre-operative or post-operative chemotherapy), and the standard of the medical fee for each fixed-point medical institution will be shown in Attachment 2; those who do not have surgical indications will be directly treated with outpatient or outpatient chemotherapy, and those who have no surgical indications will be treated with outpatient or outpatient chemotherapy.
(3)Cervical cancer.
For diagnosed patients, under the premise of voluntariness, if they have surgical indications, they shall implement "radical total hysterectomy + retroperitoneal lymph node dissection (including transperitoneal laparoscopic hysterectomy)" treatment (including pre-operative or post-operative chemotherapy), and the standards of the annual medical fees for the treatment of the patients by each designated medical institution are listed in Attachment 2; and those who have no surgical indications shall directly implement outpatient or inpatient chemotherapy. Direct implementation of outpatient or inpatient chemotherapy, radiotherapy or post-operative need to implement outpatient or inpatient chemotherapy, radiotherapy, the designated medical institutions per year, chemotherapy, radiotherapy throughout the medical cost standards see Annex 2.
(4) severe mental illness.
Patients diagnosed with schizophrenia, manic psychosis, bipolar disorder, paranoid psychosis, epilepsy accompanied by mental disorders, mental retardation (accompanied by mental disorders) shall be subject to standardized inpatient treatment:
1) For inpatient hospitalization costs for severe mental illnesses with a hospitalization period of 31-75 days, the cost of inpatient hospitalization in tertiary and above specialized hospitals shall be RMB 0.8 million per case/trial; for tertiary and above specialized hospitals, it shall be RMB 0.8 million per case/trial. /For Level 3 and above specialized hospitals, it is RMB 0.8 million per case/trip; for Level 3 and above general hospitals, it is RMB 0.7 million per case/trip; for Level 2 specialized hospitals, it is RMB 0.6 million per case/trip; for Level 2 general hospitals and Level 1 specialized hospitals, it is RMB 0.5 million per case/trip.
②No matter what the reason, patients with severe mental illness, the current hospitalization time ≤ 30 days and hospitalization costs do not reach the fixed standard, according to the actual incurred hospitalization medical expenses.
③ Whatever the reason, patients with severe mental illness are hospitalized for >75 days at a time, and the medical expenses incurred from the 76th day onwards are counted as another hospitalization expense and compensated in accordance with the original compensation plan of the coordinated area.
④ After reaching the clinical cure standard and being discharged from the hospital, if the condition requires continued outpatient treatment, the costs of outpatient medication and examination will be included in the scope of compensation for the outpatient major illnesses under the NPHC.
(5) Multidrug-resistant tuberculosis.
Multidrug-resistant tuberculosis (ICD-10: A15.0, A15.1) is subject to outpatient or inpatient standardized treatment. The cost of outpatient treatment, inpatient treatment, the cost of continuing outpatient treatment with injections or oral medication after discharge, and regular checkups are standardized at RMB 18,000/case/year.
(6) AIDS opportunistic infection.
Confirmed bacterial infections (bacterial pneumonia, bacterial enteritis, sepsis, bacterial meningitis), viral infections (CMV retinitis, herpes simplex virus infection, herpes zoster virus infection), parasitic infections (toxoplasmic encephalitis, cryptosporidiosis), and fungal infections (Pneumocystis carinii pneumonia (PCP), oral and esophageal Candida infections, cryptococcus meningitis) Patients with AIDS opportunistic infections are subject to standardized treatment, with inpatient medical costs of RMB 0.3 million/case/times, and should be discharged when they reach the standard of clinical cure. If the disease requires continued outpatient treatment, the costs of outpatient medication and examinations are included in the scope of outpatient compensation for major diseases under the New Rural Cooperative.
2, the new rural cooperative fund payment. In accordance with the fixed standard determined in the preceding paragraph, the new rural cooperative fund pays 90% for end-stage renal disease, and the new rural cooperative fund pays 80% for the rest of the diseases, and implements a fixed payment (packaged payment) for each case of major disease inpatient (or outpatient) patients.
3. Payment for patients with major diseases. Based on the approved fixed standardized medical expenses for each major disease category, patients with end-stage renal disease will pay for the expenses borne by individuals according to the 10% out-of-pocket ratio and the remaining patients with major diseases will pay for the expenses borne by individuals according to the 20% out-of-pocket ratio. Patients who are eligible for medical aid, after the payment of the New Agricultural Cooperative payment by disease, the out-of-pocket part of the cost of the aid in accordance with the local standards for aid.
4, the new rural cooperative fund for patients with major diseases fixed compensation, no starting line, not subject to the new rural cooperative reimbursement of drugs and diagnostic and treatment items directory, and not subject to the patient's year of the new rural cooperative fund maximum cap line control.
5. For special reasons such as automatic discharge, transfer, death, etc., patients with major diseases who withdraw from the main treatment and whose medical expenses do not reach 50% of the fixed standard, the actual hospitalization medical expenses incurred shall be paid by the NAC Fund and patients with major diseases in the proportion of 80% and 20%, respectively.
6, the rationality of ultra-clinical path treatment cost approval, for cases that really need to be out of the clinical path of treatment or need to cooperate with the treatment outside the clinical path, by the designated medical institutions to fill out the "Guizhou Province, rural residents of the cost of treatment costs of major diseases cost overruns in the case of cost application form" (Annex 3), at the end of the year to the Provincial Office of the examination and approval of the provincial cooperation of the Office of the Medical Office of the regular organization of experts on the ultra-clinical path of the treatment cost of rationality for examination and approval. The provincial cooperative medical office regularly organizes experts to examine and approve the reasonableness of the treatment cost of super clinical pathway. The number of cases of the same type of disease for which a designated medical institution applies for the rationalization of ultra-clinical pathway shall not be higher than 5% of the total number of cases of the type of disease treated in the hospital.
Four, outpatient, hospitalization, reimbursement and settlement process
(a) patients with major diseases to bring the certificate of participation (or card), ID card (or hukou) and so on to the fixed-point treatment hospitals (where the documents are not all the patients with major diseases, must go back to the local New Rural Cooperative coordinating regional agencies for the relevant participation and age of the certificate), diagnosed with the scope of the major diseases by the payment of illnesses. The attending physician will fill out the "Diagnosis of Major Diseases in Guizhou New Rural Cooperative Medical Care" (Annex 4), and the designated treatment hospital will review the patient's enrollment status, mark "major diseases in NRCM", and manage the patients according to the category of major diseases. For patients with major diseases requiring hospitalization, an admission notice is issued. Patients with major diseases that do not require hospitalization but are treated on an outpatient basis (e.g., end-stage renal disease, women's "two cancers" radiotherapy, multidrug-resistant tuberculosis, etc.) are treated on an outpatient basis.
(2) When patients with major diseases are hospitalized for treatment, they shall pre-pay the hospitalization fee at 20% of the fixed standard of the disease; when patients with major diseases are discharged from the hospital, they shall settle the individual out-of-pocket expenses at 20% of the actual medical expenses of the hospitalization at that time, and the pre-paid hospitalization fee shall be more than refunded and less than compensated. Outpatient treatment according to the patient and the medical institutions to sign an agreement, pay the required out-of-pocket expenses in installments.
(C) designated treatment hospitals in strict accordance with the "Guizhou Province, end-stage renal disease and other six major diseases standardized diagnosis and treatment program (2012 version)" diagnosis and treatment. The end of diagnosis and treatment, complete fill out (or HIS system automatically generated) two copies of "Guizhou Province, major diseases of the New Rural Cooperative Compensation Settlement Statement" (automatically generated by the New Rural Cooperative Information System), signed, stamped with the official seal of the department and then submitted to the hospital Agricultural Cooperative Office. The Agricultural Cooperation Office of the hospital audits and seals (one copy to be kept, and one copy to be submitted to the patient's local New Rural Cooperative Compensation Coordination Area Agency at the time of settlement), and reports the information on medical services and fund compensation for major diseases in accordance with the relevant regulations. For outpatient dialysis for end-stage renal disease, chemotherapy and radiotherapy for women's "two cancers", and multidrug-resistant tuberculosis patients, the designated hospitals first sign a treatment agreement with the patients for one year or the entire cycle, and the hospitals submit the agreement to the coordinating regional agency of the New Rural Cooperative in the patient's locality, which then preallocates a fixed amount of fees to the designated hospitals.
(d) The designated treatment hospitals apply for the new rural cooperative settlement. Sentinel treatment hospital agricultural cooperation office to submit patients with major diseases ① "Guizhou Province, the major diseases of the new rural cooperative compensation settlement"; ② discharge summary (outpatient treatment of end-stage renal disease, women's "two cancers" radiotherapy, multidrug-resistant tuberculosis patients need to be outpatient treatment summary); ③ full-cost invoices, regularly to the patient's location of the new rural cooperative coordinated area The new rural co-ordination area of the patient's local organization to apply for the allocation of the new rural co-ordination fund should be fixed amount of expenses.
(5) After receiving the information on the application for settlement of major diseases from the designated treatment hospitals, the coordinating regional New Agricultural Cooperation agencies will complete the examination within 10 working days and disburse the funds to the designated treatment hospitals in accordance with the standard of fixed payment from the New Agricultural Cooperation Fund.
V. Organization and management
(a) the provincial health department to determine the scope of major diseases, designated treatment hospitals, fixed standard, the New rural cooperative fund payment ratio, out-of-pocket ratio, hospitalization and compensation settlement process. Monitoring and regular evaluation of the actual level of medical costs of major diseases, with the actual level of costs of major diseases, high-value consumables prices, medical service price standards and other major adjustments or changes in timely adjustment of the quota standard, the establishment of the quota standard dynamic adjustment mechanism.
(ii) the provincial health department according to the ministry of health clinical path or diagnosis and treatment norms, the organization of the provincial expert group to develop "Guizhou province end-stage renal disease and other six major diseases standardized diagnosis and treatment program (2012 version)"; the provincial rural cooperative medical management office based on the standardized diagnosis and treatment of major diseases and medical service agreement, the designated rescue hospital service behavior of day-to-day supervision.
(3) The designated treatment hospitals should strictly review and confirm the patients' enrollment status, actual age and whether they meet the scope of major diseases. Patients who do not meet the scope of major diseases should do a good job of explaining the policy. The hospitals shall undertake to strictly follow the "Guizhou Province Standardized Diagnosis and Treatment Program for End-stage Renal Disease and Other Six Major Diseases (2012 Edition)", standardize the behavior of medical services and charges, ensure medical safety and quality, and take the initiative to accept supervision. The designated treatment hospitals shall not refuse to accept or shirk the patients with critical and major diseases; shall not upgrade or replace the diseases (or treatments) outside the scope of major diseases with the diseases (or treatments) within the scope of major diseases, which will increase the expenditure of the New Agricultural Cooperative Fund; shall not reduce the diagnostic and treatment items and services included in the standardized diagnostic and treatment plan for major diseases to the detriment of the patients' interests; shall not include the medical fees for standardized diagnostic and treatment plans for major diseases through outsourced prescriptions, purchasing of medicines and other medical fees; and shall actively supervise and monitor the medical services and charges. Medical costs through outsourcing prescription, outpatient prescription, outpatient examination, outpatient examination, decomposition of hospitalization, decomposition of costs and other ways to be excluded from the current hospitalization medical costs, so that the patient to pay out of pocket, increasing the economic burden on patients.
(d) designated treatment hospitals in violation of the provisions of the preceding paragraph, respectively, according to the cumulative disease, to cause the patient's medical costs increased in 10,000 yuan or less or cause the loss of the New Rural Cooperative Fund of 10,000 yuan or less, in addition to the recovery of the loss of funds (funds), the provincial health department to give a notice of criticism, and ordered to rectify the situation; on the cause of the patient's medical costs increased in 10,000 yuan (including) or more or cause the loss of the New Rural Cooperative Fund in 10,000 yuan (including) or more. (Including) above, in addition to recovering the loss of funds (fund), the provincial health department in accordance with the law to suspend or cancel the disease designated treatment hospital qualification and other serious treatment, and announced to the community.
(E) the integrated area of the new rural cooperative agencies to widely publicize, inform the participating farmers of the scope of major diseases, designated treatment hospitals, management and compensation policies, and actively guide patients with major diseases to designated treatment hospitals; is responsible for auditing and settlement of patients with major diseases of the New Rural Cooperative flat-rate compensation, simplify the relevant procedures, and timely disbursement of funds advanced to the designated treatment hospitals.
(F) The implementation of the program by the Provincial Rural Cooperative Medical Management Office is responsible for the interpretation of the implementation of March 1, 2013 (i.e.: March 1, 2013 before the admission of patients with major diseases in accordance with the Qianwei Office of the [2011] No. 183 implementation).
Attachments (attached):
1. Conditions of hospitals designated for treatment of end-stage renal disease and other six major diseases in Guizhou Province
2. List of the first batch of hospitals designated for treatment of end-stage renal disease and other six major diseases under the New Rural Cooperative Medical Scheme (NRCMS) in Guizhou Province
3. Application form for cases of over-expenditure on the costs of treatment of major diseases for rural residents in Guizhou Province
4. Application form for cases of over-expenditure on the costs of treatment of major diseases in Guizhou Province
4. New Rural Cooperative Medical Care (NRCM) Major Disease Diagnosis Confirmation Form
5. Guizhou New Rural Cooperative Medical Care (NRCM) Major Disease Compensation Settlement Form
Attachment 1
Qualifications of hospitals designated to provide relief treatment for six major diseases, including end-stage renal disease, in Guizhou Province
1.1 Qualifications of hospitals designated to provide relief treatment for end-stage renal disease (uremic syndrome)
Haemodialysis
I, Qualification of Hemodialysis Unit: The unit that carries out hemodialysis treatment must be a medical institution approved by the health administrative department and is required to undergo regular quality control and inspection every year.
(1) County hospitals carrying out hemodialysis must have five or more hemodialysis machines, and level 3 hospitals must have 10 or more hemodialysis machines (if the hardware does not meet the standard, it needs to be rectified within six months and then re-declared). Hospitals must have 20 or more internal medicine bed units with related resuscitation facilities.
(2) blood purification room structure and layout: blood purification room should be reasonably laid out, clean and contaminated areas and their channels must be separated, must have the functional areas include clean area: health care personnel office and living area, water treatment room, liquid dispensing room, clean the warehouse; semi-clean area: dialysis preparation room (treatment room); contaminated area: dialysis treatment room, waiting room, dirt treatment room, etc..
(3) Blood purification room management procedures: registration and management of dialysis medical records, management of dialyzer reuse.
(4) Management requirements for infection control in blood purification centers (see the 2010 edition of the Standard Operating Procedures for Blood Purification Management for 11 requirements).
Two, blood purification room staff standards: blood purification room must have qualified doctors and nurses. The staff of the dialysis room should achieve the relevant conditions for engaging in hemodialysis through professional training before they are allowed to work.
(1)Doctor: 1 doctor must have the title of attending physician (more than 2 years of work experience in the hemodialysis room) and above specialized in nephrology, and participate in hemodialysis training regularly every year. Long-term vascular access establishment procedures must be performed by a doctor with appropriate qualifications.
(2) Nurses: Nurses are equipped according to the number of dialysis machines and patients, and each nurse is responsible for the operation and observation of up to five dialysis machines at the same time, i.e., nurses and dialysis machines are equipped in the ratio of 1:5; and they participate in hemodialysis training regularly every year.
(3) Engineering and technical personnel: blood purification centers with more than 20 dialysis machines should be equipped with at least one full-time engineering and technical personnel.
Peritoneal dialysis
I. Layout of peritoneal dialysis room structure
(1) physicians, nurses office area
(2) receiving area
(3) training area
(4) operation and treatment area: a thermostat; spring scales or baby scales (weighing dialysate); weighing scales;
Infusion racks (hanging peritoneal dialysis fluid); infusion racks (hanging peritoneal dialysis fluid); and a peritoneal dialysis room. Dialysis solution); treatment trolley; hand-washing sink; ultraviolet lamp; wall clock; covered bucket; sphygmomanometer; diagnostic beds; oxygen supply device; central negative pressure interface or equipped with; resuscitation trolley (containing the necessary items and medicines for resuscitation).
(5)Operating room
(6)Dirt treatment area
(7)Storage area: the storage area is used to store peritoneal dialysis medical records, peritoneal dialysis fluid and consumables and other areas. It should be in line with the hospital disinfection health standards (GB15982-1995) in the provisions of the Ⅲ environment (ibid.), and keep ventilated, light and dry.
Two, peritoneal dialysis treatment professional qualifications
(1) Physician: should hold a physician's qualification certificate and physician's practice certificate, more than two physicians have been trained in nephrology specialties and peritoneal dialysis special technical training. The physician in charge of peritoneal dialysis tubing is a trained nephrologist or surgeon familiar with peritoneal dialysis tubing technology.
(2) Nurses: they should hold nurse qualification certificates and nurse practice certificates, and have undergone systematic theoretical and clinical training in peritoneal dialysis for more than 3 months. Peritoneal dialysis unit (center) outpatient follow-up patients in 20 ~ 30 cases or more require a full-time peritoneal dialysis physician and a full-time nurse, every additional 50 patients need to increase the number of full-time nurses. For every additional 80 patients, one additional full-time physician is required. The number of full-time physicians and nurses should be increased according to the number of peritoneal dialysis inpatients.
Three, peritoneal purification room management procedures
(1) medical records management: equipped with computers and Internet access; dialysis medical records by the medical institutions in accordance with the relevant requirements of unified preservation.
(2) Follow-up system: telephone follow-up; home visit; outpatient follow-up; hospitalization follow-up.
1.2 Conditions for Breast Cancer Treatment Designated Medical Institutions
I. Basic conditions: Department settings, beds and operating room conditions meet the standards of general hospitals of Grade 2 or above, and there are specialized outpatient clinics.
Second, personnel requirements: major surgery at least one chief physician or deputy chief physician two. The department should have two to three people with half a year and more specialty training experience, at least one person each year to participate in a symposium experience.
Three, equipment requirements: 1, an ultrasound probe in 7.5 megahertz or more high-frequency color Doppler ultrasound diagnostic equipment; 2, a digital mammography X-ray machine; 3, a breast biopsy of the coarse needle puncture system (including Bard puncture tissue biopsy instrument or McMurray breast biopsy system); 4, a 1.5T breast MRI (not required).
Fourth, the technical requirements: 1, the Department of Pathology can carry out rapid frozen pathology diagnosis and routine pathology diagnosis, personnel have the relevant qualifications, specialized training experience, can produce relatively credible pathological diagnosis and breast cancer-related immunohistochemistry results, and have the appropriate quality control system. Or those who do not have the above diagnostic conditions, but have fixed procedures and corresponding systems to send the specimens to other medical institutions for diagnosis, and the sending institutions must have relevant qualifications.2. Clinical specialists Doctors can standardize diagnosis and treatment (including diagnosis, differential diagnosis and treatment, in accordance with "Breast Cancer Diagnostic and Treatment Guidelines (2011 Edition)" issued by the Ministry of Health) of breast cancer patients.3. Basic equipment (e.g. linear accelerators) to carry out radiation therapy. Hospitals with basic equipment for radiotherapy (such as linear gas pedals) shall obtain the Radiotherapy License and the Large Medical Equipment Configuration License in accordance with the law. Specialized doctors and radiotherapy technicians have the relevant qualifications to carry out standardized radiotherapy, and the basic technical management of radiotherapy is in line with the requirements of the Measures for the Administration of the Clinical Application of Medical Technology.4. If there are no conditions for radiotherapy and chemotherapy, there should be a corresponding referral system, so that patients with indications for radiotherapy and chemotherapy can receive the relevant treatment.
1.3 Conditions of designated medical institutions for cervical cancer treatment
I. Basic conditions: general hospitals of Grade 2A or above with specialized outpatient clinics.
Second, personnel requirements: the gynecology department has at least one chief physician or two deputy chief physicians. The Department of Gynecology is able to carry out various diagnostic techniques and methods for cervical cancer, and is able to carry out various standardized surgeries and chemotherapies for cervical cancer, and the discipline leader has participated in more than half a year's specialty training, and someone participates in a relevant study once a year;
Third, the technical requirements: 1. The Department of Pathology is able to carry out TCT, intra-operative freezing, and pathological diagnosis of cervical cancer, and the personnel have relevant qualifications, have experience in specialty training, and are able to issue a relatively credible Pathology diagnosis and cervical cancer related immunohistochemistry results, and have corresponding quality control system. Or those who do not have the above diagnostic conditions, but have fixed procedures and corresponding systems to send the specimens to other medical institutions to make diagnosis, and the sending organizations must have relevant qualifications. 2、Operating room: it has laminar flow operating room with corresponding standardized management and ICU ward.3、Hospitals with basic equipment for radiotherapy (such as linear gas pedal) should obtain the "Radiotherapy License" and "Large-scale Medical Equipment Configuration License" in accordance with the law. Specialized doctors and radiotherapy technicians have relevant qualifications and can carry out standardized radiotherapy, and the basic technical management of radiotherapy is in line with the requirements of the Measures for the Administration of Clinical Application of Medical Technology. 4. If there are no conditions for radiotherapy or chemotherapy, there should be a corresponding referral system so that patients with indications for radiotherapy or chemotherapy can receive relevant treatment.
1.4 Conditions of designated medical institutions for multidrug-resistant tuberculosis
I. Medical institutions of the third level or above, with tuberculosis departments approved and registered.
Second, the hospital can routinely carry out culture of Mycobacterium tuberculosis, identification of bacilli, and drug sensitivity testing of first- and second-line anti-tuberculosis drugs, and can carry out PCR Mycobacterium tuberculosis testing and drug-resistance gene testing.
Three, the hospital tuberculosis department has a perfect disciplinary setup and academic echelon; the expert team has senior title personnel; can carry out standardized treatment for multidrug-resistant patients.
Four, the relevant departments are well set up.
1.5 AIDS opportunistic infections treatment designated medical institutions conditions
I, infectious disease hospitals;
Two, with infectious disease area (section) of the general hospital;
Three, with the conditions of admission of infectious disease hospitals.