In this game, public hospitals can be called the main force. This is the same at home and abroad.
Zoomed into the entire public **** health system, public hospitals in the system in what position? In the construction of the system and what role should play? What kind of responsibility?
At the 2020 Health Summit, which was officially launched on July 20, a sub-forum of the International New Healthcare section - "The Mission of Public Hospitals in the Construction of the Public **** Health System" - gave the answer.
The sub-forum was moderated by Fu Qiang, deputy director of the Health Development Research Center of the National Health Commission (NHRC), and featured speakers Francois Cremieux, vice president of the Paris Public Hospitals Group, Fang Laiying, vice president of the China Hospital Association, and Huang Erdan, director of the Health Service System Research Department of the Health Development Research Center of the NHRC.
Public hospitals at the center of the joint fight against the epidemic
Paris Public Hospital Group is the largest public hospital "medical association" in France and even in Europe, with 37 public hospitals and as many as 92,000 employees.
When the epidemic came, the Paris public hospital group not only formed a linkage within the major hospitals, but also with community hospitals and major private hospitals to combat the epidemic.
Francois Cremieux, vice president of the Paris public hospital group, said it was on the basis of the experience provided by Chinese health care workers that they were relatively "prepared" for the outbreak in the greater Paris area in early March.
According to Francois Cremieux, the hospitals of the Paris public hospital group began to prepare in early January. The first step was to stock up on anti-epidemic supplies and increase the number of beds. Second, the training of health care workers, focusing on ICU doctors and nurses in February, and then expanding to all health care workers a few weeks later.
After the outbreak, all new cases of coronary pneumonia were first admitted to public hospitals. After that, the number of patients became too large, and the Paris public hospital group organized and coordinated with other types of health care institutions, such as private hospitals, to increase capacity. "If public hospitals don't go to organize and coordinate, it's hard to say that other types of healthcare institutions are actively involved in the fight against the epidemic." FrancoisCremieux said.
As more and more patients were admitted, the Paris public hospitals realized that 95 percent of the patients did not actually need to be treated in a hospital, but could simply be treated at a community health facility or at home. So the Paris public hospital group joined forces with community health care organizations to provide care for patients with mild cases of new coronary pneumonia.
Public hospitals are the key to a universal prevention system
In addition to organizing and coordinating other health care institutions in the fight against the epidemic, public hospitals need to play a more important role in the universal prevention system.
In the view of Fang Laiying, vice president of the China Hospital Association, after this epidemic, hospitals need to pay more attention to universal precautions for the following reasons:
1. Hospitals are a key source of information about infectious diseases and many public **** health events, which are often found in the clinic;
2. The hospital is the "whistleblower," the initial evoker of the emergency response system;
3. One of the key components of emergency management response, the vast majority of public **** health incident response requires clinical support;
4. General emergency response is not just about the public **** health system, but about hospitals being a strategic force in keeping the community functioning.
Therefore, in a universal prevention system, hospitals must first take the initiative to discover information, make prognoses with professionalism, make decisions based on respect for science, and take the initiative to speak out and "speak in words that the public understands."
Fang Laiying said that public hospitals, as the main voices in major epidemics, need to take an active role in guiding public opinion. This is not only conducive to building a positive image of medical staff and a good doctor-patient relationship, but also to promoting the public's physical and mental health and social stability.
Integration of preventive and curative medicine
Public hospitals need to be preventive, but also curative.
On how hospitals can integrate preventive and curative medicine, Huang Erdan, director of the Health Service System Research Department at the Health Development Research Center of the National Healthcare Commission, believes that hospitals should focus on grasping the principle of combining peace and war and improving their capabilities. Based on the usual, make up the short board at the same time, we should focus on wartime, co-ordinate the emergency state of health care institutions mobilization response, regional linkage, personnel mobilization, and improve the grading, stratification, streaming of the major epidemic rescue and treatment mechanism.
Huang Erdan gave seven specific recommendations.
1. Integrate prevention and emergency care with disciplinary orientation: start with medical care, teaching, research, prevention and health emergency.
2. Integrate prevention and emergency care with various plans: plans for career development, disciplines, science and technology, human resources, infrastructure and medical equipment.
3. Integration of prevention and emergency care functions with major projects: upgrading the service capacity of key diseases such as oncology, cardiovascular, cerebrovascular and respiratory systems. For example, with the purpose of specialty service capacity improvement, to carry out difficult disease diagnosis and treatment capacity improvement project; with the purpose of improving the public **** health prevention, control and treatment capacity, to carry out infrastructure construction projects.
4. Integrate prevention and first aid with refined management: optimize process management, improve standardization, refinement and informationization; optimize personnel, position and salary management; strengthen planning budget and planning monitoring to ensure landing.
5. Integrate prevention and emergency care with system construction: two-tier, six-tier integrated healthcare service system.
6. Strengthening financial management and financial input guarantee: 40% of the income balance of the regional medical center is used for employee welfare, 60% for teaching and research; based on the job setup, increase the financial guarantee for personnel funding; infrastructure investment is borne by the treasury; and the government purchases the medical center's public **** services.
7. Improve the governance structure to ensure: enhance the autonomy of operation and management, based on the needs of business development to open new projects, new technologies, the implementation of the price filing system; strengthen the performance monitoring, enhance the proportion of hospitalization in the region of the residents of the radiation area, the proportion of the difficult and serious illnesses, the proportion of income related to the study of medical technology, etc.; improve the governance structure, clarify the beds and staffing levels, strict control of the scale, and strengthen the management of the budget.
In the discussion session of the forum, the three guests also discussed how public hospitals should balance and do a good job of preventive and curative medicine.