Improving the management, operation, input, price and regulatory system and mechanism of medicine and health, strengthening science and technology and human resources, information and the legal system, and guaranteeing the effective and standardized operation of the medicine and health system.
(viii) Establishing a coordinated and unified management system for medicine and health. The implementation of territorialization and industry-wide management. All medical and health institutions, regardless of ownership, investment, affiliation and nature of business, by the local health administrative departments to implement unified planning, unified access, unified supervision. The central and provincial levels can set up a small number of medical research, teaching function of the medical center or regional medical center, as well as undertake the national or regional diagnosis and treatment of difficult diseases, such as specialist hospitals and other medical institutions; counties (municipalities) are mainly responsible for organizing the county hospitals, rural health and community health services; the rest of the public hospitals by the city is responsible for organizing.
Strengthening regional health planning. People's governments at the provincial level set standards for the allocation of health resources, and organize the preparation of regional health planning and medical institution setup planning, specifying the number, scale, layout and functions of medical institutions. Scientific formulation of township health centers (village health centers), community health service centers (stations) and other primary health care institutions and hospitals at all levels of construction and equipment configuration standards. Make full use of and optimize the allocation of existing medical and health resources; medical institutions that do not meet the requirements of the plan should be gradually integrated; strictly control the allocation of large-scale medical equipment; encourage *** to build *** to enjoy, and improve the efficiency of the use of medical and health resources. New health resources must be in line with regional health planning, focusing on weak areas such as rural and community health. Strengthening the interface between regional health planning and urban and rural planning, land use master planning and so on. Establishing a mechanism for monitoring and evaluating regional health planning and resource allocation.
Promoting the reform of the management system of public hospitals. From the point of view of conducive to strengthening the public welfare of public hospitals and the effective supervision of the government, and actively explore the separation of government affairs, management and operation of the separation of the realization of a variety of forms. Further transformation of government functions, the health administrative department is mainly responsible for health development planning, qualification access, norms and standards, service supervision and other industry management functions, other relevant departments in accordance with their respective functions to manage and provide services. The implementation of public hospitals independent legal person status.
Further improving the basic medical insurance management system. The central government uniformly formulates the framework and policies of the basic medical insurance system, while local governments are responsible for organizing, implementing and managing the system, and creating conditions to gradually raise the level of coordination. Basic medical insurance management resources are effectively integrated, and the administrative management of basic medical insurance in urban and rural areas is gradually unified.
(ix) Establishing an efficient and standardized mechanism for the operation of medical and health institutions. The revenues and expenditures of public **** health institutions are all included in budget management. In accordance with the responsibilities and tasks undertaken, the government reasonably determines staffing, salary levels and funding standards, clarifies the duties of various types of personnel, strict access to personnel, strengthens performance evaluation, establishes a system of employment that allows for entry and exit, and improves efficiency and service quality.
Transforming the operation mechanism of primary health care institutions. Government-organized urban community health service centers (stations) and township health centers and other primary health care institutions, to strictly define the function of the service, and clearly stipulate the use of appropriate technology, appropriate equipment and basic medicines, to provide low-cost services for the general public, to maintain the nature of the public good. Staffing levels should be strictly authorized, a system of staff employment should be implemented, and a human resources management system should be established that allows for entry and exit and provides effective incentives. It is necessary to clarify the scope and standards of income and expenditure, implement the financial management method of approved tasks, approved income and expenditure, and performance appraisal and subsidies, and explore the implementation of a variety of proven management methods, such as the two lines of income and expenditure, and the total prepayment of public *** health and medical insurance funds, so as to strictly manage the budget of income and expenditure and improve the efficiency of the use of funds. The drug mark-up policy should be reformed, and zero-differential-rate sales of drugs should be implemented. Internal management should be strengthened and improved, and an assessment and incentive system centered on service quality and based on job responsibility and performance should be established to form a long-term mechanism to guarantee fairness and efficiency.
Establishing a standardized public hospital operation mechanism. Public hospitals should follow the nature of public welfare and social efficiency principles, adhere to the patient-centered, optimize the service process, standardize the use of drugs, inspection and medical behavior. Deepen the reform of the operating mechanism, establish and improve the hospital corporate governance structure, clarify the responsibilities and powers of the owners and managers, the formation of decision-making, implementation and supervision of mutual checks and balances, there are responsibilities, incentives, constraints, competition, and vitality of the mechanism. Promote the separation of medicine and actively explore a variety of effective ways to gradually reform the mechanism of compensating doctors with medicines. Gradually reform or abolish the policy of drug markups through the implementation of differential markups for the purchase and sale of medicines, the establishment of medicinal service fees, and other means, while taking measures to improve the compensation mechanism for public hospitals by appropriately adjusting the price of medical services, increasing government investment, and reforming payment methods. The financial and accounting management system should be further improved, budget management should be strictly enforced, and financial supervision and operational oversight should be strengthened. Localities may, in the light of local realities, carry out pilot projects for hospitals that are in a position to do so, using a variety of management methods, such as "approving income and expenditure, offsetting expenditure with income, paying over the excess, subsidizing the difference, and separating rewards and penalties". Reform of the personnel system, improve the distribution of incentive mechanisms, the implementation of the employment system and job management system, strict management of the total wage, the implementation of the quality of service and job workload-based comprehensive performance appraisal and job performance pay system, and effectively mobilize the enthusiasm of medical personnel.
Soundly improving the operation mechanism of medical insurance agencies. Improve the internal governance structure, establish a reasonable employment mechanism and distribution system, improve the incentive and constraint mechanism, and improve the management capacity and management efficiency of the medical insurance administration.
(j) Establishing a government-led multi-dimensional health investment mechanism. Clearly define the responsibilities of the government, society and individuals in health investment. Establish the government's leading role in providing public **** health and basic medical services. Public **** health services are mainly financed by the government and provided equally to urban and rural residents. Basic medical services are reasonably cost-shared among the Government, society and individuals. Specialized medical services are paid for directly by individuals or through commercial health insurance.
Establishing and improving the government's health investment mechanism. Both the central government and local governments should increase their investment in health, taking into account both the supply side and the demand side. Gradually increase the proportion of government health investment in total health costs, so that the burden of basic medical and health care costs on individual residents is effectively reduced; the rate of increase in government health investment should be higher than the rate of increase in recurrent financial expenditure, so that the proportion of government health investment in recurrent financial expenditure is gradually increased. New government health investment focuses on supporting public **** health, rural health, urban community health and basic medical care.
In accordance with the principle of hierarchical burden reasonably divided between the central and local levels of government health investment responsibilities. Local governments bear the main responsibility, and the central government mainly subsidizes the national immunization program, cross-regional prevention and control of major infectious diseases and other public **** health, basic medical care for urban and rural residents, as well as the construction of relevant public medical and health institutions. Increase the special transfer payments from the central and provincial governments to areas in difficulty.
Improving the government's investment mechanism for public **** health. Professional public **** health service organizations personnel funds, development and construction and operational funds by the government full arrangements, in accordance with the provisions of the service income paid to the financial account or into the budget management. Per capita public **** health funding is gradually increased, and a sound funding guarantee mechanism for public **** health services is in place.
Improving the government's input mechanism for urban and rural primary health care organizations. The government is responsible for the capital construction funds, equipment acquisition funds, personnel funds and operational funds for the public **** health services it undertakes for the township health centers and urban community health service centers (stations) that it organizes in accordance with national regulations, so as to enable them to operate normally. For all township health centers and urban community health service institutions, including those organized by social forces, government subsidies may be approved everywhere in such ways as purchasing services. The construction of village health offices is supported, and rural doctors are given reasonable subsidies for tasks such as public **** health services.
Implementing government subsidy policies for public hospitals. Gradually increase government investment, mainly for capital construction and equipment purchases, support the development of key disciplines, in line with the national provisions of the retired personnel costs and subsidies for policy losses, etc., the public **** health services and other tasks to give special subsidies to form a standardized and reasonable public hospitals government investment mechanism. Chinese medicine hospitals (ethnic hospitals), infectious disease hospitals, psychiatric hospitals, occupational disease prevention and treatment hospitals, maternity hospitals and children's hospitals are favored in terms of input policy. Strictly control the scale of construction of public hospitals, standards and lending behavior.
Improving the government's input mechanism for basic medical security. The government provides the necessary funds to support the establishment and improvement of new rural cooperative medical care, basic medical insurance for urban residents, basic medical insurance for urban workers, and urban and rural medical assistance systems. Normal funding is guaranteed for the relevant agencies.
Encouraging and guiding social capital to develop medical and health care. Actively promote the development of non-public medical and health institutions, and form a system for running medical institutions that diversifies the main body of investment and the mode of investment. We are urgently formulating and improving the relevant policies and regulations, standardizing the conditions of access for social capital, including foreign capital, to run medical institutions, and improving fair and impartial industry management policies. Social capital is encouraged to run non-profit medical institutions in accordance with the law. The State has formulated guiding opinions on the restructuring of public hospitals, and is actively guiding social capital to participate in a variety of ways in the restructuring and reorganization of some public hospitals, including hospitals run by state-owned enterprises. It is steadily promoting pilot projects for the restructuring of public hospitals, moderately reducing the proportion of public medical institutions, and forming a pattern in which public and non-public hospitals promote each other and develop together. Supporting qualified personnel to open businesses in accordance with the law, and facilitating access to medical care for the public. Improve the policies on the classification and management of medical institutions and tax incentives. Strengthen the supervision of social forces running medical institutions in accordance with the law.
Vigorously develop medical charity. Formulate relevant preferential policies to encourage social forces to set up charitable medical institutions, or to make charitable donations to medical aid and medical institutions.
(XI) the establishment of scientific and reasonable medical price formation mechanism. Standardize the management of medical service prices. The basic medical services provided by non-profit medical institutions, the implementation of government-guided prices, and the rest by the medical institutions to set their own prices. The central government is responsible for formulating medical service pricing policies and items, pricing principles and methods; the provincial or municipal price authorities, in conjunction with health and human resources and social security departments, approve the guide prices for basic medical services. Prices for basic medical services are set in accordance with the cost of services net of financial subsidies, reflecting the reasonable cost of medical services and the value of skilled labor. Services provided by medical institutions and physicians at different levels are subject to tiered pricing. Public medical institutions are standardizing the items and standards for fees, and research is being conducted to explore reforms in the way fees are charged on a case-by-case basis. A system for monitoring the prices of medical equipment and instruments, examining and reviewing the costs of therapeutic services, and periodically adjusting their prices has been established.
Reforming the drug price formation mechanism. Reasonably adjusting the scope of government pricing, improving pricing methods, increasing transparency, and utilizing price leverage to encourage enterprises to innovate on their own, and to promote the production and use of national essential medicines. For new drugs and patented drugs, a system for evaluating the economics of drugs before pricing is gradually being implemented. For generic drugs, a post-launch pricing system will be implemented, so as to curb low-level duplication of construction. Strictly controlling the price differentials in the distribution of medicines. Pilot programs such as differential markups and charges for pharmaceutical services are being implemented for hospitals to guide them in the rational use of medicines. Strengthening the control and management of prices in the circulation and use of medical consumables and implantable (intermediary) medical devices. Improve the pharmaceutical price monitoring system, standardize the independent pricing behavior of enterprises.
Actively exploring the establishment of a negotiation mechanism between medical insurance agencies, medical institutions and drug suppliers, and giving full play to the role of medical insurance in restraining medical services and drug costs.
(xii) Establishing a strict and effective regulatory system for medicine and health. Strengthen the supervision of medical and health care. Improve the health supervision and law enforcement system, and strengthen the capacity building of urban and rural health supervision organizations. Strengthen the supervision of the behavior and quality of medical and health services, improve the standards and quality evaluation system of medical and health services, standardize the management system and workflow, accelerate the development of unified disease diagnosis and treatment norms, and improve the monitoring network of the quality of medical and health services. It has also strengthened the supervision of access to and operation of medical and healthcare organizations. It has also strengthened the supervision of drinking water safety, occupational hazards prevention and control, food safety, medical waste disposal and other social and public **** hygiene. Crack down on all kinds of illegal acts that jeopardize people's health and life safety in accordance with the law.
Improve the supervision of medical insurance. It has strengthened the supervision of medical insurance administration, fund management and use, and established a mechanism for the effective use and risk prevention of medical insurance funds. Strengthening the role of medical insurance in monitoring medical services, improving the payment system, actively exploring the implementation of capitation payment, payment by type of disease, total prepayment and other methods, and establishing an effective constraint mechanism that emphasizes incentives and penalties. Strengthen the supervision of commercial health insurance and promote standardized development.
Strengthening drug supervision. Strengthen the government's responsibility for supervision, improve the construction of the regulatory system, and strictly supervise the research, production, circulation, use, price and advertisement of medicines. Implement the quality management standard for drug production, and strengthen the supervision of the production of high-risk varieties. Strictly implement the management standard for drug operation, explore the establishment of a management mode of classification and grading of drug operation licenses, and increase the supervision and sampling of key varieties. Establishing a rural drug supervision network. Strengthen government supervision of drug prices, and effectively curb inflated pricing. Standardize the clinical use of medicines, and give full play to the role of licensed pharmacists in guiding the rational use of medicines and the quality management of medicines.
Establishing a regulatory system with open information and multi-party social participation. Industry associations and other social organizations and individuals are encouraged to independently evaluate and monitor the operational performance of government departments, pharmaceutical institutions and related systems. Strengthen industry self-regulation.
(xiii) Establishing a sustainable mechanism for innovation in medicine and health science and technology, as well as a mechanism for talent protection. Promote the progress of medicine and health science and technology. Take medical and health science and technology innovation as the focus of national scientific and technological development, and strive to overcome scientific and technological difficulties in medicine, to provide technical protection for the people's health. Increase investment in medical research, deepen the reform of the system and institutions of medical and health science and technology, integrate advantageous medical research resources, accelerate the implementation of major special projects in medical science and technology, encourage independent innovation, strengthen the research on major disease prevention and treatment technologies and key technologies for the development of new medicines, and strive for new breakthroughs in the basic and applied research of medical science and technology, high-technology research, and research on traditional Chinese medicine and the combination of traditional Chinese and Western medicine. We will develop and produce medical equipment suitable for China's national conditions. Extensive international cooperation and exchanges in health science and technology.
Strengthen the construction of medical and health personnel. Formulate and implement the talent team construction plan, focusing on strengthening the public **** health, rural health, urban community health professional and technical personnel and nursing staff training. Formulate preferential policies to encourage outstanding health talents to serve in rural and urban communities and central and western regions. Health technicians who have been working at the grass-roots level in urban and rural areas for long periods of time are given appropriate preferential treatment in terms of title promotion, business training and treatment policies. The qualification system for general practitioners should be improved, the on-the-job training system for health personnel in rural and urban communities should be perfected, participation in academic education should be encouraged, the standardization of the practice of rural doctors should be promoted, and qualified general practitioners should be made available to grass-roots medical and health-care institutions as soon as possible. Strengthening the construction of high-level scientific research, medical and health management personnel. Establishing a system of standardized training for resident physicians and strengthening continuing medical education. Strengthen the construction of nursing teams, and gradually solve the problem of under-representation of nursing personnel. Cultivate and grow the Chinese medicine talent pool. Steadily promote the reasonable mobility of medical personnel, facilitate vertical and horizontal exchanges of talents between different medical institutions, and study and explore the multi-point practice of registered physicians. Standardize the conditions of service for hospital administrators, and gradually form a professional and specialized management team for medical institutions.
Adjusting the structure and scale of higher medical education. Strengthen general medical education, improve standardized and regulated clinical medical education, and improve the quality of medical education. Increase investment in medical education, vigorously develop higher medical undergraduate and specialized education for rural areas and communities, and take a variety of approaches, such as directional free training, to cultivate practical medical and health care personnel for rural areas in poverty-stricken areas, and create a large number of qualified doctors who are rooted in the countryside and serve the peasants.
Constructing a healthy and harmonious doctor-patient relationship. Strengthen the construction of medical ethics and medical style, attach importance to the cultivation of humanistic qualities and professional education of medical personnel, and vigorously carry forward the spirit of saving lives and helping people. Optimize the environment and conditions for the practice of medical personnel, protect the legitimate rights and interests of medical personnel, and mobilize the enthusiasm of medical personnel to improve their services and efficiency. It will improve medical practice insurance, carry out medical social work, improve the mechanism for handling medical disputes, and enhance communication between doctors and patients. In society as a whole to form a good culture of respect for medical science, respect for medical and health workers, respect for patients.
(xiv) the establishment of practical **** enjoy the medical and health information system. Vigorously promote the construction of medical and health informationization. To promote public **** health, medical, medical insurance, drugs, financial supervision of information technology construction as a focus, integration of resources, strengthen the information standardization and public **** service information platform construction, and gradually realize the unity and efficiency, interconnectivity.
Speed up the construction of medical and health information system. Improve the public **** health information system with the disease control network as the main body, and improve the prediction and early warning and analysis and reporting capabilities; focus on the establishment of residents' health records, and build a rural and community health information network platform; focus on hospital management and electronic medical records, and promote the construction of hospital informatization; and utilize network information technology, and promote the cooperation between urban hospitals and community health service organizations. It is actively developing telemedicine for rural and remote areas.
Establishing and improving the medical insurance information system. Accelerating the construction of medical insurance information systems with composite functions, such as fund management, expense settlement and control, medical behavior management and supervision, and management services for insured units and individuals. It has strengthened the construction of information systems for basic medical insurance for urban workers, basic medical insurance for urban residents, the new type of rural cooperative medical care and medical assistance, realized the docking of information systems with those of medical institutions, and actively promoted methods such as the "one-card" system, which makes it easier for the insured to seek medical treatment and increases the transparency of medical services.
Establishing and improving the information network for drug supervision, drug inspection and testing, and monitoring of adverse drug reactions at the national, provincial and municipal levels. An information system on the supply and demand of essential medicines has been established.
(xv) Establishing and improving the legal system of medicine and health. Improve health laws and regulations. Accelerating the promotion of basic medical and health legislation, clarifying the rights and obligations of the government, society and residents in promoting health, and guaranteeing basic medical and health services for all. Establish a sound system of health standards, and do a good job of articulating and coordinating relevant laws and regulations. Accelerate the legislative work on Chinese medicine. Improve laws and regulations on drug supervision. Gradually establish and improve a relatively complete health law system that is compatible with the basic medical and health care system.
Promoting administration in accordance with the law. Strict and standardized law enforcement, and effectively improve the ability of governments at all levels to use legal means to develop and manage medicine and health care. Strengthen the law of medicine and health work, and strive to create an environment conducive to the rule of law of the people's health.