Deepening the reform of the medical and health system in 2012, the main working arrangements
One, the general requirements
In-depth implementation of the "Central **** State Council on deepening the reform of the medical and health system of the opinions" (China Development [2009] No. 6) and "the State Council on the issuance of the "Twelfth Five-Year Plan" Notice on the Issuance of the Planning and Implementation Program for Deepening the Reform of the Medical and Health Care System during the "Twelfth Five-Year Plan" Period (Guo Fa [2012] No. 11), with the construction of a basic medical and health care system that meets China's national conditions at its core, adhering to the core concept of providing the basic medical and health care system as a public **** product to the entire population, adhering to the basic principles of protecting the basics, strengthening the grassroots level, and establishing a mechanism, and adhering to the guidelines of focusing on prevention, emphasizing the rural areas, and giving equal importance to both traditional Chinese and Western medicine. The Government has also been working to maintain the continuity and stability of the basic policies of healthcare reform, focusing on accelerating the improvement of the universal healthcare insurance system, consolidating and perfecting the basic drug system and the new mechanism for the operation of grassroots medical and healthcare institutions, and actively pushing forward the reform of public hospitals to make key breakthroughs, and comprehensively pushing forward reforms in related areas, so as to maintain the momentum of healthcare reform and lay a foundation for realizing the milestone reform goals of the 12th Five-Year Plan. The "Twelfth Five-Year Plan" has laid a solid foundation for the realization of the phased reform goals.
Second, the task
(a) accelerate the improvement of universal health insurance system.
1. Consolidate and expand the coverage of basic medical insurance.
The participation rate of the three basic medical insurance policies, namely, basic medical insurance for employees (hereinafter referred to as employee medical insurance), basic medical insurance for urban residents (hereinafter referred to as urban residents' medical insurance) and new rural cooperative medical care (hereinafter referred to as New Rural Cooperative Medical Care), has stabilized at 95%. Emphasis has been placed on the participation of migrant workers, employees of non-public economic organizations, flexibly employed persons, and students, preschool children and newborns. It will continue to promote the participation of retired workers from closed and bankrupt enterprises and workers from enterprises in difficulty. (The Ministry of Human Resources and Social Security and the Ministry of Health are respectively responsible for this.)
2. Continuing to raise the level of basic medical insurance.
(1) The government's subsidy standard for the New Rural Cooperative and urban residents' health insurance has been raised to 240 yuan per person per year, and the level of individual contributions has been raised accordingly, with per capita financing reaching about 300 yuan. (Ministry of Finance, Ministry of Health, Ministry of Human Resources and Social Security is responsible for)
(2) Employee health insurance, urban residents' health insurance and the new rural health insurance policy within the integrated fund maximum payment limit were raised to more than six times the annual average wage of local employees, more than six times the annual per capita disposable income of local residents, more than eight times the annual per capita net income of the country's farmers, and are not less than 60,000 yuan. The proportion of hospitalization expenses paid within the policy scope of the urban residents' health insurance and the New Farmers' Cooperative will reach more than 70 percent and about 75 percent respectively, gradually narrowing the gap between the proportion of hospitalization expenses paid and the actual proportion of hospitalization expenses paid, and the proportion of outpatient coordinated payments will be further increased. Explore the gradual establishment of outpatient co-ordination for employees' medical insurance through personal account adjustments and other means. (The Ministry of Human Resources and Social Security and the Ministry of Health are respectively responsible)
3. Reform of the health insurance payment system.
(1) Actively implement the reform of payment methods, such as capitation, per-patient payment, per-bed-day payment, and total prepayment, to gradually cover the designated medical institutions in the integrated area. The total amount of payment control has been strengthened, and a mechanism has been established to constrain the growth of medical costs in the integrated area by medical insurance, to formulate an overall control target for the expenditure of the medical insurance fund and break it down to the designated medical institutions, and to link it to the payment standard. Actively promoting the establishment of a negotiation mechanism between medical insurance operators and medical institutions and a payment mechanism for purchased services, through which the scope of services, payment methods, payment standards and service quality requirements are determined. In conjunction with the reform of payment methods, explore ways to control the burden on individuals. Gradually, the control of the growth of the total costs and sub-percentage (disease) medical costs of medical institutions and the control of personal burdens, as well as the quality of medical services, will be included in the evaluation system of medical insurance. (The Ministry of Human Resources and Social Security and the Ministry of Health are respectively responsible for this.)
(2) Improve the differential payment mechanism, with payment ratios further tilted toward primary healthcare organizations, encouraging the use of Chinese medicine services and guiding the public's first visit to the grassroots level. Include qualified private clinics and other non-public medical institutions and retail pharmacies in the scope of designated medical insurance. (The Ministry of Human Resources and Social Security and the Ministry of Health are respectively responsible for this.)
(3) Strengthening the supervision of medical service behaviors by the medical insurance, improving the monitoring and management mechanism, gradually setting up a real-time monitoring system of medical service by the medical insurance, and gradually extending the supervision of medical service by the medical insurance to medical institutions to the supervision of medical service behaviors by medical personnel. Establishing a joint anti-fraud mechanism, increasing penalties for insurance fraud, and publicizing relevant information in a timely manner. (The Ministry of Human Resources and Social Security and the Ministry of Health are respectively responsible for)
4. Further increase medical assistance.
(1) Increase the investment in relief funds to build a solid bottom line of medical protection. The scope of assistance has been expanded from low-income family members and five-guarantee households to include low-income patients with serious illnesses, persons with severe disabilities, and low-income families with elderly people and other groups in need, and to subsidize their participation in the urban residents' medical insurance program or the New Farmers' Cooperative Program. The level of assistance has been raised, the starting line for medical assistance has been abolished, the ceiling line has been steadily raised, and the proportion of assistance for out-of-pocket medical expenses for hospitalization within the scope of the policy for assistance recipients has been further increased. (The Ministry of Civil Affairs and the Ministry of Finance are responsible)
(2) Study the establishment of emergency relief funds for diseases. Through government funding, social donations and other channels of financing the establishment of the fund, to solve the cost of emergency medical treatment costs incurred by patients without the ability to pay and no master. Urgently formulate the fund management methods. (The Development and Reform Commission and the Ministry of Finance are responsible for this.)
5. Explore the establishment of a mechanism to protect against major diseases.
(1) Study and formulate protection methods for major diseases, and actively explore the use of the basic medical insurance fund to purchase commercial major disease insurance or establish supplemental insurance and other ways to effectively improve the level of protection for major diseases, and effectively solve the problem of patients with major diseases who are impoverished due to illness. Do a good job of connecting basic medical insurance, medical assistance and commercial insurance. (Development and Reform Commission, Ministry of Finance, Ministry of Human Resources and Social Security, Ministry of Health, CIRC, Ministry of Civil Affairs is responsible for)
(2) Comprehensively promote uremia, childhood leukemia, congenital heart disease in children, breast cancer, cervical cancer, severe mental illness, multidrug-resistant tuberculosis, AIDS opportunistic infections and other eight categories of major disease protection, lung cancer, esophageal cancer, stomach cancer, colon cancer, rectal cancer, chronic granulocyte leukemia, acute myocardial infarction, and other major diseases. 12 categories of major diseases, including lung cancer, esophageal cancer, gastric cancer, colorectal cancer, rectal cancer, chronic granulocytic leukemia, acute myocardial infarction, cerebral infarction, hemophilia, type I diabetes mellitus, hyperthyroidism, cleft lip and palate, etc., will be included into the scope of the pilot program. (Ministry of Health, Ministry of Civil Affairs, Ministry of Finance is responsible for)
6. Improve the level of basic medical insurance management.
(1) Actively promote the "one card" for medical insurance, making it convenient for insured persons to seek medical treatment. It has basically realized instant settlement of medical expenses within the integrated region and province of the insured, and accelerated the promotion of instant settlement of cross-provincial medical expenses focusing on retirees resettled in other places. Steady progress is being made in the cross-regional transfer of employees' medical insurance systems, and the convergence of the various basic medical insurance systems is being strengthened. (The Ministry of Human Resources and Social Security and the Ministry of Health are respectively responsible for)
(2) Strengthening the management of the income and expenditure of the medical insurance fund, the New Rural Cooperative and the urban residents' medical insurance fund adheres to the principle of balancing the income and expenditure of the current year, and the excessive balance, combined with the actual focus on increasing the level of payment for high medical expenses, so that the fund is neither precipitated excessively, nor overdrawn; the places with excessive balances of the employees' medical insurance should take effective measures to gradually bring the balances down to a reasonable level. reasonable level. (The Ministry of Human Resources and Social Security and the Ministry of Health are respectively responsible for this.)
(3) Explore the integration of the management functions and resources of the employee health insurance, urban residents' health insurance, and the New Rural Cooperative Health Insurance System, and improve the management and operation mechanism of the basic health insurance. Areas with the necessary conditions are exploring the establishment of a basic medical insurance system for residents in urban and rural areas. (The Central Editorial Office, the Development and Reform Commission, the Ministry of Human Resources and Social Security, and the Ministry of Health are responsible for this.)
(4) Under the premise of ensuring fund safety and effective supervision, the government is encouraged to purchase services and entrust qualified commercial insurance organizations to handle various types of medical insurance management services. (The Ministry of Health, the Ministry of Human Resources and Social Security, and the CIRC are responsible)
7. Vigorously develop commercial health insurance.
Improving the industrial policy on commercial health insurance, encouraging commercial insurance organizations to develop health insurance products other than the basic medical insurance to meet diversified health needs. Encourage enterprises and individuals to participate in commercial health insurance and various forms of supplemental insurance, and formulate and implement tax and other relevant preferential policies. (Development and Reform Commission, CIRC, Ministry of Finance responsible)
(2) consolidate and improve the basic drug system and the new mechanism for the operation of primary medical and health care institutions.
8. Consolidate and improve the basic drug system.
(1) Expand the scope of implementation of the basic drug system. Consolidate the results of the implementation of the basic drug system in government-run primary medical and health care institutions, and implement the policy of equipping all basic drugs for use and payment by the medical insurance. The implementation of the basic drug system in village health clinics will be promoted in an orderly manner, and the various subsidies and support policies for rural doctors will be implemented simultaneously. For non-government-run primary health care institutions, local governments may, in light of the actual situation, take the approach of purchasing services to bring them into the scope of implementation of the basic drug system. Public hospitals and other medical institutions are encouraged to prioritize the use of basic medicines. (The Development and Reform Commission, the Ministry of Health, the Ministry of Finance, and the Ministry of Human Resources and Social Security are responsible)
(2) Standardize the procurement mechanism for basic drugs. Fully implement the "General Office of the State Council on the issuance of the establishment and standardization of the government-run primary health care institutions of basic drugs procurement mechanism of the guiding opinions of the notice" (State Office of the State Council [2010] No. 56), adhere to the recruitment and procurement of a single, quantity and price linkage, the two-envelope system, the centralized payment, the whole process of monitoring and other policies. Improving the comprehensive evaluation index system for the quality of essential medicines. Pricing of essential medicines has been standardized on a trial basis for exclusive varieties of essential medicines and essential medicines whose prices have been stabilized through multiple centralized purchases and whose supply is sufficient in the market. Exploring the establishment of a monitoring mechanism for shortages of medicines, and ensuring the supply of small-volume, clinically necessary varieties in short supply by means of bidding for designated production. Establishing provincial-level management information systems for the centralized procurement and use of essential medicines, implementing centralized payment and supply and distribution policies, and improving the rate of timely distribution. (Development and Reform Commission, Ministry of Health, Ministry of Industry and Information Technology, Food and Drug Administration is responsible)
(3) Improvement of the national essential drugs catalog. It will seriously summarize the use of basic medicines around the country, and study the adjustment and optimization of the national basic medicines catalog, so as to better adapt to the basic needs of the public for medicines. Gradually standardize the dosage forms, specifications and packaging of basic drugs. Localities will be regulated to supplement basic medicines, and policies related to the basic medicine system will be strictly implemented for the supplemented medicines. (Ministry of Health, Ministry of Human Resources and Social Security, the Chinese Medicine Bureau, the Food and Drug Administration is responsible for)
(4) to strengthen the quality of basic drugs supervision. Continue to improve the quality standards of essential drugs, implement sampling and electronic monitoring of essential drugs, and improve the ability to monitor the entire process of essential drugs from production to use. (Food and Drug Administration is responsible for)
9. Deepen the comprehensive reform of primary health care institutions.
(1) To establish and improve a stable and long-term multi-channel compensation mechanism to ensure the normal operation of primary health care institutions. The central government has established a mechanism for providing recurrent subsidies to localities after the full implementation of the national basic drug system, and has included it in its budgetary arrangements. Local governments are required to incorporate special subsidies for primary medical and health care institutions, as well as subsidies for the difference between recurring revenues and expenditures, into their financial budgets and to implement them in full and in a timely manner, with the implementation of advance appropriations followed by settlements. Fully implement general consultation and treatment fees and health insurance payment policies. Funding for basic public **** health services undertaken by primary healthcare organizations is being implemented. (The Ministry of Finance, the Development and Reform Commission, the Ministry of Health, and the Ministry of Human Resources and Social Security are responsible)
(2) Deepen the reform of the establishment and personnel system. Reasonably determine the total staffing of primary medical and health care institutions in the county, and implement dynamic adjustment according to the service function positioning and development needs of primary medical and health care institutions. Implement the autonomy of the legal person of the primary health care institutions, the full implementation of the employment system and job management system, focusing on the selection and hiring of good deans and the establishment of the tenure of the target responsibility system. (The Central Editorial Office, the Ministry of Health, the Ministry of Human Resources and Social Security is responsible)
(3) Improve the performance distribution mechanism. Adhering to the principle of "more work, more pay" and "better pay for better performance", the distribution of income will be skewed towards key positions, business backbones and personnel who have made outstanding contributions. On the basis of the smooth implementation of performance pay, places with conditions can appropriately increase the proportion of incentive performance pay, and reasonably widen the income gap. Performance pay should be paid in full and on time. Part of the surplus of income and expenditure of primary medical and health care institutions may be used to improve welfare benefits and mobilize the enthusiasm of medical personnel in accordance with regulations. (The Ministry of Human Resources and Social Security, the Ministry of Health, and the Ministry of Finance are responsible)
(4) Accelerating the clearing and resolving of debts of primary medical and health care institutions. Do a good job of verifying and locking up debts, raise and implement debt-clearing funds through multiple channels, complete debt stripping and debt-clearing work on time, and resolutely stop the occurrence of new debts. (The Ministry of Finance, the Ministry of Health, and the Development and Reform Commission are responsible.)
10. Improve the service capacity of primary medical and health care institutions.
(1) In accordance with the principle of filling in the gaps, continue to increase support for the standardized construction of township health centers. (The Development and Reform Commission and the Ministry of Health are responsible for this.)
(2) Accelerating the informatization of primary healthcare institutions, establishing a primary healthcare information system that covers the supply and use of basic medicines, residents' health management, basic healthcare services, and basic functions such as performance appraisal, unifying technical and information standards, realizing interconnection and interoperability with the basic healthcare insurance system, and raising the level of standardization of primary healthcare services. (The Development and Reform Commission, the Ministry of Health, and the Ministry of Human Resources and Social Security are responsible for this.)
(3) Strengthening the construction of grass-roots talent teams focusing on general practitioners. It will actively promote the construction of the general practitioner system, carry out the standardized training of general practitioners, continue to recruit more than 5,000 directed free medical students for township health centers and grass-roots forces in central and western China, arrange for the transfer of 15,000 serving personnel in grass-roots medical and health care institutions for training as general practitioners, carry out an ad hoc posting project for 20,000 general practitioners, improve the implementation of the policy to encourage general practitioners to serve at the grass-roots level for a long time, and strive to realize the following Every urban community health service organization and township health center has a qualified general practitioner. Supporting the construction of about 100 clinical training bases for general practitioners. The central financial administration will continue to support the central and western regions in strengthening on-the-job training for primary healthcare personnel, focusing on targeted and practical training programs that have the characteristics of general medicine and promote the use of basic medicines,*** training 620,000 people. (The Ministry of Health, the Ministry of Health of the General Logistics Department, the Development and Reform Commission, the Ministry of Education, the Ministry of Finance, the Ministry of Human Resources and Social Security, and the Central Editorial Office are responsible for)
(4) Encourage conditional localities to carry out pilot projects to reform the mode of practice of general practitioners and the mode of service, and to implement the establishment of a stable contractual relationship between the general practitioners (teams) and the residents. Primary healthcare organizations are encouraged to provide Chinese medicine and other appropriate technologies and services. Establishing and improving the system of graded diagnosis and treatment and two-way referral, and actively promoting the pilot system of primary medical care at the grass-roots level. (The Ministry of Health, the Development and Reform Commission, the Ministry of Finance, the Ministry of Human Resources and Social Security, and the Bureau of Traditional Chinese Medicine are responsible for this.)
11. Building a solid network of rural medical and health services.
(1) Public-private construction, government subsidies and other means are being used to support the construction of houses and the purchase of equipment for village health centers. Village health offices will be included in the scope of informationization construction and management of primary medical and health care institutions. Implementing multi-channel compensation and pension policies for village doctors. (The Ministry of Health, the Development and Reform Commission, the Ministry of Finance, and the Ministry of Human Resources and Social Security are responsible)
(2) Strengthening the training of rural doctors and the construction of reserve forces. Rural doctors practicing in village health offices are given free training no less than twice a year, with a cumulative training period of no less than two weeks. Local personnel will be trained in a variety of ways, including directed training, to fill the ranks of rural doctors, and to ensure that there is a rural doctor in every village health office. (The Ministry of Health and the Ministry of Finance are responsible)
(3) Strengthening the county-level health administration departments of rural doctors and village health offices, focusing on strengthening the supervision of service behavior. Actively promote the integrated management of township health centers and village health offices. (The Ministry of Health, the Development and Reform Commission and the Ministry of Human Resources and Social Security are responsible)
(3) Actively promote the reform of public hospitals.
Focusing on county-level hospitals, it will promote comprehensive reforms of public hospital management systems, compensation mechanisms, personnel distribution, drug supply, pricing mechanisms, etc. It will select about 300 counties (cities) to carry out comprehensive reforms of county-level hospitals on a pilot basis, and will encourage localities to explore specific models according to local conditions. Expanding and deepening the pilot reform of urban public hospitals.
12. Accelerating the pilot reform of county-level public hospitals.
(1) Reform the compensation mechanism. Adopt comprehensive measures and linkage policies such as adjusting medicine prices, reforming the payment method of medical insurance and implementing the government's responsibility for medical care, so as to eliminate the mechanism of "compensating doctors with medicine". Compensation for public hospitals has been changed from three channels, namely, fees for services, income from drug mark-ups and financial subsidies, to two channels, namely, fees for services and financial subsidies. Reasonable income or losses incurred by hospitals as a result of this change will be compensated by adjusting the prices of medical technology services and increasing government investment. The adjusted fees for medical technology services will be included in the scope of payment of medical insurance in accordance with the regulations. Increased government investment by the central government to give a certain amount of subsidies, the local financial to adjust the expenditure structure in accordance with the actual situation, and effectively increase the investment. (Ministry of Health, Development and Reform Commission, Ministry of Finance, Ministry of Human Resources and Social Security is responsible for)
(2) Adjustment of pharmaceutical prices. Cancel the policy of drug mark-up. Increase the price of medical technology services such as diagnosis and treatment fees, surgical fees and nursing fees. Reduce the price of large-scale equipment inspection, government investment in the purchase of large-scale equipment in public hospitals according to the cost of setting inspection prices after deducting depreciation. (The Development and Reform Commission and the Ministry of Health are responsible for this.)
Improving online centralized purchasing of medicines for public hospitals at the county level, actively pushing forward band purchasing of medicines and centralized purchasing of high-value medical consumables, compressing intermediate links and costs, and striving to reduce inflated prices. (Ministry of Health, Ministry of Supervision responsible)
(3) play the role of compensation and supervision of medical insurance. Simultaneously promote the total prepayment, capitation payment, payment by type of disease and other composite payment methods, through the purchase of services to the medical institutions to give timely and reasonable compensation, to guide the medical institutions to take the initiative to control costs, standardize diagnosis and treatment behavior, and improve the quality of service. Indicators such as the utilization rate of the basic medical insurance drug catalog and the control rate of self-financed drugs will be strictly evaluated, so as to control or reduce the personal burden on the public. (The Ministry of Health and the Ministry of Human Resources and Social Security are respectively responsible for)
(4) Implementing the government's responsibility for running medical care. The implementation of the government's capital construction and equipment purchase of public hospitals, the development of key disciplines, public **** health services, in line with the national provisions of the cost of retirees and policy loss subsidies and other investment policies. (Ministry of Finance, Development and Reform Commission, Ministry of Health is responsible for)
Rationally determine the number and layout of public hospitals (including state-owned enterprise hospitals), strictly control the construction standards, scale and equipment. Prohibit public hospitals to raise debt construction. (Ministry of Health, Development and Reform Commission, Ministry of Finance, State-owned Assets Supervision and Administration Commission)
(5) accelerate the establishment of a modern hospital management system. In accordance with the requirements of the separation of government affairs, management and operation, the implementation of county-level public hospital management and employment autonomy. Explore the establishment of various forms of corporate governance structure of public hospitals, such as councils, public hospitals, functional positioning, development planning, major investment and other powers exercised by the government-run medical subject or council. (The Ministry of Health, the Development and Reform Commission, and the Central Editorial Office are responsible for)
Establishing and improving the dean's responsibility system and the tenure target responsibility assessment system. Heads of health administrative departments at all levels are not allowed to hold leadership positions in public hospitals. Continue to deepen the reform of the personnel system, and gradually promote the socialization of social security services such as pensions for medical personnel in public hospitals. (Ministry of Health, Ministry of Human Resources and Social Security is responsible for)
(6) Improve the internal distribution of hospital incentives. Improve the internal distribution mechanism centered on service quality, quantity and patient satisfaction, reflecting the principle of "more work, more pay" and "better pay for better performance". Increase the proportion of personnel expenses to operating expenses, and improve the treatment of medical personnel. Remuneration for deans and hospital management is determined by the main body of government-run medical institutions or authorized councils. It is strictly prohibited to link the personal incomes of medical personnel to hospital revenues from medicines and examinations. (Ministry of Health, Ministry of Human Resources and Social Security, Ministry of Finance is responsible for)
13. Expand and deepen the pilot reform of urban public hospitals.
Centered on the separation of government affairs, management and management, medicine, for-profit and non-profit, to break the "medicine for medicine" mechanism as the key link, to reform the compensation mechanism and the establishment of a modern hospital management system as a grasp, to deepen the innovation of the system and mechanism, to improve the quality of service and operational efficiency, and as soon as possible the formation of the reform of the basic way. (c) To study and explore the establishment of specialized management bodies and other measures. Study and explore the establishment of specialized management institutions and other forms of government-run medical institutions to perform the functions of government-run public hospitals. According to the needs of the reform, pilot areas will be given a certain degree of autonomy in the distribution of performance pay, pricing, and drug procurement. (Ministry of Health, Development and Reform Commission, Ministry of Human Resources and Social Security, Ministry of Finance, Ministry of Education, State-owned Assets Supervision and Administration Commission is responsible for)
14. Vigorously develop non-public medical institutions.
(1) Localities should expeditiously issue implementation rules to encourage social capital to organize and develop medical institutions, refine and implement policies to encourage social capital to run medical institutions, and support the organization and development of a number of non-public medical institutions. Health and other relevant departments should clean up and revise relevant policy documents by the deadline. Further opening up the medical service market, relaxing the scope of access to medical institutions run by social capital, actively introducing powerful enterprises, overseas high-quality medical resources, social charitable forces, foundations, commercial insurance institutions, etc. to run medical institutions, and giving priority support to the organization and development of non-profit medical institutions. Expanding the scope of pilot medical institutions wholly owned by overseas capital. Encourage qualified personnel (including those from Hong Kong, Macao and Taiwan) to set up clinics in accordance with the law. Further improve the practice environment, implement policies on pricing, taxation, medical insurance designation, land, construction of key disciplines, and appraisal of titles, and subsidize social capital in organizing non-profit medical institutions in places with the necessary conditions. Actively develop the medical service industry, and encourage non-public medical institutions to develop into high-level, large-scale large medical groups and rehabilitation medical institutions. (Development and Reform Commission, Ministry of Finance, Ministry of Health, Ministry of Commerce, Ministry of Human Resources and Social Security is responsible for)
(2) Encourage public hospitals in resource-rich areas to guide the social capital to participate in a variety of ways, including hospitals run by state-owned enterprises, including the restructuring of some of the public hospitals. Encourage social capital to part of the public hospitals in various forms of public welfare support. (The Ministry of Health, the Development and Reform Commission, the Ministry of Finance, the State-owned Assets Supervision and Administration Commission is responsible for)
15.comprehensively carry out services for the convenience and benefit of the people.
(1) Patient-centered and service-oriented, simplify the process of medical services such as registration, consultation, examination, charging, and medicine collection, actively promote the construction of a regional unified platform for booking appointments, universally implement diagnostic and treatment appointments, and carry out "diagnostic and treatment first, and then settle the bill", improve the medical environment, and significantly shorten the patient's waiting time to facilitate the public's access to medical care. It is convenient for the public to seek medical treatment. Vigorously promoting quality care and advocating volunteer services. (The Ministry of Health is responsible)
(2) vigorously implement clinical pathways and strengthen quality control. Carry out quality control of single diseases and standardize medical behavior. Continue to carry out special rectification activities for the clinical application of antimicrobial drugs. Take electronic medical records and hospital management as the core, promote the construction of public hospital informationization. Tests in medical institutions are open to the public, and testing equipment and technicians should meet legal requirements or have legal qualifications, so as to realize mutual recognition of test results. (The Ministry of Health is responsible for)
16. Enhancing the service capacity of county-level hospitals.
Strengthening the capacity building of county hospitals with talents, technology and key specialties as the core, focusing on 1-2 county hospitals (including county hospitals) in each county, improving the rate of intra-county consultations and reducing the rate of out-of-county referrals. Launch the implementation of county-level hospitals to establish ad hoc positions, the introduction of urgently needed high-level talent. Consolidate and deepen the long-term cooperation and assistance mechanism of city hospitals supporting county hospitals, arrange for 6,000 key personnel of county hospitals to receive further training and study in tertiary hospitals, and develop remote diagnosis and treatment systems for rural and remote areas. (The Ministry of Health, the Development and Reform Commission, the Central Editorial Office, the Ministry of Human Resources and Social Security, and the Ministry of Finance are responsible for this.)
(4) Coordinating and promoting reforms in related fields.
17. Raising the level of equalization of basic public **** health services.
(1) Continuing to do a good job on the 10 types of national basic public **** health service programs, and focusing on improving the quality of service, residents' knowledge and satisfaction. The rate of standardized electronic construction of urban and rural residents' health records has reached more than 60%, and the number of hypertensive and diabetic patients under standardized management has reached 65 million and 18 million respectively. All patients with severe mental illnesses identified through screening were included in the scope of management. Strengthening vaccination for the National Immunization Plan. Improving the accessibility of public **** health services for migrant populations, as well as for children and the elderly left behind in rural areas. Strengthening health promotion and education, advocating healthy lifestyles, and guiding scientific medical treatment and the safe and rational use of medication. (Responsible to the Ministry of Health and the Ministry of Finance)
(2) Continuing to implement major public **** health programs, and doing a good job of preventing and treating infectious diseases, chronic diseases, occupational diseases, serious mental illnesses, major endemic diseases and other diseases that seriously jeopardize the health of the public. Improve the professional public **** health service network, continue to support the construction of rural pre-hospital emergency care system and county-level health supervision institutions, and strengthen the prevention and control of major diseases and food safety risk monitoring capacity building. (Ministry of Health, Development and Reform Commission, Ministry of Finance responsible)
18. Promote the optimization of the structure and layout of medical resources.
(1) Developing regional health planning, specifying standards for allocation of health resources in provinces, cities and counties, and prioritizing social capital for new healthcare resources. The number of beds in medical and health institutions per 1,000 resident population reaches 4, in principle, no longer expand the scale of public hospitals. (Ministry of Health, Development and Reform Commission, Ministry of Finance is responsible for)
(2) Strengthening the construction of the weak links in the medical service system, support the construction of key clinical specialties in medical institutions. Strengthen the provincial children's specialized hospitals and city and county-level general hospital pediatrics construction. Start the construction of municipal-level general hospitals in remote areas. Strengthening the standardization of medical and health information technology, and promoting the effective integration of information technology with management, diagnosis and treatment standards and daily supervision. (Development and Reform Commission, Ministry of Health, Ministry of Finance is responsible)
19. Innovative health personnel training and utilization system.
(1) Increase the training of nurses, nursing caregivers, pharmacists, pediatricians, as well as mental health, pre-hospital emergency care, health emergency response, health supervision, hospitals and health insurance management personnel and other shortage of talent and high-level talent. Issuing guidance on the standardized training system for resident physicians, and accelerating the establishment of a standardized training system for resident physicians. (Ministry of Health, Ministry of Education, Ministry of Human Resources and Social Security, Ministry of Finance is responsible for)
(2) to promote the physician multi-practice. Localities should introduce the implementation rules for multi-location practice of physicians, encourage people qualified to practice medicine to apply for multiple locations to practice, improve the registration, filing, assessment, evaluation and supervision policies for practicing physicians, and establish management files for physicians. Establishing and improving medical practice insurance and medical dispute handling mechanisms. (The Ministry of Health is responsible for)
20. Promoting the reform of drug production and circulation.
(1) Reform the drug price formation mechanism, select drugs with large clinical use, set the maximum retail guide price based on the cost of the leading enterprises, with reference to the centralized purchasing price of medicines and market transaction prices such as the sales price of retail pharmacies. Improve the price management of imported drugs and high-value medical consumables. (Development and Reform Commission is responsible for)
(2) Improve the development policy of the pharmaceutical industry and standardize the order of production and circulation. Promote pharmaceutical enterprises to improve independent innovation and optimization and upgrading of the structure of the pharmaceutical industry. Develop modern logistics and chain management of drugs, and improve the distribution capacity of drugs in rural and remote areas. Promote the acquisition, merger and joint reorganization of pharmaceutical production and distribution enterprises across regions and ownership. Encourage the development of retail pharmacies and equip them with licensed pharmacists as required. (The Ministry of Industry and Information Technology, the Ministry of Commerce and the Food and Drug Administration are responsible for this.)
(3) Improve the quality standards for medicines and raise the quality level of generic drugs. It will implement the newly revised quality management standard for drug production, revise and publish and implement the quality management standard for drug business, and regularly issue announcements on the quality of drugs. It will rigorously investigate and deal with illegal acts such as manufacturing and selling counterfeit medicines, and crack down on illegal activities such as renting and lending of licenses through "dependence" and "ticket-taking", as well as the sale and purchase of tax stamps, and the publication of false drug advertisements. (The Food and Drug Administration and the Ministry of Industry and Information Technology are responsible.)
21. Improve the regulatory system for medicine and health.
(1) Strengthen the regulatory control of medical costs. The growth rate of per capita and total costs, hospital bed days, and the ratio of drugs to control management objectives into the public hospitals target management responsibility system and performance appraisal scope, and strengthen the cost of faster growth rate of disease diagnosis and treatment of key monitoring behavior. Timely investigation and handling of unreasonable use of medicines, materials, inspections and duplicate inspections in pursuit of economic benefits. Strengthening the supervision and inspection of medical service charges and drug prices. (The Ministry of Health, the Ministry of Human Resources and Social Security, and the Development and Reform Commission are responsible.)
(2) Strengthening the supervision of the entire health care industry. Study the establishment of a scientific classification and evaluation system for medical institutions. It will strengthen the supervision of the safety and quality of medical services, strengthen the review of prescriptions and the management of drug use, and standardize the clinical use and safety management of medical devices. It will crack down on the illegal practice of medicine in accordance with the law, and seriously investigate and deal with violations of the law in key aspects such as the bidding and procurement of medicines and reimbursement of medical insurance, as well as in the process of medical services. It has established a regulatory system with open information and multi-party social participation, and encourages social organizations and individuals, such as industry associations, to conduct independent evaluation and supervision of medical institutions. Strengthening industry self-discipline and medical ethics. (The Ministry of Health, the Ministry of Human Resources and Social Security, and the Food and Drug Administration are responsible)
Three safeguards
(1) Strengthen the target responsibility system.
Establishing and improving the responsibility and accountability system, the Office of the Leading Group of Medical Reform of the State Council and the Leading Group of Medical Reform of the Provinces (autonomous regions and municipalities) have signed a statement of responsibility. The main leaders of the provincial (autonomous regions and municipalities) governments are responsible for the work of medical reform in their respective regions, and the leaders in charge of general work and health work are specifically responsible for the formation of a strong implementation mechanism in which each member unit divides up the work and works closely together. All relevant departments, provinces (autonomous regions and municipalities) to break down the tasks at all levels, and implement the responsibilities at all levels, and complete the decomposition of tasks before May 1, 2012, to make specific arrangements.
(2) Strengthen financial security measures.
Governments at all levels should actively adjust the structure of financial expenditure, increase investment, and effectively guarantee the annual health care reform tasks required funds into the financial budget, and on time and in full payment in place. In arranging the annual health investment budget, we should effectively implement the requirements of "the growth rate of government health investment is higher than the growth rate of recurrent financial expenditure, and the proportion of government health investment in recurrent financial expenditure is gradually increasing", and the investment in health care reform of all provinces (autonomous regions and municipalities) in 2012 should be significantly higher than that of 2011. It is necessary to increase special transfer payments from the central and provincial governments to areas in difficulty. Financial departments at all levels will be required to make special explanations on health inputs when reporting to the government on the draft budget. The supervision and management of funds should be strengthened, and the performance of project implementation and use of funds should be taken as an important part of the assessment of the accountability system for health care reform, so as to improve the efficiency of the use of funds.
(3) Strengthening performance evaluation.
The Office of the State Council Leading Group for Medical Reform, in conjunction with relevant departments and localities, should further strengthen the monitoring and evaluation of the progress and effects of the implementation of medical reform, and implement the performance evaluation mechanism of monthly notification, quarterly assessment, and year-round evaluation. Regular supervision should continue to be strengthened to identify problems in the implementation of healthcare reform in a timely manner, study and resolve them, and urge localities to carry out rectification. It is necessary to strengthen classified guidance, and adopt various ways to strengthen the organization and implementation, such as subdividing the work, squatting supervision and interviews and notifications. The General Office of the State Council will carry out supervision and inspection of the implementation of medical reform tasks in due course.
(D) strengthen publicity and guidance.
To adhere to the correct public opinion guidance, improve the department, local health care reform publicity communication and coordination mechanism, strengthen the active guidance and positive publicity, in-depth excavation of typical experience, close to the masses, in-depth grass-roots way to show the effectiveness of the reform, to expand the effect of publicity. It is necessary to release the progress of healthcare reform in a timely manner, improve the mechanism for verifying public opinion, actively accept the supervision of the news media, and answer and respond to issues of social concern. To mobilize all parties to participate in the medical reform of the enthusiasm, initiative and creativity, give full play to the role of the main force of medical personnel, in order to deepen the reform to create a good atmosphere of public opinion and social environment.