Up to standard community hospitals will become a "medical insurance fixed point"
----- Interview with Wen Honghai, director of the Municipal Health Bureau
"This year, the provincial capital health system will be adjusted to the urban health care system, focusing on the construction of the city's secondary health care network, a general hospital and specialty hospitals, the other level of community health service organizations.
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"Yesterday, in the city people's Congress site, the city health bureau director Wen Honghai accepted an interview with our reporter, and focused on many representatives, members and the public are very concerned about the community health services.
Community hospitals, "six unified"
Wen Honghai said: "The city health system last year, the city's community health service institutions to implement health records, prescriptions, laboratory tests, treatment orders, clothing, identification 'six unified ' and microcomputer network management, 20 rural township health centers, village health centers transformed into community health service institutions." According to the Secretary Wen Honghai, in accordance with the "general hospitals on the level, specialized hospitals to create specialties, community health service institutions," the goal of this year's provincial capital health system will be adjusted to the city's health care system, focusing on the construction of the city's secondary health care service network. Each constitute a level of general hospitals, specialized hospitals and community health service institutions, to clarify their functional positioning and development direction, to build up a reasonable layout, clear division of labor, functionally perfect, standardized services, scientific management of the medical service system. Municipal hospitals should be in accordance with the "build famous hospitals, strong features, create a brand," the idea of the general hospital bigger and stronger, the specialty features to do fine and fine, the brand effect of the call to improve the core competitiveness. In addition to continue to vigorously develop community health services, and strive to 80% of the urban areas in rural areas (towns) health centers, village health centers transformed into community health service organizations, to provide convenient, fast, high-quality and inexpensive health care services for community residents.
Promote the experience of excellent community health stations
"The existing number of community health care institutions set up is not a lot, but the setup is unreasonable, and there are duplication of construction in some areas, which need to be effectively integrated." In this regard, Wen Honghai said the city health bureau will set up new community health service organizations in accordance with relevant planning. One of the important elements is to change the poor operating conditions of staff hospitals and district hospitals, etc. into community health service organizations. "Some community health service stations in Shijiazhuang have established close ties with nearby residents and are recognized and trusted by them, and they get along well. This year, we will focus on the experience of these service organizations to be promoted."
Up to standard community hospitals will be "medical insurance designated"
Wen Honghai said, Shijiazhuang City, the current form of community health care institutions mainly include the following: the establishment of public hospitals, from the transformation of staff hospitals, and private capital investment in construction. Municipal Health Bureau will be in accordance with the "strict access, careful approval, regulate the behavior, reduce the low level of duplication of the setup" principle to set up, standardize community medical service institutions. On this basis, for community health service organizations that meet the relevant standards, the Municipal Health Bureau will actively cooperate with the relevant departments, so that it becomes a designated medical institution for medical insurance.
Selected proposals
Build a small difference forget to plan community health stations
Proposed by: Mr. Wang Shubo
Problems click
Shi City, after a few years of efforts, the initial formation of a network of basic coverage, the basic function of the service is basically perfect, the basic standardization of technology and management of the community health service system, but away from the capital of the province, "the city of suitable for living" urban positioning. However, from the provincial capital of "suitable for living in the city" of the city's positioning and build in line with the objective laws of the market economy of the medical and health system of the target requirements there are still some gaps, the masses of difficult to see a doctor has not yet fundamentally solved the problem. Existing more than 100 community health service institutions, resource shortages, uneven distribution, insufficient utilization, service capacity is not strong, the level is not high; the government compensation mechanism is not sound, the policy linkage is not smooth, the operation mechanism is unreasonable and so on, restricting the healthy development of community health service undertakings. The development of community health services is an important responsibility of governments at all levels, and government functions should be strengthened.
Viewpoints live
Further strengthening of government functions
The government should incorporate community health services into the overall planning of the local economic and social development and the two civilizations of the urban community construction planning, improve its supporting policies and measures, the establishment of a coordinating and leading institutions, and timely resolution and coordination of various difficulties, problems. The development of urban community health services, to adhere to the nature of public welfare, adhere to the government-led, encourage social participation.
New district to plan community health service stations
Optimize the structure of urban health resources, improve the service network, improve the service function, reasonable institutional settings, supervision and management norms. The relevant departments in the urban planning of new neighborhoods, remodeling, expansion of residential neighborhoods at the same time to give full consideration to the planning and construction of matching community health service sites in the community, and effectively solve the problem of community health services, improve the supporting health service facilities in residential neighborhoods.
Increase government investment
Increase government investment in community health services at all levels, the establishment of a stable investment mechanism for community health services, rationalize the compensation mechanism of community health service institutions, to establish a special subsidy for the start and development of community health services, the regular budget should be included in the financial and health services, according to the population of the jurisdiction of the full amount of the quota allocation. Encourage social forces to participate in the development of urban community health services, the government should have positive incentives.
Included in the scope of the fixed-point health insurance
Improve the operation of community health services mechanism, the establishment of a sound service institutions, improve the supporting policies, the implementation of community health services and the constraints of the first visit to the community health services, open the medical insurance on the community health service institutions, the community health service institutions to meet the standards into the scope of the fixed-point medical institutions of the urban health insurance, and actively explore the establishment of a community health service-based medical assistance system. The government is also actively exploring the establishment of an urban medical assistance system based on community health services.
Strengthening the construction of community health service teams
Strengthening the training of community service personnel, promoting the training of general practitioners and nurses, and setting up special funds for the training of community general practitioners, community preventive and protective physicians, and community nurses. Encourage medical personnel from large hospitals to serve in the community. Improve the level of service, improve the quality of service, strengthen the supervision of the quality of medicines, to ensure the safety of residents in medical treatment and medication.
Scientific evaluation
Incorporate community health services into the public **** health system, expand the scope of preventive health care, strengthen supervision and evaluation, and establish performance evaluation standards for scientific community health service organizations. Avoid the development of community health institutions to the hospital model, should establish hospitals and preventive health institutions to support the community health service system, so that community health services become a solid foundation in the network of public **** health system.
Reporter fact
Big hospitals are crowded with people, community hospitals are too cold
Phenomenon --- small illnesses also go to the big hospital
Reporters in the interviews found that people go to the big hospitals for small illnesses is a common phenomenon. the morning of February 22nd, the reporter saw the first hospital in Shijiazhuang City, the reporter said. Shijiazhuang First Hospital to see, respiratory medicine, gastroenterology outpatient clinic in an endless stream of patients, the doctor kept busy, the reporter waited for a period of time in these two departments, before managing to interview the doctor on duty. According to Wang Yuling, director of the Department of Respiratory Medicine, there is no shortage of patients with common and frequent diseases. Many people with colds go directly to the First Municipal Hospital without going to the community health service stations, and some of them have very simple conditions that can be treated at the community health stations or through life care and adjustment. Wang Yuling believes that, like some patients with simple conditions, should first go to the community health service station, the health service station clearly diagnosed as a serious illness, and then go to the hospital. And big hospital experts spend a lot of time every day to diagnose simple conditions, is a waste of medical resources. According to the hospital's gastroenterology department Han director, community health care is very convenient for patients, some simple treatment, health care and so on should be solved in the community hospital. Among the patients he treated, many had already seen in the community health service organizations, not cured, and then came to the city hospital. Mr. Chen, a patient who came to the Gastroenterology Department, said that a few days ago, he ate too much fried food and drank too many beverages, and felt nauseous all the time, so he came directly to the City Hospital for a checkup. Mr. Chen said he felt that the health service station equipment is less, the level of doctors is not high, not too assured. According to the reporter, Mr. Chen's point of view in the public have a certain representative.
Phenomenon --- community health station less people come
Compared with the big hospitals, some community health service stations have fewer patients. In a small-scale community health service station, the reporter saw here the door is cold. The health station doctor told reporters, here can be injections, infusions and other treatments, and nearby neighborhood residents can be door-to-door service. The reporter saw that the station for the neighborhood part of the residents to establish a health record. According to the doctor, the community health service station is not yet able to use the medical insurance card, "but we are fighting." In a neighborhood next to the health service station, the reporter found that the station is not well known among residents. "What diseases can be treated there? What are the benefits of building a health record?" Residents of this community health service station raised a number of questions.
Random survey
Residents of the community health station has "three uneasy"
February 22, 23, the reporter on the "community health services" this issue, in the street randomly interviewed more than 50 people. More than half of them said they rarely or basically did not go to the community health service station to see a doctor. The reporter found the following reasons for residents and community health service stations to produce a "gap": First, residents do not understand the station doctor's level of diagnosis and treatment, worried about its existence in the treatment of irregularities; Second, the residents of the station's medical equipment and medicines are not assured; Third, some health service stations can not be used with the medical insurance card. Because of the above "uneasy", therefore, many people even if only a little sick often seek far away, to the big hospital queuing. From the present point of view, community health organizations to fully gain the trust of residents, there is still a short way to go. Experience interview
"Model Health Station"
Explain the advantages of community health care
On the morning of February 23, the reporter in the better conditions of Changan District Community Health Service Center, Jianhua Community Health Service Station to see that the medical situation here is very standardized. Changan Community Health Center has a "general practice clinic", its related department Liu Jing from the director said, they have a different positioning with the specialties in large hospitals, doctors receive "general practitioner" training, now to see more and more patients with common diseases, multiple diseases. Jianhua Community Health Service Station built in the community, the service area for the fourth community council area of Jianhua, the area has 2758 households, more than 9000 people, residents can walk 15 minutes to the health service station. The station not only provides residents with good medical services, but also for residents to measure blood pressure free of charge, take care of elderly patients. 23 February morning, the area of 70-year-old Xiao old man with scabies on his neck, he walked to the Jianhua Community Health Service Station for medical treatment, and to the reporter even boasted of the convenience of the community health service station. According to Changan District Community Health Service Center Office Director Shen Jinghui said, at present Changan District Community Health Service Station has been gradually recognized by residents, playing an increasingly important role. Community health service is the direction of the development of medical care for the residents of our country, which is recognized by the Ministry of Health and the State Council. on February 8, the State Council issued the "Guiding Opinions on the Development of Urban Community Health Service", which calls for the development of urban community health service. He said that for individuals, community health service stations can reduce medical costs. Community health service stations can provide convenient, fast, thoughtful, inexpensive services, such as Chang'an District Community Health Service Station does not charge consultation fees, registration fees, free blood pressure measurement, in the charges than the district and county hospitals lower, the people can save a lot of money. In addition, Chang'an District Community Health Service Station and the city's third hospital signed a "two-way referral", some seriously ill people transferred to the city's third hospital can be exempted from registration fees, and even enjoy some preferential treatment. Health service stations have established community residents' health records, the residents' medical history, allergy history, medication history are recorded. However, it is still too early to say that the community health service stations can cure the phenomenon of "expensive", but this will be an important idea, but also an effective way. In his opinion, community health service stations can avoid the waste of medical resources. Some common and frequent diseases can be cured in the community, there is no need to go to the big hospitals, big hospitals in the serious and difficult diseases can provide better services, which can be rationalized, effective use of resources in big hospitals and health service stations. He believes that community health service stations can ease the doctor-patient relationship. Long-existing doctor-patient conflict is an important reason for the formation of a lack of communication between doctors and patients, large hospitals doctors are generally very busy, it is difficult to have enough time to communicate with patients, and health service station doctors in the community, and many residents will slowly become familiar with the communication possibilities are greater, more time, but also detailed answers to patients and residents of the health advice. In addition, according to the reporter's understanding, community health service stations also undertake health education, community rehabilitation, family planning technical services, chronic non-communicable disease prevention and treatment and control of infectious, endemic and parasitic diseases. Health service stations can provide prenatal, postnatal and menopausal health care guidance for women, and health care guidance for newborns, infants and preschool children for young parents.
New Concept of Community Health Services
Chang'an District, Shijiazhuang City, has taken the lead in the province and even the country in developing community health service organizations, and now there are 36 community health service stations and 4 community health service centers, and many of their practices have been popularized across the country.
One of the new concepts: two-way referral
According to the Changan District Community Health Service Center Office Director Shen Jinghui, a few years ago, Changan District Community Health Service Station (Center) and the city's third hospital signed a "two-way referral" agreement. Community doctors found some difficult to treat the disease, according to the diagnosis, the patient will be directly recommended to the city hospital experts, patients go to the city hospital free of registration fee. After diagnosis, treatment and examination, the specialists of the Third Municipal Hospital will recommend the patients to return to the community health service stations if they think that the patients can go back to the community health service stations for further treatment. The Third Municipal Hospital may even give certain discounts to the referred patients. On February 11 this year, Xinhua News Agency released a news release saying that the Ministry of Health will promote the two-way referral system nationwide. Community health service organizations and regional large and medium-sized general hospitals, specialized hospitals signed an agreement, so that the general common, frequent minor diseases in the community health service institutions for treatment of major diseases are transferred to the second level or above the big hospitals, and in the big hospitals after diagnosis of chronic diseases and rehabilitation after surgery can be transferred to the community health service organizations. In this way, it is possible to realize that "minor illnesses do not leave the community, and major illnesses are referred in a timely manner". According to the Ministry of Health, to increase the people's trust in community health services, there are two main areas of work, the first is to increase the training of community doctors; the second is to allow the public to understand the content and mode of community health services.
New Concept No. 2: General Practitioner
Liu Jing from the Chang'an District Community Health Service Center is a director of her department called "general practice clinic", she is known to many as a general practitioner. According to Liu Jing from the said, she as a community health center doctors, and large hospitals have significantly different specialists, the reception of patients with a variety of conditions, specialists are difficult to handle. Liu Jing from the general practitioner training, has a wealth of clinical experience, many of the old patients from this community moved away, but also deliberately come back to find Liu Jing from the doctor. It is understood that some medical universities have set up a "general practitioner" specialty, the province's health sector has also carried out many general practitioner training to meet the needs of society.
The new concept of three: resident health records
Unlike many hospitals, individual clinics, Chang'an District health service stations are equipped with resident health records. In Changan District Community Health Service Center, the reporter saw a cabinet neatly placed in the bag, each bag cover marked with home address and name, which is the resident's "personal health records. There are residents' names, age, blood type, allergy history, the main problem catalog, temporary problem catalog and other information, but also note the filing doctor, filing nurse's name and date of filing. It is understood that this file allows community doctors to understand the overall situation in the community, quickly identify the cause of illness when residents are sick, and guide residents to targeted disease prevention. In addition, the community doctor also for the widows and orphans free medical examination, if necessary, door-to-door service for the residents of the area.
The new concept of four: designated health insurance into the community
Community health service stations, although convenient, fast, inexpensive, but many service stations can not use the health insurance card, so many residents even if they suffer from minor illnesses are still often to seek far away from the big hospitals to queue up to see. The reporter learned that this is indeed a bottleneck that restricts the development of community health service stations. At present, Shijiazhuang City, only a small part of the community health service stations are listed as designated units of medical insurance. Changan District Jianhua community health service station is one of the Shijiazhuang City health insurance designated institutions. In the future, with the gradual standardization of community health service stations and related institutional reforms, more health service stations can be included in the health insurance designated units. February 8, the State Council issued "on the development of urban community health services guidance", which clearly states that the role of community health services in medical security, the requirements of community health service institutions into the urban health insurance designated medical institutions range, to guide the insured workers to the community. to seek medical treatment in the community. The Ministry of Health has said, "As soon as possible to include some qualified community health service institutions into the designated institutions for medical insurance, which will enhance the people's recognition of community health services, so that residents receive more and better services."