Work plan to solve the outstanding problems of basic medical security for poor people
In order to implement the decision-making arrangements of the CPC Central Committee and the State Council to solve the outstanding problems of "two worries and three guarantees" and further promote the implementation of the health poverty alleviation project, we will take the capacity building of county hospitals, the mechanism construction of "county-township integration and rural integration" and the standardization construction of rural medical and health institutions as the main direction to comprehensively solve the outstanding problems of basic medical care for the poor and ensure that the task of health poverty alleviation will be fully completed by 2020. According to the guidance of the leading group for poverty alleviation and development of the State Council on solving the outstanding problems of "two worries and three guarantees"
First, accurately grasp the basic medical security standards and requirements.
The basic medical care for the poor is guaranteed, mainly by including all the poor people in the scope of basic medical insurance, serious illness insurance and medical assistance. Common diseases and chronic diseases can be treated in time in county and village medical institutions, and the basic life is still guaranteed after suffering from serious illness. Establish and improve the basic medical security system, strengthen the construction of county and township medical and health institutions, equip qualified medical personnel, eliminate the "blank spots" of rural two-level institutions, and ensure that the poor have places to go, doctors and institutional guarantees.
The guiding standards include "three ones" of medical and health institutions, "three qualifications" of medical and health personnel, "three lines" of medical service ability and full coverage of medical security system (see annex for details).
Second, strengthen the capacity building of county hospitals.
(1) Increase support. We will further increase investment support within the central budget, and urge local governments to include qualified poverty-stricken counties (national key poverty alleviation and development counties and contiguous poverty-stricken counties, the same below) and county-level hospitals (including Chinese medicine hospitals, the same below) into the scope of national health security projects. All localities should implement the responsibility of investment, improve the facilities of county-level hospitals and equip them with basic equipment to ensure the normal operation of county-level hospitals.
(2) Strengthen counterpart assistance. Further clarify the objectives, tasks and assessment indicators of tertiary hospitals. Organize tertiary hospitals to increase assistance to deep poverty-stricken counties. Take the form of "group assistance", select management and technical personnel as the dean or vice president, director of nursing department and academic leader of the recipient hospital, with no less than 5 people in the assistance team (3 people can be selected by Chinese medicine hospitals), and each group of personnel will work continuously for no less than 6 months. Help poor county hospitals to strengthen the construction of local disease spectrum clinical specialties, and improve the diagnosis and treatment ability of common diseases, frequently-occurring diseases and some critical diseases in internal medicine, surgery, obstetrics and gynecology, pediatrics and emergency department.
(3) Promote telemedicine. Achieve full coverage of telemedicine in county hospitals in poverty-stricken counties, expand service connotation and enrich service content, and effectively promote the sinking of high-quality medical resources through remote consultation, rounds, teaching and training. Further standardize telemedicine services and gradually improve telemedicine charging and reimbursement policies.
Three, strengthen the "county and township integration, rural integration" mechanism construction.
(4) Strengthen the training of county and village personnel. Continue to carry out standardized training for general practitioners and assistant general practitioners, and transfer training. And increase the training of free medical students in rural areas. Continue to recruit special post general practitioners for poverty-stricken areas, and comprehensively solve the problem of no practicing doctors in township hospitals. Encourage all localities to continue to carry out free medical student training for village clinics. Continue to carry out practical skills and appropriate technical training for rural doctors, and improve the ability of rural doctors to diagnose and treat common and frequently-occurring diseases and Chinese medicine services.
(five) the overall use of county-level health human resources. Encourage the implementation of "managing townships by county" and "managing townships by village", and employ qualified medical personnel for township hospitals and village clinics. Establish and improve the stubble selection system, and solve the problem of lack of qualified doctors in village clinics by sending doctors from township hospitals to carry out rounds and stay at the station. Explore the development of non-poverty-stricken county hospitals in the province to support township hospitals in poverty-stricken areas, and regularly send doctors to practice in township hospitals.
(six) to promote the construction of county medical institutions. Where conditions permit, we will further develop the construction of compact county-level medical institutions, promote the unified operation of administrative management, medical services and information systems, improve the overall performance of county-level medical and health services, and gradually replace the total control of specific medical institutions with the total control of regional medical insurance funds.
Four, strengthen the standardization of rural medical and health institutions.
(7) Eliminate "blank spots". Promote local governments to implement the main responsibility, increase investment, complete the infrastructure construction of township hospitals and village clinics in an all-round way, and rationally allocate medical equipment in township hospitals and village clinics in accordance with the principle of filling vacancies. Strengthen the construction of traditional Chinese medicine in township hospitals and the allocation of traditional Chinese medicine equipment in village clinics. For the newly established administrative villages after poverty alleviation and relocation, temporary medical points can be set up to provide services to the masses before the local government's infrastructure such as water, electricity and network is in place.
Five, strengthen the comprehensive prevention and control of diseases in poverty-stricken areas.
(eight) the full implementation of three years of comprehensive prevention and control of key infectious diseases and endemic diseases. According to the "Three-year Action Plan for Health and Poverty Alleviation" (Guo Wei Cai Fa [2018] No.38), it is necessary to comprehensively prevent and treat endemic diseases such as AIDS, tuberculosis, schistosomiasis, echinococcosis and Kaschin-Beck disease, and classify patients with current diseases.
Safeguard measures of intransitive verbs
(nine) a clear division of responsibilities. Adhere to the management system of overall planning by the central government, overall responsibility by the provinces and implementation by cities and counties. The central department is responsible for the top-level design of health poverty alleviation policies, improving the working mechanism and clarifying the responsibility requirements; Local governments are responsible for formulating policies, determining standards and promoting implementation according to the actual situation of local poverty alleviation. Health administrative departments take the lead in implementing health poverty alleviation, strengthen the capacity building of county and rural medical and health services, and carry out classified treatment. The poverty alleviation department is responsible for bringing health poverty alleviation into the overall deployment and work assessment of poverty alleviation, and the medical insurance department is responsible for implementing medical security poverty alleviation and bringing the poor into the coverage of the medical security system. The development, reform and financial departments are responsible for strengthening the investment guarantee for health and poverty alleviation.
(ten) to formulate the implementation plan. All localities should formulate specific work standards and implementation plans in light of the actual situation, in accordance with the principles of being able to solve practical problems, being generally recognized by the poor, being quantifiable, achievable and assessable, carry out investigations according to the standards, find out the base, establish ledgers, define timetables and road maps, and report local specific work standards and survey results to the State Health and Health Commission and the State Medical Insurance Bureau before the end of July 2065438+2009. In principle, no standards will be formulated separately in all parts of the province.
(eleven) increase investment support. The central finance co-ordinates the existing funding channels in the field of medical and health care, and appropriately inclines to deep poverty areas such as "three districts and three States" when allocating funds for medical and health transfer payments. Provincial and municipal finance should give preferential support to solve the outstanding problems of basic medical security. County-level finance should implement subsidy funds for township hospitals and rural doctors according to regulations. For village clinics that serve a small population and are insufficient to maintain normal operation according to existing channels and subsidy standards, county-level finance will give appropriate subsidies. Poverty-stricken counties make full use of existing policies and support qualified projects to solve outstanding problems of basic medical security. The cooperation between the east and the west, counterpart support and designated poverty alleviation should support the solution of outstanding problems in basic medical security in poverty-stricken areas. Encourage all kinds of public welfare funds, enterprises and other social forces to support the capacity building of medical and health institutions in poor areas.
Attachment: Basic Medical Security Work Standards
First, ensure the accessibility of basic medical services.
(1) "Three Ones" in medical and health institutions.
1. Each poverty-stricken county has built 1 county-level public hospitals (including Chinese medicine hospitals) and corresponding functional buildings and facilities. Close to or subordinate to the poverty-stricken counties in the municipal administrative region, if the municipal public hospitals can meet the demand, county-level hospitals may not be set up separately according to local conditions.
2. Each township has 1 government-run health centers, equipped with corresponding functional rooms and facilities, which can undertake the responsibilities of diagnosis and treatment of common diseases and frequently-occurring diseases, initial on-site first aid and referral of critically ill patients.
3. Each administrative village has 1 clinic with corresponding functional rooms and facilities, which can provide basic medical and health services. An administrative village with a small population or area may jointly set up a village clinic with its neighboring administrative villages, and the administrative village where the township health center is located may not set up a village clinic.
(2) Medical technicians are "three qualified".
1. Each county hospital has at least 1 qualified medical practitioners in each professional department.
2. Each township health center shall have at least 1 qualified practicing (assistant) doctors or general practitioners.
3. Each village clinic shall have at least 1 qualified village doctors or practicing (assistant) doctors.
(3) the "third line" of medical service ability.
1. A county hospital (traditional Chinese medicine hospital) in a poverty-stricken county with a permanent population of 65,438+10,000 has reached the medical service capacity of a secondary hospital.
2. Township hospitals with a permanent population of 1 10,000 or more meet the Administrative Measures for Township Hospitals (Trial) (Wei Nong Wei Fa [201] 61No.).
3. Administrative village clinics with a permanent population of more than 800 people meet the requirements of the Measures for the Administration of Village Clinics (Trial) (No.33 issued by the National Health Center [2014]).
Second, ensure full coverage of the medical security system.
All rural poor people who have set up files and set up cards are included in the scope of basic medical insurance, serious illness insurance and medical assistance.