1, further standardize the construction and development of medical complexes, improve the construction of medical complexes and graded diagnosis and treatment assessment, implement the responsibility of leading hospitals, mobilize the enthusiasm of leading hospitals, and strengthen industry supervision. Encourage social medical institutions and rehabilitation nursing institutions to participate in the construction of medical complexes. (The National Health and Wellness Commission, the National Medical Insurance Bureau, state administration of traditional chinese medicine and China Disabled Persons' Federation are responsible, with the lead department ranking first, the same below).
2, improve the medical insurance payment, personnel management, service price, financial input and other supporting measures to promote the construction of medical consortium and telemedicine services. (Responsible by National Health and Wellness Commission, Ministry of Finance, Ministry of Human Resources and Social Security, National Medical Insurance Bureau and state administration of traditional chinese medicine)
3, timely sum up local experience, guide all localities to improve the medical service price, medical insurance payment and other policies of different levels of medical institutions, expand the proportion of reimbursement, and guide reasonable medical treatment. (Responsible for the National Medical Insurance Bureau and the National Health and Wellness Commission) Strengthen health education and popular science propaganda, and guide the masses to establish a scientific concept of seeking medical treatment. (Responsible by the National Health and Wellness Commission)
4, promote the family doctor contract service, improve the incentive mechanism, implement the security policy, strengthen the assessment, give priority to the key population contract service, do detailed services. (Responsible by National Health and Wellness Commission, Ministry of Finance, Ministry of Human Resources and Social Security, National Medical Insurance Bureau, state administration of traditional chinese medicine and China Disabled Persons' Federation)
5. Explore and promote the institutional innovation of disease control institutions and county-level maternal and child health care institutions, deepen the comprehensive reform of grassroots medical and health institutions, implement the funding guarantee policy, and implement the requirements of "allowing medical and health institutions to break through the current wage control level of public institutions, allowing medical service income to deduct costs, and withdrawing funds according to regulations mainly for personnel rewards" ("two permits").
According to the actual situation of different medical and health institutions, we should improve the salary distribution policy in a targeted manner to promote the medical staff's salary to reach a reasonable level. (The Ministry of Finance, the Ministry of Human Resources and Social Security and the National Health and Wellness Commission take the lead respectively according to the division of responsibilities, the same below).
6. Improve the integration of medical care and health care in counties and villages, and promote comprehensive reform in counties. Grass-roots medical staff can implement county management and township use. (The National Health and Wellness Commission, the Ministry of Finance, Ministry of Human Resources and Social Security, the Ministry of Agriculture and Rural Affairs and state administration of traditional chinese medicine are respectively responsible)
7. Carry out quality service activities at the grassroots level, strengthen the standardization construction of grassroots medical and health institutions, and further improve the quality management system and mechanism of grassroots medical and health institutions. (Responsible by the National Health and Wellness Commission, the National Development and Reform Commission, the Ministry of Finance and state administration of traditional chinese medicine)
Two, establish and improve the modern hospital management system
1, deepen the reform of medical service price. Study and introduce specific measures to promote the establishment of a timely and flexible price dynamic adjustment mechanism based on changes in cost and income structure in accordance with the idea of "vacating space, adjusting structure and ensuring convergence". By standardizing the diagnosis and treatment behavior, reducing the cost of drugs and medical consumables to make room, optimizing and adjusting the price of medical services, focusing on optimizing and adjusting the price that reflects the value of medical personnel's technical services, and reducing the prices of large medical equipment such as inspection, treatment and inspection.
Accelerate the review of new medical service price items. Allow local governments to take appropriate measures to effectively reflect the value of pharmaceutical services. (Responsible by National Medical Insurance Bureau, National Health and Wellness Commission and state administration of traditional chinese medicine)
2, the implementation of national medical and health service system planning, reasonably determine the size of public hospitals. (The National Health and Wellness Commission, the National Development and Reform Commission, the Ministry of Finance and state administration of traditional chinese medicine are responsible for) Implementing the government's investment policies for public hospitals that meet the regional health planning and the preferential investment policies for Chinese medicine hospitals. (Ministry of Finance, National Development and Reform Commission, National Health and Wellness Commission and state administration of traditional chinese medicine are responsible)
3, study and formulate measures to adapt financial investment to the development of public hospitals. (Ministry of Finance, National Health and Wellness Commission, state administration of traditional chinese medicine and other departments are responsible)
4. Summarize the pilot experience of salary system reform in public hospitals in time, and promote the establishment of a salary system that conforms to the characteristics of the industry. (Responsible by Ministry of Human Resources and Social Security, Ministry of Finance, National Health and Wellness Commission and state administration of traditional chinese medicine)
5, establish and improve the modern hospital management system pilot. Summarize and promote the experience and practice of scientific, refined and informational hospital management in time. (The National Health and Wellness Commission and state administration of traditional chinese medicine are responsible for promoting the formulation of hospital regulations. By the end of 20 18, all provinces will select 20% secondary and tertiary public hospitals and 10% non-profit hospitals organized by social forces to carry out the pilot work of formulating regulations.
Establish and improve the comprehensive budget management, cost management, financial reporting, information disclosure and internal and third-party audit mechanisms of public hospitals. All tertiary hospitals fully implement the chief accountant system. (Responsible by National Health and Wellness Commission, Ministry of Finance and state administration of traditional chinese medicine)
6, strengthen the guidance of party building in public hospitals and industry. (Responsible by the National Health and Wellness Commission, the Central Organization Department, the Ministry of Education and state administration of traditional chinese medicine)
7. Promote the reform of medical institutions run by state-owned enterprises. (Responsible by the State Council State-owned Assets Supervision and Administration Commission and National Health and Wellness Commission) Promote military hospitals to participate in the comprehensive reform of public hospitals in resident cities, and build a medical service system with deep integration of military and civilian. (The Health Bureau of the Logistics Support Department of the Central Military Commission and the National Health and Wellness Committee are responsible)
8. Continue to evaluate the comprehensive reform effect of public hospitals and allocate subsidy funds according to the evaluation results. (The National Health and Wellness Commission and the Ministry of Finance are respectively responsible)
Third, speed up the improvement of the universal medical insurance system.
1. Formulate and improve the reform plan of China's characteristic medical security system. (The National Health Insurance Bureau, the Ministry of Finance, the National Health and Wellness Commission and the China Banking Regulatory Commission are responsible)
2, improve the level of basic medical insurance and serious illness insurance, residents' basic medical insurance per capita financial subsidies to improve the 40 yuan, half for serious illness insurance. Simultaneously raise the personal payment standard. (The Ministry of Finance, the State Administration of Taxation and the State Medical Insurance Bureau are respectively responsible, with the participation of the China Banking Regulatory Commission) to expand the coverage of employees' medical mutual assistance and promote the healthy development of medical mutual assistance. (The National Federation of Trade Unions is responsible)
3. Deepen the reform of medical insurance payment methods. We will comprehensively promote the reform of paying by disease, co-ordinate basic medical insurance and serious illness insurance, and gradually expand the diseases paid by disease. Carry out the trial of payment by disease diagnosis related groups (DRGs). Promote the convergence of policies such as medical insurance payment, medical service price, drug circulation and personnel compensation. (Responsible by National Medical Insurance Bureau, Ministry of Finance, Ministry of Human Resources and Social Security, National Health and Wellness Commission and state administration of traditional chinese medicine)
4. Fully implement the settlement policy for medical treatment in different places and expand the coverage of designated institutions. (Responsible by National Medical Insurance Bureau, Ministry of Finance, National Health and Wellness Commission and state administration of traditional chinese medicine)
5. Strengthen the supervision of medical insurance on medical behavior, take measures to solve the problems of "hanging bed" hospitalization and fraudulent insurance, and scientifically control the unreasonable increase of medical expenses. (Responsible by National Medical Insurance Bureau, Ministry of Finance, National Health and Wellness Commission and state administration of traditional chinese medicine)
6. Develop commercial health insurance. (CBRC is responsible for) improving government procurement services and guiding qualified commercial insurance institutions and other social forces to participate in basic medical insurance handling services. (Responsible by the National Medical Insurance Bureau and the China Banking Regulatory Commission)
7. Explore the establishment of a long-term care insurance system. (Responsible by National Health Insurance Bureau)
Four, vigorously promote the construction of drug supply security system.
1. Adjust the national list of essential drugs, formulate guiding documents to improve the national system of essential drugs, and promote the priority use of essential drugs. (The State Health and Wellness Commission, the Ministry of Finance, the State Medical Insurance Bureau and the State Medical Products Supervision and Administration are responsible)
2, in line with the tax reduction policy of anticancer drugs, promote the provinces (autonomous regions and municipalities directly under the central government) to carry out centralized procurement of anticancer drugs in the medical insurance catalogue, and promote the negotiation of exclusive anticancer drugs outside the medical insurance catalogue. We will carry out a pilot program of centralized drug procurement in the country to substantially reduce drug prices. Accelerate the approval of new drugs listed overseas in an orderly manner. (The State Health Insurance Bureau, the State Health and Wellness Commission and the State Medical Products Supervision and Administration are responsible)
3. The research on key chemicals and key technologies of biopharmaceuticals in the Catalogue of Encouraged Generic Drugs will be included in the relevant national science and technology plan 20 18. (The Ministry of Science and Technology and the National Health and Wellness Commission are responsible)
4. Formulate the reform plan for the management of high-value medical consumables and excessive medical examination. (The National Medical Insurance Bureau and the National Health and Wellness Commission are responsible for formulating coding rules for medical devices and exploring the application of standardized coding in the registration, procurement and use of high-value medical consumables.
(The State Administration of Medical Products, the State Health and Wellness Commission and the State Medical Insurance Bureau are responsible for promoting the localization of medical devices and promoting the application and promotion of innovative products. (Ministry of Industry and Information Technology, National Development and Reform Commission, National Health and Wellness Commission and State Administration of Pharmaceutical Products are responsible)
5. Strengthen the monitoring and early warning of national shortage of drugs, establish a record system for stopping production of short drugs and APIs, reasonably determine the reserve scale, improve the reserve management measures, and establish a dynamic adjustment mechanism for the reserve catalogue. Construct a collaborative application platform for multi-source information collection and supply of national and provincial shortage drugs. Will improve the shortage of drug supply support projects into the focus of support.
Continue to carry out the pilot work of fixed-point production of drugs that are clinically necessary, with small dosage and short market supply, and organize the construction of centralized production bases for small-variety drugs (short drugs). (The Ministry of Industry and Information Technology, the State Health and Wellness Commission, the State-owned Assets Supervision and Administration Commission of the State Council, and the State Administration of Pharmaceutical Products are respectively responsible)
6. Formulate guiding documents for classified management of retail pharmacies, support the chain development of retail pharmacies, and allow outpatients to choose drugs independently in medical institutions or retail pharmacies. (The Ministry of Commerce, the State Health and Wellness Commission, the State Medical Insurance Bureau and the State Pharmaceutical Products Supervision and Administration are responsible)
Five, strengthen the construction of comprehensive supervision system.
1, establish and improve the comprehensive supervision coordination mechanism and supervision mechanism of the medical and health industry. (National Health and Wellness Commission, General Administration of Market Supervision, National Medical Insurance Bureau, state administration of traditional chinese medicine, State Administration of Pharmaceutical Products and other departments are responsible)
2, establish and improve the medical and health industry credit mechanism, comprehensive supervision results collaborative application mechanism and blacklist system. (National Health and Wellness Commission, National Development and Reform Commission, Ministry of Finance, Ministry of Human Resources and Social Security, State Administration of Market Supervision, State Medical Insurance Bureau, state administration of traditional chinese medicine, State Administration of Pharmaceutical Products and other departments are responsible)
3, establish and improve the management system of medical and health institutions at all levels. Comprehensively carry out the performance appraisal of public medical and health institutions at all levels, in principle, on an annual basis. The assessment results are reported to the government at the same level, which is linked to the financial subsidies of medical and health institutions, the overall salary level, the promotion of responsible persons, rewards and punishments, etc. , and make it public in an appropriate way.
Comprehensive medical reform pilot provinces selected 1-2 cities to carry out the performance appraisal pilot of public medical and health institutions, and ranked the assessment results. (National Health and Wellness Commission, Ministry of Finance, Ministry of Human Resources and Social Security, state administration of traditional chinese medicine and other departments are responsible)
4. Strengthen the reform and innovation of the comprehensive supervision system and mechanism, and carry out national supervision and spot checks on 10% of the supervised units in the health field. Popularize and implement the comprehensive evaluation of classified supervision and prevention of infectious diseases in medical and health institutions throughout the country. Strengthen the supervision and law enforcement of traditional Chinese medicine. (National Health and Wellness Commission, National Medical Insurance Bureau, state administration of traditional chinese medicine and State Administration of Pharmaceutical Products are responsible)
5, promote the joint punishment of medical crimes. (The National Health and Wellness Commission, the General Administration of Market Supervision, the National Medical Insurance Bureau, the state administration of traditional chinese medicine and the State Administration of Pharmaceutical Products are respectively responsible)
Six, the establishment of high-quality and efficient medical and health service system
1, focusing on regional key diseases and taking discipline construction as the starting point, establish a number of high-level regional medical centers and specialist alliances throughout the country to promote the balanced distribution of high-quality medical resources. (Responsible by National Development and Reform Commission, National Health and Wellness Commission and state administration of traditional chinese medicine)
2, improve the national health policy, popularize health knowledge, carry out health promotion, improve health protection, enhance personal health responsibility consciousness, and strive to make people less sick, less sick, and prolong healthy life. (National Health and Wellness Commission, Ministry of Education, Ministry of Finance, General Administration of Sports, etc. are responsible). 3. Study and put forward the framework of comprehensive service system and policy measures to promote the combination of prevention, treatment and rehabilitation services. (Responsible by National Health and Wellness Commission and state administration of traditional chinese medicine)
4. The per capita subsidy standard for basic public health services has been raised to 55 yuan, and the new funds are mainly used for upgrading and expanding basic public health services. (The Ministry of Finance, the National Health and Wellness Commission and state administration of traditional chinese medicine are responsible for optimizing national basic public health services and improving service quality. (The National Health and Wellness Commission and the Ministry of Finance are responsible)
5. Build a working mechanism combining chronic disease prevention and treatment, strengthen the capacity building of chronic disease prevention and treatment institutions and teams, and promote medical institutions to provide healthy prescriptions. (Responsible by the National Health and Wellness Commission)
6, promote the implementation of the national health insurance project construction plan, strengthen the construction of county hospitals, maternal and child health care, disease prevention and control and other medical and health institutions, improve the ability of diagnosis and treatment of difficult diseases. (Responsible by National Development and Reform Commission, National Health and Wellness Commission and state administration of traditional chinese medicine)
7, formulate guidance documents to strengthen the construction of disease prevention and control system, reform and improve the disease prevention and control network. (The Health and Wellness Commission, the Development and Reform Commission, the Ministry of Finance, Ministry of Human Resources and Social Security and the General Administration of Customs are responsible for adjusting the health and epidemic prevention allowance. (Responsible by Ministry of Human Resources and Social Security, Ministry of Finance, National Health and Wellness Commission and General Administration of Customs)
8, the implementation of traditional Chinese medicine inheritance and innovation project, to carry out key research and achievements transformation of traditional Chinese medicine diagnosis and treatment technology, layout and construction of a number of regional Chinese medicine (specialist) diagnosis and treatment centers and clinical cooperation between Chinese and Western medicine pilot, improve the ability and level of diagnosis and treatment of difficult diseases of traditional Chinese medicine, in-depth implementation of the "Thirteenth Five-Year Plan" grass-roots Chinese medicine service capacity improvement project, and promote the construction and upgrading of grass-roots Chinese medicine museums and medical light. (Responsible by state administration of traditional chinese medicine, National Development and Reform Commission and Ministry of Finance)
9, in-depth implementation of health poverty alleviation, continue to do a good job in special treatment of serious diseases, the implementation of comprehensive prevention and treatment of endemic diseases and infectious diseases and health promotion, and take effective safeguard measures to reduce the burden of medical treatment for poor people. (Responsible by National Health and Wellness Commission, the State Council Poverty Alleviation Office, Ministry of Finance and National Health Insurance Bureau)
10, to formulate a guiding document to promote the development of nursing services for infants under 3 years old. (Responsible by the National Health and Wellness Commission)
1 1. Formulate the service and management guidelines for the medical and nursing institutions. Hospice care pilot. (Responsible by the National Health and Wellness Commission, the National Development and Reform Commission, the Ministry of Civil Affairs and state administration of traditional chinese medicine)
12, implement a new round of action plan to improve medical services. (Responsible by National Health and Wellness Commission and state administration of traditional chinese medicine)
Seven. Promote reforms in related fields as a whole.
1. Formulate an action plan for the development of health industry, promote the classification of health industry, study and establish a statistical system and accounting system for health industry, and carry out accounting for health service industry. (The National Development and Reform Commission, the National Health and Wellness Commission, the National Bureau of Statistics and state administration of traditional chinese medicine are respectively responsible)
2. Promote the development of social medical services. Optimize the cross-departmental approval of social medical institutions. Public hospitals and private hospitals are allowed to cooperate to promote and support the development of social medical services through medical consortia and graded diagnosis and treatment. Formulate guiding documents to promote the development of clinics, revise the basic standards of clinics, and carry out pilot clinics in some cities.
(The National Development and Reform Commission and the National Health and Wellness Commission are respectively responsible, with the participation of the Ministry of Finance, the China Banking Regulatory Commission and state administration of traditional chinese medicine) to carry out the filing work of Chinese medicine clinics. (state administration of traditional chinese medicine is responsible)
3. Actively and steadily promote doctors to practice more, improve the filing system, accelerate the development of medical liability insurance, and simultaneously improve the supervision mechanism. Guide and standardize nurses' multi-point practice, and explore new modes and formats such as "internet plus" nursing service. (Responsible by National Health and Wellness Commission, National Development and Reform Commission, Ministry of Human Resources and Social Security, China Banking Regulatory Commission and state administration of traditional chinese medicine)
4. Promote the development of "Internet+medical health". Promote the construction of smart hospitals and national health information platforms, and accelerate the sharing of medical information among medical institutions. (The National Health and Wellness Commission, the National Development and Reform Commission, and state administration of traditional chinese medicine are responsible for formulating the management norms for telemedicine services. (Responsible by the National Health and Wellness Commission) Improve the charging policy for Internet diagnosis and treatment, further improve the medical insurance payment policy, and gradually include qualified Internet diagnosis and treatment services into the scope of medical insurance payment.
(Responsible by the National Medical Insurance Bureau, the National Health and Wellness Commission and state administration of traditional chinese medicine) Vigorously promote online services such as time-sharing appointment, intelligent guidance triage, waiting reminder, inspection result inquiry, outpatient settlement and mobile payment. Promote the opening of public information resources in key areas of medical and health care. Carry out pilot demonstration projects for smart and healthy old-age care services.
Promote national pilot projects for the construction of health care big data centers and industrial parks. (Responsible by National Health and Wellness Commission, National Development and Reform Commission, Ministry of Industry and Information Technology and state administration of traditional chinese medicine)
5. Deepen medical education reform through medical education and teaching cooperation. Implement and improve the health personnel training plan and related policies, and improve the standardized training and continuing education system for residents. (The National Health and Wellness Commission, the Ministry of Education, Ministry of Human Resources and Social Security and state administration of traditional chinese medicine are responsible for promoting the reform of the incentive mechanism for the training and use of general practitioners.
Strengthen the construction of general practitioners and pediatricians, expand the scope of implementation of the special post plan for general practitioners, continue to carry out training for improving the ability of county and township health personnel, comprehensively push forward the qualification examination for rural assistant general practitioners, carry out the qualification examination for doctors specializing in traditional Chinese medicine, and deepen the reform of health titles.
(Responsible by the National Health and Wellness Commission, Ministry of Education, Ministry of Finance, Ministry of Human Resources and Social Security, General Administration of Customs and state administration of traditional chinese medicine) Continue to implement free training of rural order-oriented medical students and strengthen the training of general practitioners. (Ministry of Education, Ministry of Finance, Ministry of Human Resources and Social Security, National Health and Wellness Commission and state administration of traditional chinese medicine are responsible)
Extended data
General principles of deepening the reform of medical and health system
The first is the guiding ideology of deepening the reform of the medical and health system. Guided by Deng Xiaoping Theory and Theory of Three Represents, we will thoroughly implement the Scientific Outlook on Development, proceed from China's national conditions and learn from international beneficial experience, and strive to achieve the goal of universal access to basic medical and health services and solve the most concerned, direct and realistic interests of the people.
Adhere to the public welfare nature of public health, adhere to the policy of giving priority to prevention, focusing on rural areas, and paying equal attention to traditional Chinese and western medicine, implement separation of government affairs, management, medicine, profit-making and non-profit, strengthen government responsibility and investment, improve national health policy, improve institutional system, strengthen supervision and management, innovate institutional mechanisms, encourage social participation, build a basic medical and health system covering urban and rural residents, and continuously improve the health level of the whole people and promote social harmony.
Second, deepen the basic principles of medical and health system reform. The reform of medical and health system must be based on the national conditions, proceed from reality and adhere to the correct reform principles.
1, adhere to the people-oriented principle and give priority to safeguarding people's health rights and interests. Adhere to the purpose of medical and health services for people's health, take the protection of people's health as the center, and take everyone's access to basic medical and health services as the fundamental starting point and foothold. From the design of reform scheme, the establishment of health system to the construction of service system, we should follow the principle of public welfare, provide the basic medical and health system as a public product to the whole people, focus on solving outstanding problems strongly reflected by the masses, and strive to achieve universal medical care.
2, adhere to the national conditions, the establishment of China characteristics of the medical and health system. Adhere to the basic national conditions, sum up the practical experience of medical and health reform and development in a realistic way, and accurately grasp the laws and main contradictions of medical and health development; Adhere to the coordination of basic medical and health services with economic and social development and people's affordability.
Give full play to the role of traditional Chinese medicine (ethnic medicine); Adhere to local conditions, classified guidance, give full play to local enthusiasm, and explore the establishment of a basic medical and health system in line with national conditions.
3, adhere to the unity of fairness and efficiency, the combination of government-led and market mechanism. Strengthen the government's responsibility in the basic medical and health system, strengthen the government's responsibility in system, planning, financing, service and supervision, safeguard the public welfare of public medical and health, and promote fairness and justice.
At the same time, pay attention to the role of market mechanism, mobilize social forces to participate, promote the formation of an orderly competition mechanism, improve the operational efficiency, service level and quality of medical and health care, and meet the multi-level and diversified medical and health needs of the people.
4. Adhere to overall planning, solve current outstanding problems and improve the system. Proceed from the overall situation, coordinate urban and rural and regional development, take into account the interests of all parties such as supply side and demand side, pay attention to the combination of prevention, treatment and rehabilitation, and correctly handle the relationship between the government, health institutions, pharmaceutical enterprises, medical personnel and the people.
We should not only focus on the long-term, innovate the system and mechanism, but also focus on solving the outstanding problems in medical and health undertakings based on the current situation. Pay attention to the overall design, define the overall reform direction, objectives and basic framework, highlight key points, implement them step by step, and actively and steadily promote the reform.
Third, deepen the overall goal of medical and health system reform. Establish and improve the basic medical and health system covering urban and rural residents, and provide safe, effective, convenient and cheap medical and health services for the masses.
By 20 1 1, the basic medical security system will cover all urban and rural residents, the basic drug system will be initially established, the urban and rural primary medical and health service system will be further improved, basic public health services will be popularized, breakthroughs will be made in the pilot reform of public hospitals, the accessibility of basic medical and health services will be significantly improved, the burden of medical expenses for residents will be effectively reduced, and the problem of "difficult and expensive medical treatment" will be effectively alleviated.
By 2020, a basic medical and health system covering urban and rural residents will be basically established. We have generally established a relatively complete public health service system and medical service system, a relatively sound medical security system, a relatively standardized drug supply security system, and a more scientific management system and operation mechanism of medical and health institutions, thus forming a diversified medical service pattern. Everyone enjoys basic medical and health services, basically meeting the people's multi-level medical and health needs, and the people's health level has been further improved.
Central People's Government of People's Republic of China (PRC)-Deepening the Reform of Medical and Health System