2. Establish a resource sharing mechanism with complementary advantages. Implement regional health planning and rationally allocate health resources. The superior health resources in the county can be used * * * to maximize the utilization rate of resources and improve the efficiency of resource use. On the premise of ensuring medical quality and medical safety, according to the level of medical institutions in the county, the mutual recognition items of medical examination and medical imaging examination between medical institutions are reasonably determined, and mutual recognition of examinations in the county is implemented. Gradually implement centralized supply of all kinds of materials and logistics support services to reduce costs.
3. Establish a graded and reasonable business cooperation mechanism. According to the functional orientation of tertiary institutions and the service capacity of various medical and health institutions, the service scope of the partners is reasonably determined, the two-way referral system is formulated, the referral procedures, standards and technical specifications are clarified, and patients are transferred up and down in time. Give full play to the role of the new rural cooperative medical system in regulating the flow of patients and guide patients to choose medical institutions reasonably. Establish consultation, mutual dispatch of doctors, guidance of ward rounds, joint surgery, joint first aid and first aid systems between cooperative units. Formulate a unified medical quality continuous improvement system and medical quality control system in the county, and the superior medical institutions will guide the subordinate cooperative units to implement them. County-level preventive health care institutions provide technical support and operational guidance for disease prevention and control, maternal and child health care and health education in township hospitals and village clinics. The prevention and protection personnel of township hospitals should supervise the village-level public health work in pieces.
4. Establish business guidance and personnel training mechanism for counterpart support. Establish business guidance and personnel training systems from county to township and township to village, and promote technical exchanges and technical support between units. Improve the professional level of rural health institutions through ward rounds, consultations, training courses, business personnel exchanges, advanced studies and other ways. Medical institutions at higher levels should uniformly arrange the staff of subordinate cooperative units to participate in the rotation of clinical personnel departments, give priority to the training of cooperative units, absorb the staff of subordinate cooperative units to participate in continuing medical education training courses, encourage joint declaration of scientific research topics, and carry out scientific research.
5. Establish a reasonable salary distribution mechanism. The county government should set up special funds to compensate and reward the units that have paid more and made outstanding contributions in vertical cooperation. Give play to the guiding role of the government and encourage higher-level institutions to give support and help to lower-level institutions. Reasonable distribution of the same income in business cooperation, timely reconciliation and acceptance and payment procedures.
1. Reasonably compile the revenue and expenditure of township hospitals. Pilot counties (cities, districts) should comprehensively consider the public health and basic medical tasks, staffing, service scope, business development and other factors undertaken by township hospitals, and scientifically and reasonably determine the revenue and expenditure items of township hospitals in accordance with the principle of balance of payments and fixed income, and verify the revenue and expenditure. Township health centers organize income and arrange expenditure according to the approved annual budget, in which the government subsidy income is implemented according to the relevant provisions of Several Opinions on Rural Health Subsidy Policy in Shandong Province (Lu Shefa [2003] No.3). Personnel expenses such as salaries and allowances in township hospitals within the scope prescribed by the state, operating expenses such as materials, instruments, medicines, transportation, water and electricity necessary for work, expenditures on projects such as infrastructure repair, equipment renewal and personnel training, expenses for retirees, and handling of public health emergencies shall be implemented in accordance with relevant policies.
2. Standardize the revenue and expenditure management of township hospitals. Relevant departments at the county level should formulate a unified financial revenue and expenditure management system for township health centers throughout the county, set up independent accounts for each health center, and implement centralized household management of the revenue and expenditure of health centers. Pilot counties can be managed by means of income-to-expenditure and differential subsidies; You can also explore the method of paying the proceeds in full and then paying them monthly. Capital construction and equipment purchase should be implemented according to the approved annual plan. In order to ensure the normal operation of the hospital, a certain amount of liquidity can be allocated to the hospital.
3. Reasonably handle the balance of payments of township hospitals. Part of the funds of the balance of business income and expenditure of township hospitals should be converted into the development fund of township hospitals, which is mainly used for the training and year-end assessment and reward of township hospitals by the health administrative departments at the county level. Part of the funds can be returned to the hospital, and the specific proportion is determined by the pilot counties (cities, districts).
4. Reform the income distribution mechanism of township hospitals. The health administrative department at the county level shall manage the personnel and funds of township hospitals according to their responsibilities, and establish a performance evaluation mechanism for township hospitals and health personnel. Incorporate the business volume, service quality, completion of public health tasks, satisfaction of service population and improvement of health status of service population into the assessment scope, as the main basis for returning the income and assessment rewards of township hospitals. Strengthen the management of the selection and appointment of the presidents of township hospitals, and implement the appointment system of the presidents and the target responsibility system for the term of office. Reform the internal distribution of township hospitals, expand the autonomy of unit distribution, reasonably determine the performance pay according to the principle of post, task and performance pay, taking into account the skills and quality of health personnel, and shall not directly link the business income of medical personnel with service charges.
1. Strengthen organizational leadership. The pilot work involves many interests and is a complex and arduous task. Under the leadership of the local government, we should carefully organize and improve measures to actively promote the implementation of various pilot tasks. The health administrative departments of pilot counties (cities, districts) should set up specialized agencies to undertake the vertical cooperation and financial revenue and expenditure management of township hospitals respectively. All medical and health units should implement the "number one" responsibility system and target management to ensure the smooth implementation of the pilot work.
Second, formulate and improve policies and measures. The pilot counties (cities, districts) shall, on the basis of a baseline survey of health resources and health services within the county, formulate an implementation plan, clearly define the policies and measures for vertical cooperation and the management of two lines of revenue and expenditure in township hospitals, and stipulate the responsibilities, tasks, working procedures and reward and punishment measures of each unit. It is necessary to comprehensively use administrative and economic means to guide all units to consciously fulfill their responsibilities and obligations.
Third, strengthen supervision and assessment. Establish a pilot work evaluation system, establish an assessment, supervision and reward mechanism, clarify the responsibilities and obligations of all units involved in the pilot, and decompose the tasks into units and departments, with the responsibility to people. County-level health administrative departments should regularly organize supervision and inspection, municipal health administrative departments should regularly organize regular assessment, and our office will also organize annual work assessment before the end of the year. The evaluation focuses on whether to establish a long-term mechanism and implement it effectively, whether the health service capacity of grass-roots institutions is improved, whether the burden of farmers' medical treatment is reduced, and whether rural grassroots medical and health services are implemented. Through inspection and evaluation, we will constantly sum up experience and analyze problems to promote the healthy development of the two reforms.