The "Guiding Opinions on the Pilot Work of Integrated Management of County and Township Medical and Health Services in Fujian Province" are hereby printed and distributed to you, please earnestly organize the implementation. Please submit the list of pilot counties (cities) in each district and city to the Provincial Health and Family Planning Commission for the record before September 10.
Fujian Provincial Health and Family Planning Commission Fujian Provincial Department of Finance Fujian Provincial Department of Human Resources and Social Security
August 25, 1965 438+04
Guiding opinions on the pilot work of integrated management of county and township medical and health services in Fujian Province
In order to speed up the development of county medical and health undertakings in our province, promote the comprehensive reform of county and township medical and health institutions, integrate medical and health resources, realize the enjoyment of resources, further enhance the rural health service capacity, and meet the people's demand for medical treatment, according to the Notice of the General Office of the People's Government of Fujian Province on Forwarding the Implementation Opinions of the Provincial Health Department and other departments on Establishing the Division and Cooperation Mechanism between Public Hospitals and Grassroots Medical and Health Institutions (Min Zhengban [2010] No.52) and other documents.
I. Work objectives
In accordance with the requirements of "protecting the foundation, strengthening the grass-roots units and establishing mechanisms", aiming at establishing a medical and health service system that adapts to the economic and social development of the county, and in accordance with the principles of government-led, benefiting the people, highlighting key points and adapting measures to local conditions, we will explore the establishment of a division of labor and cooperation mechanism between public hospitals and grass-roots medical and health institutions through the pilot project of integrated management of medical and health services in the county and township, further improve the utilization rate of medical and health resources and the comprehensive service capacity, and strive to achieve the goal of 20 15 in the county.
Second, the scope of the pilot
All districts and cities (except Xiamen) can choose 1-2 counties (cities) according to local conditions, and carry out the pilot project of integrated management of county and township medical and health services in county-level public hospitals and 1-2 tertiary first-class hospitals.
Three. primary mission
(A clear functional positioning
County-level public hospitals (including traditional Chinese medicine hospitals) are the "leaders" of medical and health institutions in the county and rural tertiary medical service networks, and mainly undertake tasks such as basic medical services for residents in the county, diagnosis and treatment of common and frequently-occurring diseases, treatment and referral of major and difficult diseases, popularization and application of appropriate medical technologies, emergency treatment of natural disasters and public health emergencies, and teaching, training and technical guidance for grassroots health personnel in township hospitals. Township health centers provide comprehensive services such as basic medical care, basic public health and family planning technology, and are entrusted by county-level health and family planning administrative departments to be responsible for the business management and technical guidance of village clinics within their respective jurisdictions.
(B) the establishment of a new management system
In accordance with the requirements of "four unifications, three invariants and one promotion", pilot counties (cities) focus on selecting 1-2 Class C township hospitals and county-level public hospitals (including traditional Chinese medicine hospitals) with weak technical strength to implement integrated management, integrate medical and health services at the county and township levels, establish a synergistic relationship of interdependence and complementary advantages, and realize resource sharing and unified management. Specific requirements:
1. Unified management of personnel. Pilot counties that implement the integrated management of county and township medical and health services can bring the management authority of township hospitals with weak technical strength and few medical personnel into the unified management of county hospitals; Doctors who have obtained the qualification of practicing (assistant) doctors and registered on the job in township hospitals with more personnel can also be included in the unified management of county-level hospitals. County-level hospitals make overall arrangements for the use of personnel in accordance with the principle of "relatively fixed posts and the flow of personnel as needed". The staff of township hospitals and county-level hospitals enjoy the same rights in terms of wages, selection and use, and the evaluation of professional titles is carried out according to the original evaluation conditions. All localities should give township health centers more convenient recruitment policies and more favorable post setting policies, and appropriately increase the proportion of senior posts.
2. Unified management of medical services. The medical services of township hospitals are managed by county hospitals in a unified way, so as to unify rules and regulations, technical specifications, personnel training, business guidance and work assessment, and carry out medical services in accordance with functional orientation and technical requirements.
3. Unified management of medical equipment. Strengthen the integration of elements and functions of county and township medical and health resources, build a resource sharing platform such as laboratory center, image consultation center and disinfection supply center, promote mutual recognition of inspection results, and improve the scale and intensive utilization of high-quality medical resources. Encourage the purchase of services from qualified social professional service institutions such as medical inspection and disinfection supply through service outsourcing, and improve the diagnosis and treatment ability and management level at the grassroots level.
4. Unified management of performance appraisal. Medical and health institutions under the integrated management of counties and townships should implement unified performance appraisal and independent financial accounting. County-level hospitals independently distribute according to the results of performance appraisal, so as to achieve more work, excellent performance and equal pay for equal work. Income distribution focuses on clinical frontline, key posts, business backbones and personnel with outstanding contributions, and appropriately tilts to township posts to widen the income gap reasonably. County-level health and family planning administrative departments should improve the performance appraisal system of county-level and township-level medical institutions, formulate reasonable patient diversion assessment indicators, and strengthen supervision and guidance on the implementation of financial accounting systems in county-level hospitals and township hospitals. The disposal of assets shall be carried out in accordance with the unified provisions of the county-level state-owned assets management department.
5. The institutional setup and administrative system will remain unchanged. County-level hospitals and township hospitals retain the original institutional setup and administrative system, and township hospitals can add county-level hospital branch brands.
6. The institutional functions and tasks remain unchanged. The tasks undertaken by county-level hospitals such as medical and health care services in the county, technical guidance of primary medical institutions and personnel training remain unchanged. Township hospitals still undertake basic public health services and family planning technical services such as residents' health records, health education, planned immunization, prevention and treatment of infectious diseases, children's health care, maternal health care, elderly health care, chronic disease management, severe mental patients management, health supervision and co-management, and traditional Chinese medicine health management, as well as basic medical services commensurate with their functions.
7. The financial investment guarantee mechanism remains unchanged. The current financial investment policies and channels of county and township medical institutions remain unchanged. The development and construction funds such as capital construction and equipment purchase of tertiary township hospitals and the basic public health service funds shall be fully and timely allocated by the government, and the staff salaries shall be fully allocated according to the current policy.
8. Promote the construction of graded diagnosis and treatment system. Taking county-level hospitals as the center and integrated management of counties and townships as the carrier, measures such as medical care, medical insurance, price, personnel training, and innovating new models of primary medical services are comprehensively applied to improve the division of labor and cooperation mechanism between county-level hospitals and primary medical and health institutions and promote the construction of graded diagnosis and treatment system. Pilot counties should formulate clinical standards, referral procedures and management norms for two-way referral of outpatient and inpatient services at county and township levels, cancel the two-way referral of patients' medical insurance and the second deductible line of the new rural cooperative medical system in the integrated management of county and township medical and health institutions, and promote the implementation of the two-way referral policy. In principle, primary medical and health institutions should give priority to outpatients. Medical institutions at the county and township levels should clarify the admission conditions of hospitalized diseases. Patients who meet the admission conditions of hospitalized diseases at the grass-roots level should be given priority to the grass-roots level. Patients who meet the referral conditions should give priority to receiving medical treatment and hospitalization services in county hospitals, and gradually realize seamless referral. Grassroots medical and health institutions can also provide patients with inspection and appointment services in county-level hospitals, and feedback the inspection results in time. By strengthening the referral service, unblocking the referral channel, guiding patients to seek medical treatment at the grassroots level, and gradually realizing the first diagnosis, two-way referral and graded diagnosis and treatment at the grassroots level.
Fourth, the job requirements
(A) to strengthen organizational leadership
The administrative department of health and family planning in the pilot counties (cities) should strengthen the organization and leadership, formulate the pilot work plan for the integrated management of county and township medical and health services in light of local conditions, and clarify the main body of responsibility, tasks and time schedule. In addition to close integrated management, we can also carry out loose integrated management of medical services such as trusteeship, technical cooperation and counterpart support. Through effective management methods, we can effectively improve the level of integrated management and promote the improvement of county medical service capacity. Preparation, finance, personnel and other departments should actively cooperate in accordance with their respective responsibilities, form a joint force, and promote the smooth development of the pilot work.
(B) a clear division of responsibilities
County hospitals rationally allocate human resources according to the requirements, formulate feasible work plans and take effective measures to improve the service capacity of township hospitals in view of the medical service needs of township hospitals. While doing a good job in medical and health services, township hospitals should conscientiously do a good job in basic public health services and family planning technical services, and perform the supervisory duties of village hospitals within their jurisdiction.
(3) Strengthen supervision and guidance
All localities should attach importance to strengthening the process management of the pilot work, strengthen communication and coordination, find problems and improve them in time, and constantly improve policies and measures. Pay attention to the initiative, enthusiasm and creativity of pilot counties (cities), sum up work experience in time, and promote the pilot work of integrated management of county and township medical and health services to achieve practical results.