Health: county order to "union" will "overcome"

Healthday news reporter zheng cao

        County hospital rapidly expanding

        9:00 am, the reporter walks into HanShanXian in anhui province people's hospital outpatient service building, here was thronged with doctor was surrounded by patients. In the inpatient department, because too many patients, the hospital had to put a layer of the hall ZhuYuanLou on both sides of the cashier's move to all outdoor, the house free used as ward. Until at 8, county hospital ZhuYuanLou or people come and go, one side of image daily is also lights, still have patients waiting outside.

        HanShanXian people's hospital, vice President of the yonghong introduction, the hospital bed only 280 pieces, even in the least, utilization of beds by more than 80%, and in normal times, insufficient beds can only extra bed, to the Spring Festival of migrant workers migrant workers return home, beds and more nervous.

        "The original hospital 200 beds at discontent, now when living up to 300 beds are not enough use." The yonghong told reporters that change will occur in the years. His analysis, on the one hand, the new farming and security level, farmers' ability to the county to see the doctor; On the other hand basic-level countryside medical institutions referral even don't accept patients, the county hospital also more and more.

        HanShanXian of another medical institution at the county level public hospital, the same situation. Although just move, part of the ward and department also in decoration, the chief JinWenChao said, the hospital utilization rate still at 120%.

        Reporters noticed that not all of the patients were in serious condition to the county to treatment not, also have inside come out from dozens of to do a the appendix or a hernia operation. The net at the county level hospital, let many business dropped more cold and cheerless center of the hospital.

        This also promote more patient flow to the county public hospital, and even appeared "in the problem of" difficult. A county health officials said that, when the nervous to bed, even the county government staff all should look for a relation to live in county hospital.

        The local government will this phenomenon at the county level of the medical institution to hardware insufficient. Therefore, the county hospital rebuilding moved is written into "1025" planning, by 2015, the county hospital total ChuangWeiShu will reach 1100 pieces, including county hospital ChuangWeiShu of at least one times to expand. County health bureau chief WangZhaoXian estimate, by then medical hardware should be able to meet the basic needs.

        In 2012, the county hospital. Site will completion, governments put great enthusiasm, in construction process, the scale of the county hospital are still expanding. "The original design of the budget is 70 million yuan, now come down surely is 120 million yuan." The yonghong said.

        However, and other counties, cities at the county level compared to the hospital, HanShanXian expansion plan still appears very subtle. The patient in the hospital at type growth, and the government to promote the enthusiasm, let many county hospital rapidly expanding, ChuangWeiShu more than four digits of large medical institutions in the county has not rarely seen.

        But, for a single infrastructure and hardware into, whether from go up at all improvement of service ability at the county level and the hospital? At the county level alone of the scale expansion of hospital, whether from the fundamental solution to the problem of rural residents hospital? This still need queried.

        The doctor enthusiasm is not high

        In the county hospital business prosperity at the same time, the doctor did not show much excited. The surgeon LiuYu (a pseudonym) to journalists complain, hospital or according to the basic qualifications and wages level, work to little effect on how much income.

        "The doctor's enthusiasm is not high, also lack of high quality talent." The yonghong admit, lack of human resource question, not only in the rural hospitals very outstanding, in the same hospital outstanding, especially anesthesia medical department, video, etc. "The county hospital and prepare, but no one willing to vacancy."

        WangZhaoXian confirmed that. Due to register a number and even not enough jobs, they had to be a new organization for recruitment. This let WangZhaoXian confused: "by rights, treatment of what is not bad, how be called no one?"

        The doctor's attitude and the different levels, and also affect the level of hospital services. Similar grassroots health hospital avoid risk, excuse the patient's phenomenon in the county hospital also exist. Many patients to demand higher than to the county hospital. The hospital now patients, 90% are from the rural areas of the patients, the affluent most county residents to outside the county medical attention.

        "The children in the county is ill, parents don't go to here to send, direct tore hefei hospitals or nanjing......." LiuYu said, "why? Not somebody else think you level difference bai."

        In 2011 the two meetings, deputy director of the national development and reform commission, the cure of the state council, director of SunZhiGang do, said in public hospitals in the reform, can use for reference in the new reform of personnel system reform, to reform of the income distribution system, to break a medicine medical mechanism, medicines procurement mechanism, the funds to guarantee system, and a series of reform practice.

        And HanShanXian adjacent in wuhu, anhui province, and grassroots health hospital the same drug zero rate differential at county level hospital reform has vigorously began, the city and county level public hospitals to home will mechanism of system reform.

        Drug zero rate differential touched on the most sensitive nerve. The yonghong said, now a lot of profit at the county level and the hospital is on drugs, if fully dissection, county hospital survival I'm afraid there will be problems. So far, the government except in the special subsidy on infrastructure projects, to the hospital the daily input only enough for retired worker annuities. If to carry drugs zero rate differential, the government's investment must be based on the multiple growth.

        WangZhaoXian said, the reform of the financial compensation, involving placement, than the hospital reform involved parties more, the operation is more complicated. "How change, now haven't count, and the government is still consider very carefully."

        (next turn version 2) (up to the first edition)

        Rural county to take everything into consideration

        County public hospital reform, in addition to medical institutions themselves about, the more relationship in the county medical resources adjustment and county village level 3 network integration layout.

        WangZhaoXian said, with the development of the county hospital, in the future will be in hospital to consider county hospital managed, in to the county medical resources horizontal consolidation, and on the basis of the county hospital divided by management area of rural hospitals, village clinic, a resource, human and financial resources integrated management of the medical group, form county, township and village integrated management of the medical institution of new pattern. The government is responsible for monitoring the health hospital's public health work progress, the medical service is by the superior, the organization carries out the hospital.

        Establish community of interests, can let level 3 network effective interaction. The practice also proof, this approach is effective, when the tank with the township health centers it is through the big hospital joint cooperation, to cultivate the advantage of the project.

        In addition, experts suggest, can use reorganization of the rural level 3 health network opportunity, break "ownership" barriers, make county, township and village level 3 health the flow of talent big pattern, form the perfect "almighty, YongZhe down" mechanism of employing. The so-called level 3 health the flow of talent big pattern, it is completely according to the business level and business ability, allow health personnel in rural level 3 health network free flow within. Such reasonable flow of talent mechanism, make rural health talent chain by the county hospital internal extended to rural hospitals and village clinic and relieve the bottleneck of the service to because people missing. "In the next county reform will is a whole, again not isolated at a level of medical institution reform." WangZhaoXian said.

        Journal reporters

        The cure of the "building mechanism" to be more to force

        Health hospital is cold and cheerless, farmers don't want to see the doctor at the grassroots level. This change is not only in a county in a province. In the 2012 national conference on health, many health TingJuChang refer after the reform of basic happen this change.

        In reform, administrative management department to change the medical and health institutions service orientation, improve the operating mechanism of the determination and courage is very big, the comprehensive reform in basic also achieved significant results, and public health work to get a great strengthened, and the medical share in the lower, the rural excessive medical treatment, not the rational use of drugs in the situation to improve. But some parts of the system are still have failed to solve problems, such as the ability of the doctors still don't let sink into the roots, appear even the hospital doctors to the county backflow phenomenon; The medical staff team enthusiasm is still not aroused, but for the return to the "big-pot roce" dangerous; The primary service ability of degradation trend didn't get basic twist and turn, in some areas and even have signs of acceleration.

        If at the mercy of the institutes of health service ability of degradation trend intensifies, farmers in the hospital to get new farming together after security, natural meeting "voting with their feet"-a doctor to seek county concentration. County hospital even speed expansion, and medical treatment of the tide in the pressure to bear, not to worry, difficulties in getting in the county will spread? The change trend of the farmers go to a doctor, will not give health investment direction issue wrong induction signal, lead to medical waste of resources?

        And health hospital there have also been concerns, there are more grass-roots village clinic. The reporter interviewed in always observed in, because the cure of the rural doctors to the service function transformation to public health and, at the same time, the use of drug strictly limited and by a drug zero rate differential effects, many rural doctors have no enough time, also do not have enough to provide basic medical service enthusiasm, willing to go to the doctor more and more farmers village clinic less. In the long run, the country WangDe medical service capacity will be more hasten is weakening, the weakening trend is designed in our reform? Long-term since, the rural township and village level two medical services and public health service ability disequilibrating conditions are still with us, the present basic unit of all kinds of policies can make medical that part of the weakening of medical service ability into the public health service ability?

        Think about the problem, we are faced with the process of urbanization, the population to cities and towns to the medical service demand on the regional influence. The variable to join, the more we need to constantly adjust the medical resources allocation of thought.

        The new problems of basic appear, and once again, the government and the public to suggest the hardship and complexity of medical and the long-term, has again highlighted the cure of the process of the urgency of "building mechanism".

        Thankfully, the face to the problems, and health management has to do that. In order to arouse the enthusiasm of internal medical staff, some places will be basic wage and performance of the proportion of the original wages by 73 or 64 to 37, increase in part of the assessment live; In order to alleviate the situation of lack of talented, some place to start will be health hospital backbone treatment to emulate county hospital, even the rural institutions directly into the hospital system at the county level, in the county in the structure of talents is not reasonable adjustment to solve problem; Some provinces has begun to open the basic-level medical institutions service items.

        Three years after the cure, as local began to review and adjustment grassroots comprehensive reform, believe that there will be more and more such targeted policy measures introduced. The cure of how much air is not built the ward, the configuration of how many advanced equipment, the foothold shall is "people" : let cure man has the power, can let the person have a medical. More important is to build primary health personnel can let "carry gas", and can play a great enthusiasm and energy mechanism.