How can the people, to see the doctor, more convenient?

08:20 March 10, 2016

Source: People's Daily - the People's Daily

This year's government work report, "coordination promote the reform of medical treatment, health care, medical linkage" "basic public health services for financial aid from 40 yuan to 45 yuan per capita, to accelerate the grassroots and rural health resources flow". "Twelfth five-year" period, our country health reform has made great achievements, especially the primary care level is improved. However, the current level of primary care remain weak, lack of talent, such problems as shortage of funds, how to solve these problems? Some representatives gave his advice.

Hierarchical diagnosis difficult to implement, still need to enhance the level of primary care

The hospital why always crowded, grading treatment what are the difficulties in place? Basic medical college of Beijing union medical college, dean of Shen Yan represent thought, primary care level is relatively weak.

"A lot of old towns and townships equipment or missing, technology level also tend to lag behind." Shen Yan said, "at the grass-roots level is difficult to meet the demand of medical treatment, farmers were forced to go to large hospital. The patient cluster large hospital, cause 'look medical ailments, big mara car', waste precious medical resources, also increased the farmers' medical burden."

Sianing deputy director of the guangxi zhuang autonomous region health development planning commission members believe that even a higher level than in towns and townships of public hospitals at the county level, resources, ability is insufficient.

"Insufficient public hospitals at the county level resources. First of all, insufficient beds. In guangxi for example, in 2015, the autonomous region at the county level public hospital beds per thousand permanent population was 1.4, lower than the national requirements. The second is the basic construction do not meet the standardization requirements. At the same time, talent shortage, pediatrics, intensive areas such as medicine, oncology service ability is weak, it is difficult to undertake the superior hospital patients." Sianing said.

Strong base is one of the basic principles of health care reform. Sianing suggests that countries should increase investment in county hospitals, "in the county-level hospitals standardization construction, remote medical treatment system, ensure service ability to achieve 90% disease, take the superior turn hospital patient care specialist equipment configuration of increasing investment, targeted to enhance the level of county hospital medical personnel professional technology and promoting the construction of regional medical association, strengthening the construction of county-level hospitals clinical key specialty."

Capital talent is not enough, also need to increase investment in basic-level hospitals

Grassroots medical level is weak, on the one hand, is limited funding, lack of hardware facilities; On the other hand is the brain drain, good doctors do not leave.

In anhui province hospital ge-liang xu representative point of view, a drug after zero rate, basic-level hospitals funding gap problem worthy of attention: "the direction of the drug is zero rate we do medical, also want to see to the common people. However, after the hospital who will fill the vacancy money?"

Ge-liang xu is introduced, the provisions of the national level for the project price appropriate adjustments, by improving the medical service charge, operation and other aspects, make up for the drug after the zero rate possible funding gap, but it also faces some challenges in practice: "such as towns and townships, the original villagers to see the doctor could say hello to, but now the hospital charge or improve the registration fee, patients may some theory guilds will directly go to the hospital."

"So, some professional hospital, should strengthen the basic-level hospitals in support, build a basic level, to let more patients out of the county." Ge-liang xu said.

Health development planning commission director of jiangsu province 王咏红 representative thinks, "in the past, hospitals run by drug addition, financial aid and service charges. Now cancel drug addition, that is about to set up scientific compensation mechanism, increase in government spending."

Have money, to retain talent. Chongqing cancer hospital chief physician housekeeper thought, although the basic-level hospitals in gradually improve the hardware facilities, but platform is limited, hard working conditions at the grass-roots level, low treatment factors, makes the basic-level hospitals keep talents. To solve this problem, can try the title evaluation system, to establish a relatively independent under the title assessment system at the county level, through to the title, give treatment, attract suitable talents, retain the useful talented person.

Ge-liang xu suggested that want to retain talent, at the grass-roots level is to strengthen the orientation training, "willing to work in grassroots hospital of university undergraduates are very few, so can consider directional training grassroots doctors. In addition to increasing the directional training education." The second is to promote grass-roots vitality, "mainly by increasing the construction of township hospitals and medical personnel at the grass-roots level welfare increase government spending, introduced relevant national policy support, solve the problem of the doctor's treatment at the grass-roots level."

Village doctor team is not stable, still need to solve the identity, pension and other worries

Basic health care, also need to enhance the level of basic public health services at the grass-roots level and establish a relatively stable team of village doctor.

Gao guangsheng, director of the fourth hospital of Harbin in heilongjiang province geriatrics department representative said: "the vast rural areas in our country has 1.4 million rural doctors, to provide farmers with basic medical and health services and health care. But for a long time, the village doctor's identity, qualification, aptitude and retirement benefits, become their worries."

The xinjiang uygur autonomous region people's hospital of department of gynaecology, director of the institute based on noor omar niyaz representative at the grassroots research found that many of the local village doctor often because of poor living conditions, unable to solve the problem of identity and other reasons to give up the job.

To the problem of the identity of the village doctor gao guangsheng proposed independent qualification evaluation system, the rural doctors' composition of rural doctors is more complex, for their aptitude should adopt "the old man old way new methods, new". To establish rural doctors practicing medicine practical, operable, is different from the city a doctor, an independent assessment and examination system."

Gao guangsheng also suggested that, after the qualification authentication, village doctor can be incorporated into the unified management of village clinics, according to the corresponding professional qualifications and professional titles, and receive the same treatment doctors in town, fundamentally solve the problem of the stability of our country rural grassroots medical and health web.

"Properly solve the problem of village doctor identity and endowment, relationship to the farmers in our country will have access to basic medical and health service fairness and quality." Based on noor omar niyaz said: "can solve the problem of village doctor identity, with reference to the successful experience of the conversion of the run by the local teachers, to develop regional health human resource planning, including village doctor, and according to the planning for career preparation, the village doctor formal health workers into the country."

(reporter lancy hu, fangyuan, yuan-fan Yang, sun zhen, Jiang Yunlong, Yao Xueqing, Zhang Shuo, qiao, He Lu, li)

The People's Daily (12 March 10, 2016)