Notice about advancing grading diagnosis and treatment of pilot work

The national health and family planning commission of the People's Republic of China

The 2016-08-19

The medical hair [2016] no. 45

Provinces, autonomous regions and municipalities directly under the central government health and family planning commission, the administration of traditional Chinese medicine, the xinjiang production and construction corps health bureau:

For the implementation of the "about promoting the construction of the grading system guidance" (countries do hair [2015] no. 70, hereinafter referred to as "opinions"), the general office of the state council concerning the deepening medical and health system reform in 2016, the key task of notice (the hair [2016] 26 date) regulation, and the government work report of 2016 "about the job requirements, everywhere to declare, on the basis of the national health and family planning commission and the state administration of traditional Chinese medicine identified four municipalities directly under the central government such as Beijing, shijiazhuang city, hebei province, 266 district cities as a pilot city grading diagnosis and treatment of pilot work (see attachment). Now is to promote grading diagnosis and treatment of pilot work put forward the following requirements:

A, raise awareness, strengthen the leadership

Provincial family planning administrative department of public health and pilot cities (including management of traditional Chinese medicine department, hereinafter the same) to fully recognize the importance of hierarchical diagnosis and treatment work, the difficulty and complexity, give play to the role of good pilot cities "vanguard", strengthen the sense of responsibility and mission, in accordance with the relevant "opinion" work requirements, grading diagnosis system construction should be brought into the deepening health reform work arrangements, strengthen organization and leadership. On the basis of full investigation and argumentation, and combined with local medical practice, set specific goals and feasible pilot work plan, clear targets and time schedule, to perfect the management system and strict enforcement, pilot work tasks on time, high quality.

Second, the pilot, highlight the key

The family planning administrative department of health of the pilot cities to work in accordance with the relevant "opinions" requirement, surrounding the pilot work plan, develop and implement various supporting policies and measures for the pilot, deployment start pilot work as soon as possible. On the full implementation of "opinions", on the basis of relevant requirements, in 2016, mainly to do the following work:

(a) to further promote grass-roots service ability. Continue to strengthen the ability construction of grassroots medical institutions and hospitals at the county level, outer surrounding county, higher rates of disease, to strengthen the appropriate technical promotion and improving the capacity of county-level hospitals disease diagnosis and treatment. By forming medical association, counterpart support, physician practice, more cities to level 2 above hospitals practitioners to grassroots health institutions more, or regular visits, visits, to accelerate the grassroots and rural health resources flow, enhance the service ability. Improving the capacity of grassroots medical and health institutions of traditional Chinese medicine services and medical rehabilitation service ability, strengthening the construction of characteristic of traditional Chinese medicine diagnosis and treatment area, promote comprehensive service mode of traditional Chinese medicine, give full play to the traditional Chinese medicine in the role of common disease, frequently-occurring disease and chronic disease prevention and control.

(2) to promote the family doctor service signing. Signed to carry out the "about promoting the family doctor service guidance" (the reform do hair [2016] no. 1) about the job requirements, promoting summarizes place to promote family doctor sign contracts mature experience, on sound contract signing and management policy files, set up a sound system of general practitioners. Clear sign service connotation and standard, the standard contract service charges, perfect the contract service incentive constraint mechanism. Signing service expense of medical insurance fund, for the basic public health service, and individual citizens share the signing.

(3) to explore a medical association. Provincial family planning administrative department of public health and pilot cities to overall planning, through the form of couplet of medical, gradually form the responsibility, right, clear the area of collaborative service mode, using information technology means such as telemedicine, promoting regional medical resource sharing and longitudinal flow, perfect medical services system classification. On the basis of the original work, encourage area according to the medical couplet body in a nearby, voluntary principle, avoid across the province set up form, inside the couplet of medical liability and benefit sharing mechanism, fully arouse the enthusiasm of members of the unit. In urban areas, encourage conditional area is established on the basis of ownership of assets integrated medical couplet, also can establish, with emphasis on the resource sharing, technical collaboration, d. In the county, the key to a county hospital, township integration management of medical association.

(4) scientific implementation of slow partition. With medical couplet body as the carrier, ambulatory surgery as the breakthrough point, according to medical couplet body within the function orientation of medical institutions and medical service ability, clear medical couplet body inside nasty slow partition service process.

1. To carry out the medical institutions function. Urban tertiary hospital mainly provide the critical and difficult complex disease medical services; City secondary hospital mainly receive tertiary hospital referral of patients with acute disease recovery, patients with postoperative recovery and critically ill patients with stable period; Tertiary hospital of traditional Chinese medicine mainly make full use of the technology and methods of traditional Chinese medicine and modern science and technology, provide the critical and difficult complex diseases services and the advantages of traditional Chinese medicine of traditional Chinese medicine diagnosis and treatment of diseases of TCM clinic diagnosis and treatment services; Secondary hospital of traditional Chinese medicine mainly make full use of the technology and methods of traditional Chinese medicine and modern science and technology, to provide Chinese medicine diagnosis and treatment of common disease, frequently-occurring disease, chronic diseases in the area of the rescue, emergency and severe cases patients complicated complex diseases up referral services; Chronic medical institutions to clear diagnosis, patients with stable condition of patients with chronic diseases, rehabilitation period, geriatrics patients and patients with adanced tumor treatment, rehabilitation and nursing service.

2. Set up medical institutions in this couplet of medical collaboration mechanism. Beyond the patients of clinical ability of medical institutions, near to the medical couplet body within the superior hospital; Clear, stable condition to the diagnosis of patients with chronic diseases, rehabilitation period patients transferred to medical institutions at a lower level, provide continuity and treatment services for patients. Conditional region, within couplet of medical patient referral center, responsible for coordinating patient two-way referral services. For grassroots service system is not sound, weak ability of Chinese medicine in the area, to discriminate between the traditional Chinese medicine hospital, hospital of traditional Chinese medicine of traditional Chinese medicine outpatient medical services should be brought into the first option, give full play to the service ability of TCM hospital, meet the needs of the people first option to see the traditional Chinese medicine.

3. The gradual ambulatory surgery. As the breakthrough point, to medical couplet body in tertiary hospitals and their collaboration in secondary hospitals and grassroots medical institutions gradually promote division of labor cooperation between daytime operation mode. Tertiary hospital phase in ambulatory surgery, optimize medical service process, improve the efficiency of medical service, on the premise of guarantee medical quality and safety, provide patients with efficient service operation in the day, and the postoperative rehabilitation in patients with stable transferred to the secondary hospitals and medical and health institutions at the grassroots level to establish a system for patients with postoperative follow-up, to guide subordinates do patients with postoperative rehabilitation, medical institutions and grassroots medical and health institutions to open a green channel for ambulatory surgery.

(5) to accelerate health information construction and promoting regional medical resource sharing. To speed up the construction of regional health information platform, and gradually realize continuous recording electronic health records and electronic medical records and at different levels, and information sharing between different categories of medical institutions. Use of remote medical informatization means such as to promote medical resources longitudinal flow, improve the high quality medical resources accessibility and efficiency of medical service as a whole. Development of medical and health services based on Internet, make full use of the Internet, data, etc. The role of information technology in the classification diagnosis and treatment. Explore set up medical imaging diagnostic center, medical test laboratory, such as independent medical institutions, implement regional resources sharing.

(6) coordinating departments and improve the supporting policies. Provincial family planning administrative department of public health and pilot cities to strengthen with the national development and reform (price), finance, human resources, social security and other relevant departments of communication and cooperation, the innovation system mechanism, perfect the supporting policies, to coordinate, promote and create conditions for promoting the construction of the grading system. To further improve pharmaceutical price policy, implement tiered pricing measures. Perfect health care payment policy, promote the reform of medical insurance payment methods, improve the performance salary allocation mechanism. To carry out the financial aid policies. By grading diagnosis and treatment of pilot, form more can copy, can promote the beneficial experience.

Third, strengthen assessment, timely summary

Provincial family planning administrative department of public health and pilot cities to build a pilot evaluation mechanism and method of performance appraisal, earnestly implement the responsibility system and accountability. Priority tracking and supervision system is established and the pilot work task set annual quantitative indicators, strengthening policy guidance, the pilot work regularly in the area under its jurisdiction to carry out the situation of supervision inspection. Seriously the baseline survey, conduct pilot evaluation work to provide baseline data for the future. Establishes a system of classification, diagnosis and treatment of pilot work data information, regularly submit, to strengthen the monitoring of the situation, collect the relevant data, using information technology means to carry out data analysis. Timely grasp the pilot work progress, summarizes the promotion useful experience.

Must strengthen the exchange of learning, fully draw lessons from other pilot areas mature experience, innovative ideas, and constantly improve. Each pilot cities pilot work plan, the family planning administrative department of public health can be a reference in the residents' choice of Shanghai community health service center, on the basis of family doctors to sign again choose a district medical institutions and a municipal medical institutions for signing, form signing of "1 + 1 + 1" combination of medical institutions, with 60 years of age or older as the main body, to voluntarily signed up for the principle, on the basis of quality service, gradual progress to establish the classification system. Xiamen to high blood pressure, diabetes, set up by specialists, general practitioners, and health management division team of ties with "three division condominium" so as to realize the large hospitals and community hospitals. By forming of jiangsu province medical association, in its internal resource sharing, information interconnection, personnel deployment, homogeneous service. Hangzhou is given priority to with family doctors signed promote grading diagnosis and treatment work.

Fourth, strengthen the propaganda, guide public opinion

Provincial family planning administrative department of public health and pilot cities to strengthen publicity and education, to implement the administrative personnel and related training of medical personnel, establish the classification system as the performance of social responsibility, inevitable requirement to promote the development of enterprise, enhance the initiative, improve the enthusiasm. Fully give play to the role of the media, strengthen the basic-level medical health agency services and hierarchical diagnosis and treatment work of propaganda, improve the capacity for the social from all walks of life and the people of the classification system of recognition and support. Widely spread knowledge of disease prevention and control, establish a scientific concept, promote patients near and give preference to basic medical and health institutions.

Please the family planning administrative department of health under the pilot cities before September 15, 2016 issued by the pilot work plan, and start the pilot work. Please provincial family planning administrative department of public health to collect summary jurisdiction pilot cities formally issued by the pilot work of the project, and submitted to the state before September 30, 2016, health and family planning commission and the state administration of traditional Chinese medicine for the record.

Provincial family planning administrative department of public health in monthly summary trial work within their respective jurisdictions, and before the next January 15, the state health and family planning commission will work monthly progress medical hospital authority. National health and family planning commission will timely organization of hierarchical diagnosis and treatment of pilot work of the supervision inspection, in accordance with the "opinions" attached "grading diagnosis and treatment of pilot work evaluation standard" carries on the detailed review.

The national health and family planning commission contacts: medical hospital authority Rui-rong hu, wang yi,

Telephone: 010-68791887, 68791886

Fax: 010-68792963

Email address: bmaylzyc@163.com

The state administration of traditional Chinese medicine contacts: the department Qing-bin meng

Telephone: 010-59957680

Fax: 010-59957684

Email address: yizhengsiyichu@126.com

Attachment: hierarchical diagnostic pilot cities list

The national health and family planning commission of the state administration of traditional Chinese medicine

On August 19, 2016

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