About to do a good job of 2016 county-level public hospital reform

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

The 2016-09-18

Countries who do restructuring letter [2016] no. 972

Provinces, autonomous regions and municipalities directly under the central government health and family planning commission, financial department (bureau), the xinjiang production and construction corps health bureau, the bureau of finance:

In 2015, the reform of public hospitals at the county level comprehensive comprehensive away, important progress has been made and a new breakthrough. Uneven progress, but there are still around reform has to be deepened reform of key areas and crucial links, maintain the public welfare, to mobilize enthusiasm, ensuring the sustainable operation mechanism is not yet fully established, the reform task is very heavy. Implemented for the implementation of the general office of the state council on the implementation of the reform of public hospitals at the county level comprehensive opinions do hair [2015] no. 33 (countries) and the general office of the state council concerning the deepening medical and health system reform in 2016, the key task of notice (countries do hair [2016] 26 date) the relevant requirements, strengthen perfect the comprehensive reform of public hospitals at the county level, strengthen classified guidance and demonstration lead, do it right now, in 2016 at the county level public hospital reform work order is as follows:

First, consolidate the improve public hospitals at the county level comprehensive reform

Consolidate break with medicine medical achievements, deepen the reform of mechanism of system of public hospitals at the county level, enhanced its management system, operation mechanism, price adjustment, personnel, income distribution, comprehensive reform of medical insurance payments.

(a) all across the country, reform of the county (city) focus on completing the following tasks:

1. The formation of public hospital management committee at the county level, the performance of the government functions, be responsible for the hospital development planning, articles of association for major projects, the implementation, financial investment, so as dean, operation regulation, performance appraisal, etc. The implementation of public hospital personnel management at the county level, the deputy recommended power, performance salary of internal division and annual budget enforcement management autonomy. To establish modern public hospital management system, to promote public hospitals at the county level to the town, phasing out the administration level of hospital.

2. The formulation and implementation of the county medical and health service system planning, clear at the county level, the construction scale of public hospital beds and equipment configuration standards, planning and implementation to the public on a regular basis. It is forbidden to public hospitals at the county level to borrow debt construction and the purchase of large medical equipment. Construction of super planning and construction, or borrowing, shall be investigated for relevant personnel responsibility.

3. To consolidate cancel drug addition reform efforts. All public hospitals at the county level to cancel the drug addition (except traditional Chinese medicine yinpian), at the same time, improve the adjustment of medical service prices, increase government subsidies, reforming health insurance payment and hospital to strengthen the accounting and save running cost share of compensation mechanism.

4. Reasonable verification of public hospitals at the county level of the total, innovative management style, step by step to prepare the records. In the post setting, income distribution, title evaluation, management, use, etc., to prepare the treatment of internal and external personnel to plan as a whole to consider.

5. All public hospitals at the county level is given priority to with the macro-reforms, multiple payment methods of combination of composite health care reform, further expanding coverage. In order to strengthen the management of clinical pathway, strive for more than 80% of the county-level hospitals to carry out the clinical pathway management.

6. Strictly control the medical expense unreasonable growth. According to the provincial (autonomous regions and municipalities), city () to determine the regional medical costs increase, will control cost target decomposition to each county public hospitals, public medical expenses growth on a regular basis. Implementation at the county level public hospital outpatient and hospitalized patients expenses and income per capita growth drop, medical service income (excluding pharmaceuticals, consumables, and large equipment check income) business income proportion of ascension, patients' out-of-pocket medical expenses of total medical costs decline.

(2) comprehensive reform pilot province county (city) wants to be coordinated in the reform of medical treatment, health care, medical linkage on the breakthrough, on the basis of the above six task, to further advance the following four tasks:

1. The push by the party committee and government is mainly responsible for comrades or a is mainly responsible for comrades to reform leading group leader, give full play to the leading group for reform of overall coordination effect.

2. Promote rationalize the basic medical insurance management system, unified handling management, can carry on the establishment of medical insurance fund management center, undertake fund pays and management, medicines procurement and payment, payment standard, designated agency agreement management and billing and other functions, give full play to health care for pharmaceutical production circulation enterprises, hospitals and doctor's supervision.

3. In accordance with the \"total amount control, structural adjustment, mixed, gradually in place,\" and the principle of \"make room, structure, cohesion\" steps, straighten out the medical service prices, further reduce the medicine proportion (not including Chinese medicine yinpian) and one hundred yuan of medical income income (excluding pharmaceuticals) consumption of health material cost.

4. Perform in the public hospital drug procurement \"two votes\", to carry out the high value medical consumables centralized purchasing.

Second, strengthen the demonstration led

Reform of the state council office, the national health and family planning commission, ministry of finance jointly in qidong city, jiangsu province, anhui tianchang, youxi county, fujian province, mutual aid minority autonomous county in qinghai province to carry out the reform of public hospitals at the county level comprehensive demonstration work, mining, summing up experience, concise pattern, forming a typical experience of copy, can promote. 4 counties (city) public hospital reform on the basis of more than 10 mission, to further advance the following four tasks:

(a) the full implementation of government policy on the investment of public hospitals. In accordance with the relevant regulations, and gradually resolve eligible public hospitals at the county level of long-term debt.

(2) the medicine proportion (excluding Chinese medicine yinpian) dropped to 30%, one hundred yuan of medical income income (excluding pharmaceuticals) consumption of health material cost reduced to 20 yuan.

(3) the medicare according to macro-reforms disease group (disease) for no less than 100, covering more than 40% of the number of cases from hospital.

(4) local JiuZhenLv increased to 90%.

Provinces (area) to refer to the national requirements for the work of demonstration, in accordance with the party committee government attaches great importance to, department coordination principle such as the coordination, the foundation of the reform is good, choose 3-5 counties (cities) at the provincial level demonstration work. Municipality directly under the central government, xinjiang production and construction corps can choose according to actual condition part of the county (city,) to carry out the pilot work. Determining demonstration county (city), in different level of economic development should have representative. Provincial demonstration county (city) should be based on the existing reform, further deepening the reform of management system and operational mechanism, and pay more attention to the reform of the systematic, holistic, collaborative, and promote the reform of \"3 d\" linkage as a whole, for the national cement improve the comprehensive reform in public hospitals at the county level. The relevant state departments to timely with a variety of forms such as the attendant, sum up the experiences of popularizing.

Third, strengthen classified guidance

Combination of public hospital reform effect evaluation work, the provinces, autonomous regions and municipalities) carefully summarize the top the reform experience of the county (city) and promotion, will be tested, can copy can promote the reform of the achievement to rise to the policy and system; Encourage various counties (city) shall, in accordance with the comprehensive reform pilot provinces and demonstration county (city) standard, self-compression, deepen reform, strengthen the acquisition of the masses. To rank in the county (city), to increase the intensity of reform, the mass transfer efficiency, combined with local actual improve policies and measures, in view of the weak links and fields, to strengthen the reform of \"3 d\" linkage and integrity, systematic and co-ordinated, push forward the reform to a new level. The low-ranking county (city), should strengthen the guidance and guidance, short into gear and strengthen health organization leadership, mainly be responsible for the comrades to personally coordinate, enrich the reform, to strengthen the reform. The task and responsibility to make the listing, specific to things, responsibility to the people, get through the \"last one kilometer\" of policy implementation. Must expand the reform way of thinking, innovative working methods, to achieve \"overtaking corner\".

Fourth, strengthening supervision inspection

Provinces, cities and county levels supervise, examine the accountability mechanism should be established and the comprehensive reform of public hospitals at the county level is incorporated into the performance appraisal to the government at all levels. Provinces, cities and two levels of health care departments concerned should regularly conduct supervision inspection, discover new experience, new bright spot in time, take the initiative to grasp the new situation and new problems, and report to the superior departments. National authorities will continue to carry out the annual evaluation work, the reform of public hospitals at the county level comprehensive effect of counties (cities) give notification commendation and the backward county (city) give notification criticism and wages the fiscal subsidy funds.

General office of national health and family planning commission General office of the ministry of finance

On September 5, 2016