Seven years health reform in our country, where is the bright spot, the difficulty

09:19:04 on November 24, 2016

Source: the liberation daily

Yesterday morning, the 9th world health promotion conference parallel BBS "deepening health reform", the national health system reform, director-general of the state family planning commission Liang Wannian introduction, after the reform, our country medical service utilization is rising rapidly, last year the national clinical medical institutions rose to 7.7 billion, increased by 57% before the reform, the total health expenses personal burden rate fell to 29.27%. Residents' health level, the highest average life expectancy of 76.34 years, the country, the maternal mortality rate dropped to 20.1 per one hundred thousand people, infant mortality rate dropped to 8.1 ‰, the three major health indicators were achieved the United Nations development goals in one thousand.

On the BBS, experts from the administrative department of public health, basic level medical institutions and managers put the eyes on the primary care. The who representative in China to give mark hurd comments: "primary care like the bottom of the pyramid, to construct good bottom, China has made great achievements in this aspect."

The national basic coverage: 95%

As the world's largest developing country, China's population reached 1.375 billion in 2015, the per capita GDP of $7600, the total health expenses as a share of GDP is 6.05%. In terms of health resources, per thousand population with 2.22 (assistant) medical practitioners, registered nurses for 2.37 5.11 beds, bed number.

Liang Wannian said, since in 2009 launched a new round of reform, our country has basically built universal basic medical security system. Contributors in basic health care at present, more than 1.3 billion people, coverage above 95%, security level has greatly increased. This year the urban and rural residents basic health care per capita government subsidy standard has been raised to 420 yuan per person per year.

China's geopolitical vast, large difference of regional development, improve the medical and health service system at the primary level is not easy. Liang Wannian is introduced, the central government has invested 100 billion yuan to support the construction of medical and health institutions. With free basic public health services for the urban and rural residents, government subsidies for this year up to 45 yuan per capita.

Shanghai small target: popularize the family doctor

Shanghai population, aging degree is high, relatively abundant medical resources, how to "grassroots"? Shanghai health development planning commission director WuJingLei proposed, first start from the "achieve a small goal", namely to promote the family doctor system, realize hierarchical diagnosis and treatment. He introduces, have one in every 100000 people in Shanghai community health service center, an average of 80 to 900000 people have one regional medical center, it constitutes the hierarchy of medical services in Shanghai. Shanghai community residents to sign "1 + 1 + 1" the family doctor service of community health service center (1, 1, 1 regional medical center, tertiary hospitals), led by the family doctor to realize orderly referral, smooth link different levels of medical institutions.

Megacities popularize family doctors, remote areas of these "small target" how to do? In the 118.3 square kilometers of the Inner Mongolia autonomous region, in grassroots health care "small box" become nomads. Yin Chilin introduction, deputy director of the Inner Mongolia autonomous region health development planning commission traffic inconvenience, prevention treatment costs are increased. Set flow in a health service, herding families placed a small box, "two point one line" with GPS support, effectively solve the herdsmen "slight illness drag, carry".

Zero rate of sales, prices fell thirty percent

At present, the public hospital comprehensive reform pilot city has expanded to more than 200 prefecture-level cities, cover two-thirds of the country, reform of public hospitals at the county level have been fully implemented. Liang Wannian said to province as a unit for centralized purchasing, implementing zero rate online sales, drug prices reform before falling by thirty percent on average. To gradually establish the maintenance public welfare, to mobilize enthusiasm, ensuring the sustainable operation mechanism at the grass-roots level.

In October last year, the abolition of all 204 cities in jiangsu province public hospital drug price, public hospital compensation mechanism is done through government spending. Jiangsu province health development planning commission director 王咏红 supplement, the public hospital in accordance with the approved beds, thus solving the problem of equal pay for equal work. The government subsidies and allowances for medical workers.

Anhui province people's hospital of tianchang, dean Xu Changsong introduced to hospital medical management paradigm shift gratifying change. In the people's hospital of tianchang, the clinical macro-reforms become effective management, payment. The hospital a total of 247 clinical pathway diseases, clinical path form 263 a, 200 diseases into the press disease to pay. Turn the management pattern, hospital medicine proportion, inpatient time expenses index has significant positive trend.

Regional balance, drug innovation is still hard

Liang Wannian, hierarchical diagnosis and treatment, to establish modern hospital management system, etc., is still a "crack" of health reform in our country. National health development planning commission proposed schedule, to expand family doctor signing service, strive to achieve in 2020 signed services covering the whole people; Reform of public hospitals will be implemented next year, separating and separated, build system of compensation in accordance with industry characteristics.

Hurd is advice, how to realize the balance between Chinese regions, quite challenging. Such as Shanghai and Inner Mongolia, the regional difference is big, the government pay the same money, people get the services may be completely different. How different conditions according to each region, a target for system design, worth exploring. In addition, how to integrate existing resources, but also have not been able to solve the crux of the reform.

Experts put forward at the same time, our country has a great potential in the field of drug innovation. Currently, innovative drug registration process slow, make many drugs for time later than other countries. In perfecting the national system for basic drugs, we will accelerate reform of the drug approval system should not be forgotten. (reporter Gu Yong)