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2011 年 reform of public hospitals work

provinces, autonomous regions and municipalities, State Council department:

reform of public hospitals contained in the correction of assorted interests namely the converge of medical and health system and complicated. 2011 is the achievement of five key health system reform, the decisive three-year mandate, and also of public hospital reform in the decisive year. Reform of public hospitals do a good job this annual, and strive to comprehensive reform of the institutional mechanisms for a discovery on difficult issues, ambition arrange a solid foundation for further reform. All localities and departments should strengthen the leadership and close coordination, cautious organization and deployment, to ensure the reform of public hospitals to achieve the desired results.
State Council on the issuance of 2011
10
SCS 〔2011〕
State Council
二 ○ 一 一年 二月 二十 八日
under the Fa 〔2009〕 12), guidance
a working fancy of ​​
in accordance with the upper and lower linkage, the increase vitality, and the boost of the principle, adhere to the entire areas, either close and distant,timberland channel Can no work behind in period , entire in, focused, side push test side, the people closely around the ease medical treatment is difficult, priceless medical problems , looked in the national implementation of a number of standard and fast public hospital reform policy measures aimed at the people get benefits and medical staff encouraged to achieve a breakthrough. At the same time, vigorously promote the pilot cities in the Benefiting the convenience measures should implement institutional mechanisms to promote comprehensive reform and to establish long-term mechanism to closely join to make it cooperate with each other and promote each other.
two major institutional mechanisms to carry out comprehensive reform
(a) promoting the separation of management from operation, to deepen public hospital management system.
1. strengthen the health executive departments industry-wide management responsibilities. All medical and health institutions by the health administrative departments to implement a unified planning, unified access, unified supervision. Strengthen the administrative departments of health care regulatory functions,paul smith towelling dressing gown, to strengthen medical services regulatory capacity building. Improve the organization, personnel, technology, equipment, access and exit mechanisms, and improve health care standards, norms and quality evaluation system, strengthen medical services, quality, safety and health agencies monitor the operation of regulation. Health administrative departments at all levels shall not perform as leadership positions in public hospitals.
2. to establish a unified, efficient and responsibilities persistent with government-run health system. Take various forms such as the establishment of specialized management agencies to determine the government run medical institutions, government-run public hospital to act its functions, is responsible for public hospitals, funds management, financial control, performance evaluation and the human mainly responsible for hospital appointments.
(b) promote the conduct of public businesses divide, and improve corporate governance of public hospitals.
1. explore the establishment of the Council and additional forms of corporate governance structure of public hospitals. Clearly the Council, the President and the hospital treatment, staff and other duties ashore behalf of the General Assembly to create decision-making, implementation, monitoring every department, operating machinery of checks and balances of power. Council members in public hospitals should include representatives of government ministries, government-run health agency representatives, hospital staff representative, on behalf of clients, specialists and scholars.
2. rationalize the owners and managers of public hospitals, power and liability. Functional orientation of public hospitals, development planning, major investments, the President and the hospital management to develop such compensation by the government scamper medical institutions of power or the Council to exercise. Implementation of the neutral legal status and public hospital management autonomy, strengthen management responsibilities, according to state regulations and internal management staff employed income distribution. Implementation of Opening Hospital Affairs, promoting democratic governance.
3. improve the Public Hospital appointment system and explore the open recruitment President, highlighted in the appointment or recruitment of professional management skills. Strengthen the management capacity of premier of training and promoting professional premier, professional building. President in accordance with national policy guidance to establish the distribution of income incentive and restraint mechanisms.
4. reasonably determine the public hospital performance appraisal system. Study the establishment of the public welfare for the gist of the public hospital performance appraisal system, and gradually expand the scope of public exam results, and appraisal results with the President the meeting and removal, stimuli and hospital financial assistance, staff linked to mean income levels.
5. promote the performance of public hospitals, Function and Development building, investment and financing behavior regulation, strengthen allowance, income, assets, cost accounting and control, financial management supervision. Explore the establishment of the hospital central bookkeeper system, establish a sound internal control system, implementation of internal and external audit system.
(c) promote the isolation of medicine and improve the compensation mechanisms in public hospitals.
1. reforms to make health system drugs. Explore a variety of characteristic ways to separate medicine, drug addition phasing policy, public hospitals, thereby reducing the reasonable income, to take an annexed pharmaceutical service fees, some measures such as technical service fees, medical insurance fund and by increasing government investment and other aisles to compensate. Pharmaceutical services Feinaruji to pay the health care scope. Payment system to encourage reform of income as a starting point to solve the drugs make health problem.
2. of reasonable adjustment price of medical services. In agreement with the overall control, the principles of restructuring, rationalizing technical services reflect the amount of medical personnel of medical service price; government-funded public hospitals, the purchase of colossal equipment cost less depreciation according to formulate retard prices; plants (referred) introduced into the level of medical supplies centralized commanding and acquisition, to provinces (autonomous regions and municipalities) for the unit to gradually open; to strengthen price management of medical supplies. All medical institutions should adopt appropriate methods to publicity medicines, medical supplies,timberland boots hip hop 80 jaws constantly linked apt the classical proverb 60, prices and charges for medical services standard. Reform of health care services to develop guidance on the charging usage, carried out by direction of disease such fares reform, and explore will aid control costs, transparency, facilitate the action of medical services charging methods.
3. to implement on a large public hospital infrastructure and equipment procurement, the development of key disciplines, in line with state regulations and policy costs for retirees and other government perquisite to wastage of investment policy.
(d) to promote and profit from nonprofit health care organizations improve the management system of classification.
establish medical institutions of different nature of the business management system, improve the non-profit medical institution's assets management system, financial and accounting systems, governance and supervision and management system. Different types of medical institutions regulate the transition process. Held strictly defined social capital nature of the business of medical institutions, in accordance with the nature of the business standard management. The Government shall not be held for-profit medical institutions.
Third, to promote the development of public hospital services system
(a) optimize the layout and structure of public hospitals.
1. to study and formulate plans to strengthen local health guidance, improve the local arranging guidelines for medical institutions to study the evolution of a national health attention resources in assorted districts of the guiding criteria, develop the layout of public hospitals, restructuring guidance. All districts in local health planning, regional medical traditions within the framework of planning, evolution of public hospital setting and development planning, to decide the feature of public hospitals, type, amount, size and layout.
2. in accordance with the volume control, structural adjustment, the modest size of the rule of strict control of public hospitals, the scale of construction, standards and loaning behavior, to take the fashionable, expansion, relocation, coalition, restructuring, etc., to optimize the delivery of resources in public hospitals . Focus on strengthening the District, suburban, urban and other places of satellite and pediatric, maternity, cerebral health, contagious disease prevention and control, elderly care, rehabilitation and medical services in the areas of capability building.
3. promoting public Chinese medication (including national medicine) hospital reform and development. Improve the public service system of Chinese medicine hospitals, and promote Chinese medicine communities,buy paul smith shoes, into the grass roots, into the rural areas, give full play to the characteristics and advantages of Medicine. Focus on the strengthening of national Chinese medicine expert, and raise the clinical effect of orthodox Chinese medicine. Government investment in the implementation of preferential policies on the public hospital for Chinese medicine to study and formulate favorable Hosps play a dominant specific of Chinese medicine's economic policies.
(b) give priority to construction and development of county-level hospitals.
1. Government priorities in each county to run a county hospital. Based on the work of the previous two years, the chief support 300 so another this year on the county-level hospitals (including the Chinese Medicine Hospital, the same under) standardization. More than 30 million population of the county (city) basically completed ahead the end of 2011, two 1st class of more than a public hospital, the prevalent disease, caustic, and some difficult emergency diagnosis and treatment of complicated diseases can be basically solved in the county.
2. deepen their counterparts in urban tertiary hospitals support the county hospital. Continue to implement the Promoted the urban tertiary hospital doctors sent to the county hospital circulation system, each county not less than one hospital, less than 5 per hospital doctors. Presence to properly resolve the city hospital staffing and benefits involved in the issue.
3. to strengthen the backbone of county hospital personnel training. Strict access to county-level hospital staff, new medical staff into the county hospital must have appropriate qualifications. Organization has not been standardized residency training graduates for New 3-year clinical standardized training. After standardized training of physicians to encourage county-level hospitals to employment, and its long-term to create conditions in the county hospital. Improve the continuing education system to encourage county hospitals through various forms of health professionals to improve operational capacity and overall quality. The culling of county hospitals around the backbone of 6,000 physicians or other health professional and technical personnel to their counterparts in the tertiary hospitals for further study. Complete heading of county health personnel evaluation criteria, highlighting the clinical skills assessment, dilute the papers and alien language requirements.
4. tread by step comprehensive reform of county hospitals. Comprehensive reform program to develop county-level hospitals in the country serving a population of 300 selected more based on county-level hospitals to better personnel management and income distribution, performance assessment, quality care, payment, adjusted price of medical services, implementation of clinical path, promoting information technology as the focus of the comprehensive reform. Encouraged to expand the scope of the pilot areas where conditions permit, to increase the pilot efforts.
(c) the establishment of public hospitals and primary care health facilities division of labor cooperation mechanism.
1. amount over hospitals and primary care health facilities division of labor work experience, study and formulate the guiding file.
2. strengthen the county-level hospitals supported by the township health centers. In 20% of the county (city) to explore the vertical and technical cooperation to promote the county and township, rural health service system to improve the overall efficiency. Priorities in citizen privation counties and parts of the province for the implementation of 2 key counties for poverty abatement than their similarities in support of medical and health institutions of township hospitals project.
3. in urban public hospitals and community health services division of labor between the long-term settled cooperative mechanism. Take various forms such as signing long-term cooperation agreement, the integrated use of health insurance payments, medical service price adjustment, financial investment and other policies to encourage doctors to a large grass-roots visits, and gradually form a grass-roots first diagnosis, medical grade, two-way referral pattern.
4. organize medical groups, to provide mobile medical services in remote areas.
(d) accelerating the construction of hospital information.
1. study the establishment of a unified national system of hospital information construction standards for the comprehension of inter-agency and inter-regional, cross-interoperability of medical information resources, shared use root.
2. unified planning, integration of resources, and gradually improve the assembly and regional health information systems, electronic medical records and hospital management to focus on the construction of hospital information web to support the hospital and medical staff to provide patient-centered coordinated, coherent and convenient services. Meanwhile, the public hospitals and primary health care institutions to establish collaborative division of the upper and lower connection mechanism,ugg boot on sale, the establishment of effective medical services regulatory system to provide technical support.
3. to promote the county-level hospitals and urban tertiary hospitals to carry out activities in telemedicine, remote consultation, remote diagnosis, remote inspection, tele-education and information sharing, give full play to the role of radiation quality medical resources. 2011 500 county hospitals in remote areas and urban tertiary hospitals, long-distance diagnosis system construction.
IV Huimin advantage fathom implemented in the country
(a) improve the public medical services.
1. generally appointment to carry out treatment services. All three A-level general hospitals nationwide to implement a variety of ways appointment clinics, community treatment referral priority reservation to the end of 2011, community referral clinic appointments accounted for 20% the proportion of the amount of the local patient referral appointment rate of 50% including dental, prenatal care, referral and other postoperative review appointment rate of 60%.
2. optimize the Hospital of the environment and processes. Accordance with the Peak shifting services and sub-periods to carry out treatment, simplify medical procedures and abbreviate the waiting time for the masses. Improve patient information management platform, public medical services information, to provide appointment register, call number, report card printing services.
3. extensively handy outpatient services. The country generally carried out three weekends and holidays hospital outpatient clinics to enrich the power to stretch the out-patient period. Through the purchase of services and other measures to encourage and support medical staff to the tertiary hospitals and health institutions to carry out basic health care practice activities.
4. the promotion of quality care. All 3 hospitals extensive to carry out high-quality care, 50% of the hospitals of quality care defense covers more than 50%, 40% of the prefectural (metropolis) level II hospital and 20% of the shire hospital to carry out high-quality secondary care. Improve the readiness and implementation of professional nursing staff, medical service costs and internal distribution of proceeds and other support policies.
(b) implementing measures to control medical costs Huimin.
1. to explore a diversity of basic health care reform, payment methods, promoting the Capitation, according to DRGs, the aggregate prepaid and other payment methods. Explore the basic health care agencies and public hospitals to determine the scope of services through the negotiation, payment, payment standards and service quality requirements. Strict examination prepared a basic medical insurance drug menu drug rate, rate of utilization and control of pharmaceuticals and other indicators at their own consumption.
2. to achieve basic health care costs are stable. Hospital information system to do elementary health care information systems and docking, public hospitals, insurance co-ordination within the region to receive inpatient medical costs were only part of the individual pays the remaining part of the basic health care agencies and direct billing. Significantly reduced the sum of assured patients prepaid remittance, health care agencies allocated a definite amount to the hospital's working capital, and time and in full settlement of health care costs.
3. promote the prerogative with public hospitals, the use of essential drugs, nationwide use of applicable technology. The progressive presentation of joint recognition of test results at the same class of medical institutions.
4. improve the way drug centralized bidding, promote the common medical supplies, bidding and purchasing, in the case of quality assurance to reduce procurement costs and procurement prices.
5. strengthening hospital financial management, implementation of cost accounting and control, efficiency of resource use.
6. to strengthen the regulatory control of medical costs. Around the level of economy and social development according to the basic medical insurance fund support capability, the cost of medical services, alterations in the comprehensive development of medical technology to determine patient and hospital in the region are sub-cost growth, people growth rate, hospitalization rate, drug costs and drug growth accounting and other control and management objectives, management by objectives into public hospitals, the scope of accountability and performance assessment. To strengthen the medical expenses increase faster diagnosis and treatment of disease behavior regulation.
(c) strengthen the medical safety and quality supervision.
1. to study and formulate the basic medical needs to adapt to the clinical pathway, expanding the scope of hospital and disease. The end of 2011, formulated and issued to 300 the number of clinical paths, 50% of the three A-level general hospitals and 20% of the two first class general hospital management of the implementation of clinical pathways, respectively diseases hospital of not less than each 10 and 5.
2. supervision and guidance to strengthen punishments and hospital personnel, strictly according to statute practice, and strengthen the key areas and key parts of the management, ensuring the safety and quality health care.
3. to carry out medical evaluation of safety and quality control, and promote the work of the hospital management evaluation review, organize special inspection of medical safety and quality management activities. Complaint treatment mechanism in patients with established, adopted in time, to seriously residence patient grumbles and improve public satisfaction.
five medical personnel to fully organize the eagerness of
(a) improve the public hospital personnel and income distribution system.
full implementation of the employ system, and basically complete the implementation of the Establishment and Management positions, the implementation of open recruitment and rivalry because employ, the establishment can be hired, promoted or demoted in the employ system. Improve the staff representation estimation system, the implementation of job performance wage system, the medical staff wages and the digit of therapeutic services, quality, technical difficulty, cost control, and other human interlocked to satisfaction, so that hard work and peerless value disburse to amend Clinical first-line nurses and doctors salary levels.
(b) reasonably determine the staffing of public hospitals.
function according to the hospital position, workload and other elements used for the compilation of existing, reasonably determine the medical staff development, research and support to determination the absence of nurses in rural areas, grassroots staffing problems.
(c) create a rewarding environment for medical practice.
carry out the Medical discussion mediation mechanism to create a third gathering, to develop medical liability warranty and medical accident warranty, strengthen physician-patient communication, doctor-patient relationship agreeable. Strengthen the positive publicity and guidance, in the entire society to respect medical science, the social atmosphere of adore for medical personnel. Organizations or support the creation of a number of typical role and reflect the medical front, the conspicuous actions of video art works.
(d) to create good conditions for profession development.
establish and implement standardized general practitioners and specialists training system, improve the training modules and policy measures. Establishment of 100 standardized training bases, recruiting people to carry out a standardized training. Strengthen policy guidance, support hospitals to improve the core clinical skills medical personnel to carry out job training. Strengthen the construction of three key specialties of Clinical significantly improve the level of medical services and medical staff capacity.
(e) to promote the reasonable stream of medical personnel.
improve the practice of multi-point pilot practicing physicians, normative documents, we will extend to all public hospital reform in urban and other areas where conditions allow, will apply to the physician staff to loosen the conditions to increase the number of multi-site practice . Encourage practitioners to public hospitals, primary care practitioners and health institutions to carry out activities.
(f) promote the maximum vocational honesty.
strengthen medical ethics and the ideological and political work, care to the quality of medical staff exercise and professional quality humanities training, vigorously promote the life-saving humanitarian spirit.
six doctors do to promote a diversified pattern of
(a) the elegance of social capital organized to encourage and guide the policies and measures of medical institutions.
implement the develop and improve the implementation details and supporting documents, to encourage and guide the implementation of social capital, the policy of organized medical institutions, non-public medical institutions to promote sustained and healthy development, hasten the formation of diverse patterns of physicians do to meet people's demand for multi-level medical services.
(b) non-public medical institutions to allow a reasonable development.
1. bring an end to ...the region in the formulation and adjustment of regional health planning, Medical Institutions and other medical and health resources planning, to give non-public medical institutions allow causativeable space, explicit non-public medical institutions, health personnel, beds,ugg Wuhu rustic dialects R & B Kazakhstan has, and proportion of the total assets of development indicators. Need to be adjusted and new medical and health resources, in line with the conditions of way standards, the priority held by the medical institutions of social capital.
2. control the scale of special needs services in public hospitals, public hospitals invest special needs services, hospital medical services shall not surpass 10% of resources.
(c) improve the social capital systematized medical train environment.
1. non-public medical institutions where the implementation of the Government provided medical services and drug price policies, in line with the relevant provisions of nailed Medicare, the program should be merged into urban basic medical insurance, new rural cooperative medical care, medical assistance,tory burch kristen wedge, work harm insurance, maternity insurance and other nailed social security services, administered service accord, and perform the same with the public sector reimbursement policy. And other measures to encourage bidding, select the fit non-public sector commitment to public health services and government published health in agriculture, support the border, counterpart support and other missions.
2. to support non-public medical institutions in accordance with the approved scope of practice, hospital level services such as population size, with large medical equipment and reasonable. Encourage medical staff in public and non-rational flow among the public sector, the relevant units and departments shall, in accordance with the relevant provisions for the practice change, personnel and labor narrations convergence, social insurance relationship among the migrate, document transmit and other procedures.
(d) to promote the healthy development of non-public medical institutions.
1. guide the specification of non-public medical institutions according to law practice. Range of non-super-clinic services, and severely crack down on unlawful medical practice and health care fraud activities. Regulate behavior in medical advertising. Strengthen the medical safety and quality supervision and inspection, inspect and evaluation.
2. promote the non-public medical institutions to carry out commerce activities by nature of the business. Non-public medical institutions to implement the state's financial accounting system. Income from non-profit medical institutions causativeable counting to the provisions of expenditures can only be accustom for medical institutions to persist to develop.
seven, the requirements
(a) strengthen the organization and leadership. All localities and departments should fully understand the importance of reform of public hospitals, complexity and urgency, additional sense of political responsibility, to put this reform program, strengthen leadership, careful organization and deployment. Local government is responsible for comrades to individually attend to, work plans, wreck down goals and tasks, delegate responsibility, to strengthen supervision and inspection. Ministry of Health, Office of the State health care reform is the reform of public hospitals in the lead unit, the pilot reform to strengthen the work of the national co-ordination, organization and implementation and inspection guidance, the Ministry of Health to integrate the internal forces of the interim set up a special working body of public hospital reform . Central Programme Office, the Development and Reform Commission, Ministry of Finance, Human Resources and Social Security, according to the Chinese Medicine Council and other departments closely with the division of responsibilities, and strengthen guidance and supervision over the work of inspection.
(b) strengthen the support for protection. Governments at all levels to addition investment in public hospitals fiscal aid to seriously implement the policy to actively support the establishment of public hospitals and primary care health facilities division of fatigue cooperation mechanism, the comprehensive reform of institutional mechanisms for public hospitals,tory burch ella nylon tote, dwellers and hospital standardized message technology training. The use of funds to strengthen monetary management, improve capital efficiency. All pertinent departments should further inquiries and studies, closely tracking the progress of work and actively formulate and improve relevant supporting policies.
(c) actively enhance the guide. Medical staff apt strengthen the dissemination and mobilization go in array to support the reform of the health professionals to actively participate in reform, reform to play a dominant role. To warmhearted proclaim the policies of public hospital reform measures and the results fulfilled, to strengthen the policy interpretation, so namely the all social understanding, cooperation and support reforms, reform of public hospitals to establish a nice environment.

public hospital reform the organization of work notice