Primary medical service capabilities are improved in this way (Health Focus)

  The National Health Commission and other departments recently issued the "Three-year Action Plan for the "High-Quality Service at the Grassroots Level" Activity and Community Hospital Construction", which proposes that by 2025, township health centers and community health service centers serving a population of more than 10,000 people will generally reach capacity. standard.

  Improving grassroots medical service capabilities and allowing people to obtain more equitable, accessible, systematic and continuous medical and health services nearby are important components of building a high-quality and efficient medical and health service system.

In the county medical and health service system, township health centers are the hub that connects the previous and the next, and assume the important function of maintaining the health of the people at the grassroots level.

Recently, reporters visited township health centers in Hunan, Chongqing, Sichuan and other places to find out how to improve primary medical service capabilities.

  Concentrate efforts to cultivate and build a number of grassroots clinical specialty departments in township health centers, significantly improving medical service capabilities

  He straightened his hands, raised them above his head, and leaned forward, Liu Peide took a deep breath.

Early in the morning, he practiced breathing exercises in the corridor of the town health center.

Liu Peide, 76, lives in Guangping Village, Huangxu Town, Jingyang District, Deyang City, Sichuan Province. He had a high fever a while ago and was sent to Huangxu Town Health Center.

  "My chronic obstructive pulmonary disease is an old problem, and it tends to relapse in the winter." Liu Peide said while practicing. "Fortunately, the town health center has a respiratory department with specialist doctors, and the doctor also taught me breathing exercises. Yes. You can get treatment right at your doorstep, eliminating the need to travel more than ten kilometers to a big hospital in the city."

  In 2020, through the specialist alliance, the Jingyang District Hospital of Traditional Chinese Medicine in Deyang City assisted the Huangxu Town Health Center in building a respiratory department. Experts from the Hospital of Traditional Chinese Medicine regularly conducted consultations and taught ward rounds, and the health center opened beds and trained medical staff.

As the director of the Respiratory Medicine Department of Jingyang District Hospital of Traditional Chinese Medicine, Shi Chongyou goes to Huangxuzhen Health Center for one day every week to diagnose and treat respiratory diseases for the local people.

  In order to improve professional capabilities, Huangxuzhen Health Center has increased investment to improve department equipment and technical projects, and is fully equipped with ventilators, pulmonary function meters, and electrocardiogram monitors.

Taking into account the needs of local people, the health center has also launched new projects such as pulmonary function testing, non-invasive ventilator-assisted ventilation, electronic bronchoscopy and endoscopic treatment.

Since the establishment of the Respiratory Department, it has treated approximately 90,000 patients.

  "Township health centers are mainly responsible for the diagnosis and treatment of common diseases and frequently-occurring diseases, and improving medical service capabilities is the focus." Wang Jun, director of the Health Policy Research and Evaluation Center of Renmin University of China, believes.

  In recent years, various localities have concentrated their efforts to cultivate and build a number of grassroots clinical departments in township health centers through specialist alliance cooperation, clinical teaching, project collaboration, etc., and their medical service capabilities have been significantly improved.

In Yichang City, Hubei Province, some township health centers have hemodialysis rooms; in Mianzhu City, Sichuan Province, some town health centers have opened dental specialties...

  According to the person in charge of Wengjiang Town Health Center in Pingjiang County, Hunan Province, township health centers currently have medical equipment such as color ultrasound and fully automatic biochemical analyzers, as well as pre-hospital and in-hospital emergency equipment, including defibrillators, ECG monitors, Cardiopulmonary resuscitation equipment, etc.

The improvement of hardware equipment has greatly improved the health center's basic diagnosis and treatment capabilities and emergency first aid capabilities.

  Continue to improve the level of refined management within the medical community and attract outstanding talents to stay at the grassroots level

  69-year-old Granny Cheng fell at home and suffered unbearable swelling and pain in her right wrist. She came to the Health Center of Shiyan Town, Changshou District, Chongqing.

Liao Xiaoyong, an orthopedic and traumatologist at the Changshou District Hospital of Traditional Chinese Medicine, conducted a consultation at the Shiyan Town Health Center. After his diagnosis, he discovered that Granny Cheng had a fracture of the distal end of her right radius, and she was quickly reduced and fixed accordingly.

  Liao Xiaoyong is a "county-hired" doctor who was assigned to work at the Shiyan Town Health Center in August last year and has been serving in the health center for more than half a year.

"Thanks to Dr. Liao, fractures can now be treated in villages and towns, and there is no need to queue up in urban hospitals for treatment," said Granny Cheng.

  In response to the problems faced by grassroots medical and health institutions in recruiting and retaining people, Chongqing has adopted the reform of the "county-employed township employment" and "township-employed village employment" mechanism to dispatch doctors to work in township health centers, and has also made economic adjustments to the dispatched doctors. Salaries and work funds will be guaranteed, and medical and health talents will be encouraged and guided to flow to the grassroots level.

  "Since August 2022, Changshou District has dispatched two batches of 63 doctors from district-level hospitals to grassroots medical and health institutions, including many urgently needed professionals in obstetrics and gynecology, pediatrics, dentistry and other departments." Changshou District Health Committee Organization Personnel Lin Lu, chief of the department, said.

So far, the dispatched talents have served more than 21,600 people at the grassroots level, driving the total number of visits to primary medical and health institutions to increase by 24% year-on-year. People can enjoy expert services without leaving the streets or communities.

  “County employment and rural employment” not only brings talent support to grassroots medical and health institutions, but also helps grassroots promote new technologies and new projects.

“We have used doctors sent below as a link to carry out more than 120 academic lectures and technical trainings in grassroots medical and health institutions. We have taught more than 90 grassroots talents, sent more than 60 people to higher education, improved more than 90 system operating procedures, and promoted 40 new technologies and new projects. The remaining items have greatly improved the technical level of primary medical and health institutions." Lin Lu said.

  "To improve primary medical service capabilities, we must release the vitality of primary medical and health institutions." Wang Jun said that innovating talent management models, promoting personnel and salary reforms, continuing to improve the level of refined management within the medical community, attracting outstanding talents to stay at the grassroots level, so that It truly becomes the local health gatekeeper.

  In Pingjiang County, Hunan Province, the local medical community of the General Hospital of Integrated Traditional Chinese and Western Medicine, through the vice-president, is divided into responsibilities, and in the form of departmental assistance, it provides comprehensive and precise management of township hospitals in terms of hospital management, medical services, and basic public health. Provide assistance and inject "living water" into grassroots health development.

  "Experts from the General Hospital have helped us establish a complete management and operation system, standardize department responsibilities, clarify department quality goals, standardize medical behaviors, and improve various management works of township hospitals." The person in charge of Wengjiang Town Health Center said that in recent years , the people’s sense of gain from medical treatment continues to increase.

  Establish a scientific and reasonable referral mechanism to form a medical treatment pattern in which "minor illnesses are treated at the grassroots level, serious illnesses go to the hospital, and recovery is returned to the community"

  Not long ago, Mr. Deng, a villager in Anding Town, Pingjiang County, Hunan Province, suddenly felt chest pain and came to the town health center for an electrocardiogram examination.

After the examination, the doctor immediately uploaded the data to the county ECG platform. The doctor on duty diagnosed acute anterior wall myocardial infarction. He quickly dialed the emergency number and informed the emergency department and chest pain center to be prepared. At the same time, he instructed the doctors at the health center to carry out treatment before the ambulance arrived. Rescue.

Within 20 minutes, the first aid station transferred the patient to Pingjiang County First People's Hospital for surgery.

  In recent years, various localities have used information technology to share information between medical institutions, further improving the efficiency of referrals and allowing more high-quality resources to sink to the grassroots.

For example, Pingjiang County has formed a mutual recognition and sharing of medical diagnosis information within the county by building a medical imaging center, an electrocardiogram center and an ultrasound diagnosis center.

  "In the past, the county's 24 township health centers generally had a shortage of ECG, imaging, testing and other professionals. Most health centers have DR (digital X-ray) equipment and electrocardiographs, but often do not have specialized technicians and diagnosticians." Wu Shiqi, director of the Medical Reform Office of the Pingjiang County Health Bureau, told reporters that for inspections and testing items that township health centers could not do before, now staff come to take samples every day, and doctors from county-level hospitals issue reports for free through the platform, realizing medical technical services for township inspections and county inspections. Level diagnosis, regional sharing.

  "Through the information sharing platform, some patients stay in township health centers for diagnosis and treatment, and some patients are transferred to county hospitals, which avoids repeated examinations, saves labor costs, reduces missed diagnoses, and buys time to rescue critical and severe patients." The relevant person in charge of the Health Bureau of Pingjiang County, Hunan Province said that in 2023, the county's grassroots medical treatment rate will reach 76.26%, and the county's proportion of hospitalizations will reach 86.78%. Positive progress has been made in hierarchical diagnosis and treatment.

  At present, various localities are continuously improving referral efficiency through innovative service models and accelerating the implementation of hierarchical diagnosis and treatment systems.

It is understood that Qujiang District, Shaoguan City, Guangdong Province has promoted joint outpatient clinics and joint wards, brought some surgical and rehabilitation treatment services to the grassroots level, opened up a green channel for patient referrals, and implemented the implementation of medical business income generated from patients referred up and down. Shared allocation is implemented on a monthly basis to promote the orderly development of two-way referral work.

  "Establish a scientific and reasonable referral mechanism to ensure that patients can be smoothly transferred from primary medical institutions to secondary hospitals and above, forming a medical pattern of 'treating minor illnesses at the primary level, going to the hospital for serious illnesses, and returning to the community for recovery'," Wang Jun said. All localities should further improve the medical service system, clarify the process and standards of two-way referral, improve referral efficiency, and allow patients to receive timely and effective treatment and rehabilitation services in medical institutions at all levels.

  Yang Yanfan Youyi Chang Biluo

  (People's Daily)