Satisfy demand, use drugs rationally, and increase salary

Promote the high-quality development of public hospitals (Big Health Observation)

　　Public hospitals are the main body of China's medical service system. To improve the quality of health supply and service level, the high-quality development of public hospitals must be placed in a more prominent position.

　　Recently, the General Office of the State Council issued the "Opinions on Promoting the High-Quality Development of Public Hospitals" (hereinafter referred to as the "Opinions"), which clarified the goals, directions, and measures for the high-quality development of public hospitals, which is the fundamental follow of the reform and development of public hospitals in the new stage. It is of great significance to comprehensively promote the construction of a healthy China and better meet the people's growing needs for a better life.

　　A few days ago, the State Council Information Office held a regular policy briefing. Relevant persons in charge of the National Health Commission and the National Medical Insurance Bureau introduced the relevant situation of promoting the high-quality development of public hospitals.

Build a new system for high-quality development

Meet the multi-level and diversified medical needs of the masses

　　"At present, our country has turned to a stage of high-quality development, and the people's demand for multi-level and diversified medical and health services continues to grow rapidly. Accelerating the improvement of the quality of medical and health supply and service levels is the requirement to meet the needs of the people for a better life." Deputy National Health Commission Director Li Bin introduced that the "Opinions" insisted on focusing on people's health, strengthening the dominant position of public hospitals, adhering to government-led, charity-led, and public-owned hospitals, and strived to transform the development of public hospitals from scale expansion to improved quality and efficiency through five years of hard work. , The operation mode has shifted from extensive management to refined management, and resource allocation has shifted from focusing on material elements to more focusing on talents and technology elements.

　　"These'three turns' are the path choice to realize the transformation and upgrading of public hospitals, and are a fundamental strategy for maintaining public welfare, mobilizing enthusiasm, and ensuring sustainable development." Li Bin said that after more than 40 years of reform and opening up, medical service system construction and 20 years In recent years, the capacity building of hospitals and the practical exploration of deepening the reform of the medical and health system in the past 10 years have shown that Chinese public hospitals have reached a critical period of shifting from "quantity accumulation" to "quality improvement", and the focus of development must be on improving quality and efficiency. .

　　The "Opinions" make it clear that a new system for the high-quality development of public hospitals must be constructed.

Li Bin introduced that the country will promote the construction of national medical centers and regional medical centers, making them an important engine for national medical progress.

Construct provincial-level high-level hospitals and reduce cross-provincial medical treatment.

Develop compact urban medical groups and county medical communities, give full play to the leading and leading role of public hospitals, realize the expansion of high-quality medical resources and the balanced distribution of regions, so that the masses can enjoy high-quality medical services.

　　"On the basis of summarizing the action plan to improve medical services, we have summarized the experience in key links that affect the people's sense of access to medical treatment." said Jiao Yahui, director of the Medical Administration and Hospital Administration of the National Health Commission, high-quality in public hospitals In the development stage, it is necessary to continue to vigorously promote service models such as multidisciplinary diagnosis and treatment, day surgery, responsible holistic nursing, and continuous nursing, vigorously develop telemedicine and Internet diagnosis and treatment, and further improve measures to benefit the people such as appointment diagnosis and treatment and online payment.

At the same time, we will build a smart hospital with the “trinity” of smart medical care, smart service and smart management, and improve the efficiency of medical services through information technology, so that the masses can enjoy high-quality medical services more conveniently and efficiently.

　Deepen the reform of medical insurance payment methods

　　Give public hospitals the motivation to use drugs rationally and control costs

　　Medical insurance funds are an important source of funds for public hospitals.

The "Opinions" proposes to deepen the reform of medical insurance payment methods, implement a diversified and compound medical insurance payment method based on disease-based payment, explore the implementation of total payment for close medical consortia, scientifically formulate total medical insurance budgets, and encourage localities to explore in line with China Medical insurance payment method with medical characteristics.

　　Huang Huabo, Director of the Medical Service Management Department of the National Medical Insurance Administration, said that the National Medical Insurance Administration will actively play its role as a "strategic buyer" and continue to promote the reform of payment methods that meet the characteristics of different medical services, so that public hospitals have the motivation to use drugs rationally and control costs. There is an incentive to treat and refer patients reasonably, so as to support and promote the high-quality development of public hospitals.

　　Huang Huabo introduced that starting from 2019, the National Medical Insurance Administration has launched a national pilot program for payment by disease diagnosis-related grouping (that is, DRG payment) in 30 cities across the country.

At present, all 30 pilot cities have entered the simulation operation, and some cities have already started to pay.

　　Beginning in 2020, the National Medical Insurance Administration has launched pilot projects for regional point-based total budgeting and disease-based point payment (DIP payment) in 71 cities across the country, which has changed the previous working method of setting total indicators for specific medical institutions. The total amount of the regional medical insurance fund is controlled, and the hospitalization is paid according to the value of the disease.

At present, these 71 DIP pilot cities have all completed pre-grouping work.

　　On the basis of national pilot projects, some provinces have also selected cities with relatively high enthusiasm for work and relatively good basic conditions to carry out the pilot projects. The preliminary survey is about more than 100.

Up to now, there are more than 200 DRG and DIP pilots nationwide.

　　In addition to the pilot work, the compact county medical community total payment mechanism is also being improved.

The National Medical Insurance Bureau, in conjunction with the National Health Commission, formulated the evaluation criteria and monitoring index system for the construction of a compact county medical and health community, and carried out monitoring and evaluation related work to guide the development of the compact county medical community, and promote the sinking of high-quality medical resources to the grassroots Medical and health institutions, thereby improving the efficiency of the use of medical insurance funds, and providing more high-quality medical insurance services for the majority of insured persons.

　　At the same time, the National Medical Insurance Bureau is also exploring medical insurance payment methods that meet the characteristics of traditional Chinese medicine, and constantly improving medical insurance policies that support the inheritance and innovation of traditional Chinese medicine.

Huang Huabo said: "We will work with the State Administration of Traditional Chinese Medicine to promote the payment of superior TCM diseases according to the type of disease, and encourage TCM and corresponding Western medicine to achieve'same disease, same quality, same price'."

Mobilize the enthusiasm of medical staff

　　Reasonably increase salary levels and broaden career development space

　　Medical staff are the loyal guardians of people's health and the main promoters of the construction of a healthy China.

The "Opinions" require that the new impetus for the high-quality development of public hospitals be activated, and the work impetus of medical staff shall be stimulated in terms of personnel management, remuneration, and training evaluation.

Xu Shuqiang, director of the System Reform Department of the National Health Commission, introduced that to promote the high-quality development of public hospitals, we must always protect and give full play to the enthusiasm, initiative and creativity of the majority of medical staff.

　　First, reasonably increase the salary level of medical staff.

The medical industry is characterized by a long training period, high professional risk, high technical difficulty, heavy responsibility, and reasonable salary.

It is necessary to allow medical and health institutions to break through the current level of wage control in public institutions, and allow medical service income to deduct costs and withdraw various funds in accordance with regulations, which are mainly used for personnel rewards.

Reasonably determine and dynamically adjust the salary level of medical staff, establish a salary system that mainly reflects job responsibilities and knowledge value, and realize job-based responsibilities, job-based wages, responsibilities and salaries, and assessments.

More attention should be paid to the guarantee function of the remuneration system, matching the pay and remuneration, and stimulating the motivation and vitality of the majority of medical staff to start their own businesses.

　　Second, broaden the career development space of medical staff.

Improve the training and training system for medical staff so that every medical staff has the opportunity to receive continuing education and vocational retraining to achieve knowledge renewal.

Accelerate the cultivation of high-level compound medical talents, and cultivate a group of international-level strategic talents, leading talents and innovative teams.

Reform and improve the talent evaluation mechanism, adhere to hierarchical and classified evaluation, follow the characteristics of the medical industry and the law of talent growth, reasonably set evaluation standards, highlight moral ability and performance orientation, focus on clinical work quality indicators, explore the implementation of the achievement representative system, and eliminate the only papers, Only academic qualifications, only awards and other tendencies.

　　Third, care for the physical and mental health of medical staff.

Establish a long-term mechanism for protecting, caring and caring for medical personnel, improve working environment and conditions, and reduce workload.

It is necessary to implement a system of study, work, rest and paid leave, safeguard the legal rights and interests of medical staff, and effectively solve the practical difficulties of medical staff.

Encourage public hospitals to care for the growth of young medical staff by setting up youth learning funds and other methods.

　　Finally, improve the social status of medical staff.

Establish a professional honor system for medical staff and create a good atmosphere in which the whole society respects medical care, so that the majority of medical staff can feel the pride of realizing value, the sense of accomplishment of contributing to the society, and the sense of professional honor that is respected.

　　Wang Meihua