Behind the forty-seven minutes to enter the county for surgery-

The compact medical community "reshapes" county medical resources

  ◎Our reporter Zhang Jiaxing

  Forty-seven minutes, this is the time it took for a stroke victim from Henan to be admitted to the county hospital's catheterization laboratory to start surgery.

  One-key call, green channel, remote ECG, remote imaging, and remote consultation. On the way the patient comes to the hospital, some examinations related to preoperative preparation have been completed, and the patient will be operated immediately upon arrival.

  "County-level hospitals completed the information connection with township health centers and village clinics, ensuring the prime time for treatment. This year, 41 patients with myocardial infarction were saved and 53 stroke patients were prevented from sequelae." On November 30 At the regular press conference of the National Health Commission of Japan, Liu Shengli, member of the Standing Committee of the Zhoukou Municipal Party Committee, Secretary-General, and Director of the Reform Office of Zhoukou, Henan Province, stated the key to "grabbing time with death": by promoting the construction of a compact county medical community, medical and health institutions It has realized the collective management and operation mode of unified management of human, financial and material, and the integration of county and village.

  According to reports, since the National Health Commission launched the construction of a compact county medical and health community in 2019, all localities have started from the roots. Linkage, some linked the assessment results of township hospitals with the contracting funds, the annual salary of the dean, and financial subsidies... It changed the problem that the medical community was not close enough in the past, and formed a "close type of chess, management of an account, and service to the whole family" in the county. "Architecture.

  From coalition to "reshaping", fundamental changes have taken place in the system and mechanism

  The "compact type" is added before the medical community, what has changed?

  "Different from the previous county medical community, the compact county medical community focuses on building a community of responsibility, management, service, and interest." Nie Chunlei, director of the grassroots department of the National Health Commission, explained that, in the final analysis, it is for the county A systematic "reshaping" of medical and health resources!

  From alliance to "remodeling", the institutional mechanism of the medical community has undergone a fundamental change.

  Nie Chunlei said frankly that the "community of interest" is the core of the construction of a close county medical community.

Taking the medical insurance fund as an example, the payment of the medical insurance fund no longer takes the county hospitals as a separate main body, but as an important source of common benefits for medical institutions within the medical community.

Therefore, whether medical insurance costs can be saved is the common responsibility of all participating units, and whether the medical community can truly implement the package payment of the medical insurance fund and retain the balance is related to each medical community’s participating units.

  In addition, making full use of modern information technology and realizing unified management of "people, finances, things, and things" are the characteristics of a close medical community.

  Medical resources are sinking, and people see a doctor at home

  The advantage of the "compact type" is obvious. Medical resources that were previously difficult to sink will become easier to sink as the intimacy of the "one game of chess", "one account" and "family" changes.

  "The integrated reform has revitalized the county medical and health resources and optimized the allocation of resources." Zhang Bo, deputy director of the Shanxi Provincial Health Commission, said that Shanxi has integrated all medical and health institutions in the county into an independent legal person medical group, which implements administration, personnel, capital, and "Six unified" management of business, performance, and medical equipment.

Under the integrated structure, the medical staff of county-level hospitals can provide technical support for the family doctor team, which promotes the implementation of the family doctor’s contracted services; the two-way referral channel is smoother, and it is convenient for the common people to see a doctor at home, and refer to the superior hospital. .

  Ningbo, Zhejiang Province puts the article on "Digital Medical Community Construction".

Zhu Xiaoli, deputy head of Yinzhou District, Ningbo City, introduced that people in the district can not go out of the community to see a famous doctor.

Through the regional remote consultation of the General Hospital of the Medical Community, consultations with nearby experts can be realized, mutual recognition and sharing of inspection results, and intelligent medical treatment such as Internet medicine and nursing, to build a new home "medicine + medicine + nursing" integrated service system, where the masses can ask online For medical consultation, medicines can be delivered to the home, and nursing care can be provided on-site.

  Three-level distribution and benefit sharing, allowing village doctors to be "healthy gatekeepers"

  “We have implemented a mechanism for village doctors to withdraw when they reach their age, and pay old-age insurance for village doctors to solve their worries.” Yang Fawu, president of Suixi County People’s Hospital in Huaibei City, Anhui Province, said that the close medical community must play a role and the county must be improved. The enthusiasm of medical staff in medical institutions at the township and village levels.

  In addition to solving the pension problem, for rural doctors, the surplus of the medical insurance fund has also allowed them to have a stable income and no longer "guerrilla".

"We have established a three-level distribution and benefit-sharing medical insurance fund use mechanism." Yang Fawu introduced that the medical insurance fund was packaged into the medical community, and the balance was distributed at a three-level ratio of 6:3:1. Since 2017, the county hospital medical community has packaged The balance of funds reached 94,394,600 yuan for four consecutive years.

  In the compact county medical community, the role of the “health gatekeeper” of rural doctors has become clearer, and they are also playing an increasingly important role in the management of chronic diseases and health.

  In 2021, Suixi County will pilot a new cost-guided "health management" initiative again.

According to reports, the medical insurance payment for common chronic diseases is used by the health center on a per capita basis, and the balance is retained at a ratio of 2:5:3 between the county and the village.

From the perspective of the proportion of the balance, it is not difficult to see that the new policy favors funding for township hospitals and village clinics.

  At the same time, the grassroots are eager for talents and pay more attention to talent training.

"We encourage and fund the county and rural medical staff to participate in or go out for advanced studies. The health center has 249 rotation training and 101 village doctors." Yang Fawu said that the county government has specially coordinated 3.5 million yuan for doctor training. When the funds are less than After 500,000 yuan, a new round of funding will be launched.