China News Service, March 15. According to the website of the National Health and Health Commission, the National Health and Health Commission, the Ministry of Finance, the Ministry of Human Resources and Social Security, the National Medical Insurance Administration, the State Administration of Traditional Chinese Medicine and the National Bureau of Disease Control and Prevention "Guiding Opinions on the High-Quality Development of Doctors' Contracted Services" (hereinafter referred to as the "Guiding Opinions") states that starting from 2022, on the basis of existing service levels, the coverage rate of contracted services for the entire population and key populations will increase by 1 to 3 percentage points per year. By 2035, the coverage rate of contracted services will reach more than 75%, basically achieve full coverage of households, the coverage rate of contracted services for key groups will reach more than 85%, and the satisfaction rate will reach about 85%.
The "Guiding Opinions" made requirements for the overall development of family doctor contract services and the goals of the next stage, contract team building, strengthening the connotation of contract services, and improving the guarantee mechanism, mainly in the following aspects.
One is the general requirements.
The "Guiding Opinions" determine the general idea of actively expanding service supply, expanding service coverage, promoting effective contract signing, standardizing contract performance, improving the level of incentive and guarantee policy supply, and systematically and coordinating the high-quality development of family doctor contract services in the next stage.
The phased target requirement of increasing the coverage of contracted services by 1-3 percentage points per year is put forward. By 2035, the coverage of contracted services will reach more than 75%, and the coverage of contracted services for key groups will reach more than 85%.
Gradually expand the coverage of contracted services, and gradually build a family doctor system with family doctors as the gatekeepers of health.
The second is to increase service supply.
The "Guiding Opinions" supplemented the source channels of the family doctor team, proposing that in addition to general practitioners, other types of clinicians (including traditional Chinese medicine), rural doctors and retired clinicians can also be used as family doctors.
Adhering to the orientation of openness and innovation, the "Guiding Opinions" proposes to encourage all kinds of doctors to participate in contracted services, guide qualified public hospital doctors to join the team of family doctors, and support socially-run medical and health institutions to carry out contracted services.
The purpose is to increase the supply capacity of contracted services by attracting the participation of the majority of health professionals, and to better form a service platform close to the lives of the masses.
At the same time, the "Guiding Opinions" clearly stipulates the practice places of family doctors, requiring doctors from second-level and above medical institutions to join the team of family doctors to use primary medical and health institutions as a platform to carry out contract services.
The "Guiding Opinions" also rationally optimizes the diversity of contracting entities, that is, family doctors can either form a team to provide contracting services, or individuals can provide contracting services as contracting entities. In the future, the contracting methods will be more flexible.
In addition, the "Guiding Opinions" proposes to further strengthen the family doctor training and training system. While actively expanding the family doctor team by increasing the training of general practitioners, focus on business training and optimize the family doctor's clinical diagnosis and treatment service capabilities and general practice concepts, knowledge, and skills. skills training system.
The third is to improve the content of medical and health services.
The "Guiding Opinions" proposes to further improve the ability of family doctors to carry out diagnosis and treatment of common diseases, frequently-occurring diseases and chronic disease management, and expand service items that meet the needs of the masses in accordance with regulations, such as rehabilitation, combination of medical care and nursing, palliative care, smart diagnosis and treatment and other services , to further strengthen the basic medical service function of primary medical and health institutions.
The "Guiding Opinions" put forward a phased goal for long-term prescription services, that is, all township health centers and community health service centers should provide long-term prescription services by 2025.
In addition, the "Guiding Opinions" interprets the medical service function of family doctors in terms of carrying out door-to-door services, providing priority referrals, and traditional Chinese medicine services.
It is emphasized that primary medical and health institutions have functional connections with the contract work in terms of appointments and intelligent triage, pay attention to strengthening the connection between family doctors and contract residents, and guide contract residents to gradually form the habit of seeking medical treatment for the first consultation in primary medical and health institutions.
And optimize the effect of basic public health and health management services by opening electronic health records to individual contracted residents.
The fourth is to optimize service methods.
The "Guiding Opinions" focuses on the diversification of contracted services and the richness of residents' choices, and proposes optimization suggestions for contracted service methods.
First, a flexible service agreement scheme is proposed. Based on the validity period of the previous 1-year service agreement, it can be adjusted to 2 or 3 years flexibly, so as to maintain a long-term stable contractual relationship with residents and reduce the work of primary medical and health institutions. burden needs.
The second is to supplement the definition of the contracted object. On the basis of the previous main purpose of signing the contract with individuals, it has expanded to support the signing of agreements with families and functional communities as units to meet the diverse needs of various groups of people for contracting forms. , and improve the efficiency of contract management.
In order to make the contracted residents feel the continuity, synergy and comprehensiveness of the contracted services, the "Guiding Opinions" proposes to strengthen the collaboration between general practitioners and specialist doctors, through the green referral channel between family doctors and specialist doctors, etc. It provides "one-stop" health services for contracted residents.
In addition, the "Guiding Opinions" also proposed to carry out combined contracting on the basis of the grid layout of medical consortium construction, and to carry out "Internet + contracting services" simultaneously to meet the needs of residents for online contracting, referral and various forms of health consultation. Functional requirements, and use information system data as an important indicator for evaluating and evaluating contract performance.
The "Guiding Opinions" will continue to focus on key groups, and focus on priority signing and priority services for key groups and chronic disease patients.
Fifth, improve the guarantee mechanism.
The "Guiding Opinions" further clarified the connotation and financing mechanism of contracted service fees, and emphasized the key role of basic medical insurance in guiding residents to seek medical treatment at the grassroots level and graded diagnosis and treatment.
By adjusting the price of medical service items to reflect the value of medical personnel's technical labor services, by promoting the per capita payment for outpatient medical treatment in primary medical and health institutions, and combining with the incentive mechanism for surplus retention, guide suppliers to actively improve the level of preventive health care and health management, and give full play to the cost of family doctors. "Gatekeeper" role.
The medical insurance sector shall strengthen the management of agreements, improve settlement methods and incentive policies for the retention of balances.
The "Guiding Opinions" also proposes to guide residents' expectations reasonably, and improve the recognition and trust of family doctors in the whole society by establishing typical cases and carrying out family doctor (team) evaluation and competition activities.
In terms of strengthening performance appraisal, the "Guiding Opinions" proposes that the number of contracted service providers, the proportion of key populations, renewal rates, health management effects, service quality, and contracted residents' satisfaction should be used as evaluation indicators, and the application of results should be strengthened. Fund allocation, performance distribution, etc. are linked.