Notice of the National Health Commission on Printing and Distributing the Work Plan for the Demonstration Project of the Integration of Medical Care and Nursing
Guowei Aging Issue No. 14 [2022]
The health and health committees of all provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps:
In order to conscientiously implement the decisions and arrangements of the CPC Central Committee and the State Council, and to implement the spirit of the "Opinions of the CPC Central Committee and the State Council on Strengthening the Work on Aging in the New Era" and the "14th Five-Year Plan for the Development of the National Aging Cause and Service System for the Elderly", upon approval, our commission organized a medical Support the creation of demonstration projects in conjunction with education.
The demonstration project for the integration of medical and elderly care has set up three projects: the national demonstration province (district, city), the national demonstration county (city, district), and the national demonstration institution for the integration of medical and elderly care.
The "Work Plan for the Demonstration Project of the Integration of Medical Care and Elderly Care" is hereby printed and distributed to you. Please organize and implement it carefully in accordance with the actual situation, and deeply explore typical demonstrations with a good foundation of cultivation work and a high degree of public recognition, so as to further promote the high-quality development of the integration of medical care and elderly care in the region.
Demonstration project work plan for the integration of medical care and elderly care
In order to implement the decision-making and deployment of the Party Central Committee and the State Council on the integration of medical care and elderly care, guide and encourage local governments to further promote the development of the integration of medical care and elderly care, and better meet the needs of elderly health care services, according to the "General Office of the State Council forwarded by the Health and Family Planning Commission and other departments on promoting medical care and elderly care services. "Notice of Guiding Opinions on Combining Health and Elderly Care Services" (Guobanfa [2015] No. 84), and "Several Opinions on Further Promoting the Development of the Combination of Medical Care and Elderly Care" by the National Health Commission, the National Development and Reform Commission, the Ministry of Civil Affairs and other departments ( Guowei Aging Fa [2019] No. 60), the National Health and Health Commission took the lead in organizing the establishment of a demonstration project for the integration of medical care and elderly care. The work plan is as follows.
1. Create goals
Through the establishment of national demonstration provinces (autonomous regions and municipalities), demonstration counties (cities, districts) and demonstration institutions, summarizing and promoting good experience and practices, giving play to the role of radiation and driving, guiding and encouraging local governments to further promote the integration of medical care and elderly care, and establishing and improving The policy system for the integration of medical care and elderly care will attract more social forces to actively participate in the integration of medical care and elderly care, and continuously improve the service capability and level of the combination of medical care and elderly care, so as to better meet the needs of the elderly for health care services.
2. Create the scope
(1) National demonstration provinces (autonomous regions and municipalities) for the integration of medical care and elderly care.
Provinces with mature conditions and good work foundation can apply to the National Health and Health Commission in the name of the provincial (autonomous region, municipality) people's government to create a national model province (autonomous region, municipality) for the integration of medical care and elderly care according to the actual situation.
There is no fixed cycle for the creation of demonstration provinces (autonomous regions and municipalities).
(2) National demonstration counties (cities, districts) for the integration of medical care and elderly care.
Counties, county-level cities, and municipal districts with mature conditions and good work foundations can apply for creation according to procedures.
Demonstration counties (cities, districts) creation activities are carried out every 2 years, each time about 100 demonstration counties (cities, districts) are created, and the creation work will be completed in 2030.
(3) National demonstration institution for the integration of medical care and elderly care.
A medical institution or an elderly care institution that has the qualification of a medical and health institution and has been registered with an elderly care institution.
Demonstration institution creation activities are carried out every 2 years, and about 100 demonstration institutions will be created each time (including demonstration institutions with traditional Chinese medicine characteristics), and the creation work will be completed in 2030.
3. Create standards
(1) National demonstration provinces (autonomous regions and municipalities) and national demonstration counties (cities, districts) for the integration of medical and elderly care
1. The party and government attach importance to, and departmental coordination.
Formulate and implement the "Notice of the General Office of the State Council Forwarding the Guiding Opinions of the Health and Family Planning Commission and Other Departments on Promoting the Combination of Medical and Health Care and Elderly Care Services" and the "Several Opinions on Further Promoting the Development of Medical Care and Elderly Care" issued by the National Health Commission and other departments at the same level. Opinions or work plans, the integration of medical care and nursing care as an important part of improving people's livelihood is included in the local economic and social development plan, and into the overall deployment of deepening the reform of the medical and health system and promoting the development of elderly care services.
At the same level, a working mechanism for the integration of medical care and nursing care has been established with the coordination of the party committee and the government, the leadership of the health and health department, the cooperation of relevant departments, and the participation of the whole society. Each department has a clear division of labor and responsibilities in place.
2. Policy support and strong promotion.
Formulate and implement relevant policies and measures such as fee reduction and exemption for the combination of medical care and elderly care, investment and financing, land use, approval and registration.
Lottery public welfare funds used by local governments at the same level for social welfare undertakings should appropriately support the development of medical and elderly care services.
Based on local conditions, improve medical insurance management measures, formulate and introduce relevant support measures such as personnel training and informatization.
Encourage social forces to set up medical and elderly care institutions, support social forces to participate in the combination of medical and elderly care through various modes such as franchise, public construction, private construction, or private office assistance, and provide multi-level and diversified health care services for the elderly.
Socially-run medical and elderly care institutions can undertake services such as local public health, basic medical care, and basic old-age care.
3. Consolidate and strengthen the foundation, optimize and improve.
The combination of medical and elderly care services shall be developed through various modes such as medical and nursing contract cooperation, medical institutions providing elderly care services, elderly care institutions providing medical and health services in accordance with laws and regulations, and extending medical and health services to communities and families.
Implement the national basic public health services for elderly health management, elderly health and medical care combined service projects, family doctor signing services, family hospital bed services and other relevant requirements, promote appropriate technical products and services of traditional Chinese medicine, and enhance the community's ability to integrate traditional Chinese medicine, medical care and elderly care services. , and give full play to the advantages and roles of traditional Chinese medicine in healthy elderly care.
Qualified medical and health institutions can provide door-to-door medical and health services for the elderly at home in accordance with relevant norms and standards.
Promote the integration of medical care and elderly care in rural areas, and realize the overall planning and adjacent construction of township health centers and nursing homes, village clinics and rural happiness homes in areas where conditions permit, so as to basically meet the needs of rural elderly health care services.
The proportion of geriatric medicine departments in general hospitals at level II and above is higher than the national average. All elderly care institutions in the region can provide medical and health services for the elderly in different forms, and medical and health institutions generally establish green channels for registration and medical treatment for the elderly.
4. Pay attention to management and strengthen supervision.
Formulate and implement relevant normative documents and standards related to the combination of medical care and elderly care.
Regularly inspect and evaluate the service quality of medical and elderly care institutions, instruct medical and elderly care institutions to strictly implement relevant rules and regulations, diagnosis and treatment norms and technical regulations, and timely track and urge rectification of problems found.
The combination of medical and health care data is accurate and can effectively guide practical work.
5. Improve support and strengthen guarantee.
Implement and implement the regional registration system for physicians, and medical personnel in medical and nursing institutions will participate in professional title evaluation and continuing education on an equal basis with other medical and health institutions.
Specific policies have been introduced to encourage medical personnel to practice in medical and elderly care institutions, and to establish a rotational training mechanism for medical personnel in medical and elderly care institutions.
The use of Internet and other technologies to carry out medical care and elderly care services can provide targeted and convenient combined medical care and elderly care services for the elderly.
Cultivate and support voluntary services for the elderly, and carry out voluntary services for institutions that combine medical care and elderly care.
6. Recognized by the masses, the evaluation is good.
The combination of medical and elderly care services has been generally recognized by the local elderly, and there have been no major negative events such as medical quality safety and elderly-related events within 5 years.
The combination of medical care and elderly care has been affirmed by the higher authorities and related departments, and the media has made many positive comments.
(2) National Demonstration Institution for the Integration of Medical Care and Nursing
It has been in operation for 5 years or more, and the occupancy rate in the past 2 years has reached 60% or more of the actual operating beds. It can provide appropriate preventive health care, disease treatment, rehabilitation care, stable life care and end-of-life care for the elderly. More than 50% of the disabled and demented elderly are admitted to the integrated medical and nursing service of palliative care.
On the basis of satisfying the above conditions, the following institutions are recommended as a priority: carry out comprehensive health and needs assessment of the elderly, establish electronic health records for the elderly, and share the assessment results with medical and elderly care service providers.
Actively intervene for the physical function decline (such as physical decline, cognitive impairment, depressive symptoms, etc.) and geriatric syndromes (such as urinary incontinence, fall risk, etc.) that may occur in the elderly to prevent or slow down disability and dementia.
Provide psychological interventions, training and support to informal caregivers such as family members of older adults aged at home.
Focus on giving full play to the characteristics and advantages of traditional Chinese medicine, and provide the elderly with traditional Chinese medicine constitution identification, health care and other health care services.
Use information technology to improve the quality and efficiency of medical and elderly care services.
1. Environmental facilities are good.
According to the type of institution, the architectural design of the service site conforms to the relevant national standards such as the architectural design specifications of relevant medical institutions and the "Architectural Design Standards for Elderly Care Facilities", "Code for Fire Protection in Architectural Design", and "Code for Barrier-Free Design".
Equipped with medical and elderly care facilities and equipment that meet service needs, and regularly maintained and maintained to ensure the safe use of equipment.
2. The staff is good.
Corresponding management, professional technology, service and logistics personnel should be allocated according to the type, scale and service needs of the institution. The number of personnel should meet relevant national requirements. All personnel must be certified in accordance with relevant national laws and regulations or have passed relevant professional training. Can be employed and organize regular assessments.
Managers should have relevant management experience.
All kinds of professional and technical personnel shall establish professional and technical files.
3. Good internal management.
Follow the "Regulations on the Management of Medical Institutions", "Basic Specifications for Service Quality of Elderly Care Institutions" and other relevant systems, establish a management system that is matched with medical and elderly care services, and strengthen service management, personnel management, financial management, environment and facility management, and production safety management. and logistics management; medical institutions also need to strengthen medical management, nursing management, pharmacy management, hospital infection management, medical document management, etc.
4. The service quality is good.
Understand the health status of the elderly, formulate targeted personal service plans for the elderly, provide professional, safe and standardized medical and health services and elderly care services, and provide health education, health management, disease diagnosis and treatment, and rehabilitation according to institutional responsibilities and service needs Nursing, living care, catering services, cleaning and sanitation services, washing services, cultural entertainment, psychological and spiritual support, palliative care and other services, so that chronic diseases can be managed, acute diseases can be detected early, minor diseases can be handled, and serious diseases can be easily referred for referral.
Open service items and charging standards, establish a complaint feedback mechanism, and improve service quality in a timely manner.
5. The service effect is good.
Complying with relevant national laws, regulations and policies, no major safety production accidents, major medical malpractices and violations of laws and disciplines have occurred within 5 years.
The operation of the institution is in good condition and has the potential for sustainable development.
The establishment of an external monitoring and evaluation system for service quality will produce good social benefits, and can play a radiating and driving effect on other integrated medical and elderly care service institutions.
Carry out a third-party social satisfaction evaluation, and the satisfaction survey results of the elderly and their family members are 95% and above.
4. Workflow
(1) National Demonstration Provinces (Autonomous Regions, Cities)
1. Application creation.
Provinces (autonomous regions, municipalities) with mature conditions and good work foundation can apply to the National Health Commission in the name of the provincial (regional, municipal) people's government to create a national model province for the integration of medical care and health care (with the creation activities of the province (region, municipality) attached) plan, including work progress, next steps to create a work plan, etc.).
2. Support guidance.
The National Health and Health Commission is responsible for specific support and guidance for the promotion of powerful and exemplary provinces (autonomous regions and municipalities) to create demonstration provinces (autonomous regions and municipalities) for the integration of medical care and elderly care.
3. Evaluation and acceptance.
After the establishment period expires, the National Health and Health Commission organizes evaluation and acceptance of the declared provinces (autonomous regions, municipalities), and those that meet the standards are determined to be "National Demonstration Provinces (Autonomous Regions, Municipalities)".
4. Dynamic management.
Dynamic management of provinces (autonomous regions, municipalities) that are being created and named model provinces (autonomous regions, municipalities), in the event of major adverse social impact incidents, illegal cases or poor implementation of policies related to the combination of medical care and elderly care, service levels are significantly reduced, and the rights of the elderly are violated, etc. In the case of serious landslides in services, the creation of the project shall be terminated in a timely manner according to the procedure or the naming of the demonstration province (district, city) shall be cancelled, and the demonstration province (district, municipality) shall not be reapplied for within 3 years.
(2) National Demonstration Counties (Cities, Districts) and Demonstration Institutions
1. Self-assessment declaration.
Each reporting unit conducts a self-check item by item according to the work standards. Those who meet the conditions can fill in the declaration form and submit it to the provincial health and health commission level by level.
2. Preliminary recommendation.
The health and health committees of all provinces (autonomous regions, municipalities) and Xinjiang Production and Construction Corps can refine the work standards, improve the evaluation system, conduct a strict preliminary review of the applying units, determine the list to be recommended, and submit them in writing to the National Health and Health Commission.
3. Evaluation and acceptance.
The National Health and Health Commission organizes evaluation and acceptance of recommending units.
4. Publicity naming.
According to the evaluation and acceptance, the list of candidate demonstration counties (cities, districts) and demonstration institutions will be determined and announced on the website of the National Health Commission.
If there is no objection after the announcement, the National Health and Health Commission will determine it as a "National Model Counties (Cities, Districts)" and "National Model Institutions for the Integration of Medical Care" and announce it.
5. Dynamic management.
Carry out dynamic management of demonstration counties (cities, districts) and demonstration institutions. In the event of major adverse social impact events, illegal cases or ineffective implementation of policies related to the combination of medical care and elderly care, service levels have dropped significantly, and the rights and interests of the elderly have been violated. Serious decline in work services. The naming of demonstration counties (cities, districts) or demonstration institutions shall be cancelled in a timely manner according to the procedures, and no further application shall be made to create demonstration counties (cities, districts) and demonstration institutions within 3 years.
National Health Commission
April 18, 2022
(form of information disclosure: active disclosure)