Various localities take multiple measures to promote the expansion and balanced distribution of high-quality medical resources
Normalize multi-level medical services to protect health (Promote the construction of a healthy China②)
core reading
General Secretary Xi Jinping pointed out in the report of the 20th National Congress of the Communist Party of China, "Promote the expansion of high-quality medical resources and the balanced distribution of regions, adhere to the principle of prevention, strengthen the health management of major chronic diseases, and improve the ability of grassroots disease prevention, treatment and health management."
Form a medical consortium to sink high-quality medical resources, establish a follow-up system for chronic diseases and smart health records, and promote family doctor contract services to increase the rate of first visits at the grassroots level... Various localities have innovated to promote the construction of a healthy China and effectively protect the health of the people.
Full medical coverage
Promote resource sinking
Li Yun (pseudonym), an elderly man who lives in Jingyu County, Baishan City, Jilin Province, suddenly developed abdominal pain and high fever symptoms, and his family rushed the old man to Jingyu County People's Hospital.
Li Hang, a hepatobiliary surgeon dispatched by the China-Japan Friendship Hospital of Jilin University to the People's Hospital of Jingyu County, received the treatment. He found out that the old man was suffering from common bile duct stones combined with acute suppurative cholangitis, and his condition was critical.
Li Hang quickly contacted and transferred the old man to the Changchun branch of the China-Japan Friendship Hospital of Jilin University.
The expert team of the Changchun Campus quickly formulated a treatment plan and used super minimally invasive techniques to remove the stones in the patient's body in only 10 minutes.
Convenient access to high-quality medical resources, thanks to the close connection.
In September 2021, the China-Japan Friendship Hospital of Jilin University and the Jingyu County People's Hospital will be officially inaugurated as a close medical consortium and Jingyu Branch of the Internet Hospital.
In recent years, Jilin Province has established government-led sub-regional, hierarchical and multi-form medical alliances.
The province has established 5 provincial-level medical associations, 25 urban medical associations, 17 county-level medical associations, and more than 150 specialized medical associations.
At present, medical alliance units at all levels cover all public medical institutions above the second level and more than 110 private medical institutions in Jilin Province, initially achieving full coverage of medical institutions of different types and levels.
Jilin Province has also introduced policies such as "physicians do not need to file for practice in multiple institutions within the medical consortium" to optimize the policy environment for the sinking of medical resources.
Statistics show that the five major medical associations at the provincial level in Jilin send more than 10,000 medical personnel to lower-level hospitals on average every year, and treat 188,000 patients.
In the past five years, nearly 30,000 physicians have been transferred to grass-roots medical institutions in the province.
Today, in county hospitals that can link high-quality resources, patients feel more at ease.
For ordinary illnesses, experts in Changchun can consult via video, and sometimes experts will visit the county hospital.
The China-Japan Friendship Hospital of Jilin University has established an Internet hospital to promote remote diagnosis and treatment services, realize remote imaging, ultrasound, electrocardiogram, pathology consultation, and conduct difficult case discussion and training at the same time.
"Internet hospitals can realize the integration of online and offline diagnosis and treatment services." Zhang Hailong, Director of the Internet Hospital Office of China-Japan Friendship Hospital of Jilin University, introduced that relying on the construction of Internet hospitals, the "medical alliance + remote consultation" model will be realized.
Interconnection has accelerated the expansion and sinking of medical resources in Jilin Province.
Jilin Province coordinated the establishment of a provincial-level telemedicine consultation platform, which runs horizontally through the five major provincial medical alliances, vertically links 43 county-level hospitals, and simultaneously extends to township health centers across the province. Since its opening, a total of 4,552 remote consultations have been performed.
The "medical consortium + remote consultation" model is trying to improve the experience and effect of medical treatment for the masses.
Today, the number of referrals from secondary and tertiary hospitals to grass-roots medical and health institutions and continuous medical institutions in Jilin Province has increased from 15,000 in 2015 to 140,000 at present. more than 90 percent.
Chronic disease home follow-up
Create an electronic file
67-year-old Zeng Shaofang received a text message informing her of chronic disease follow-up visits.
Since his wife Uncle Huang suffered a stroke, the quarterly follow-up visits for diabetes depended entirely on community doctors.
On November 3, the reporter came to Uncle Huang's house with the medical staff as scheduled.
As soon as she entered the door, Lu Qiuhong, a general practitioner at the Guijingwan Community Health Service Station in Liubei District, Liuzhou City, Guangxi, took out a tablet computer and quickly called up the health files of Uncle Huang and his wife.
The files are very detailed, including chronic disease prevalence, main medications, previous follow-up records, and physical examination reports.
Next, the medical staff gave Uncle Huang a comprehensive physical examination.
When doing urine routine testing, when the scanning gun sweeps over the reagent strip, the tablet computer will immediately display the results, and the results of blood sugar, blood pressure, electrocardiogram, etc. can also be seen on the system soon.
It turned out that this tablet computer integrated the "Smart Public Health" follow-up system.
Through the use of cloud laboratory and other functions, the system helps Xiacun outpatients and home follow-up doctors to complete follow-up services for major chronic diseases such as hypertension and diabetes health management.
"The system automatically imports the follow-up results into the archives of the government's public health system, providing convenience for strengthening the management of patients with chronic diseases, supervising medication, and following up on treatment plans."
Zeng Shaofang recalled that the conditions were not good in the past, and she had a headache and brain fever and could only find a cure by herself.
"The changes are too great now! The health service station not only holds health lectures frequently, and the equipment is getting more and more advanced, but also invites a doctor from the First Affiliated Hospital of Guangxi University of Science and Technology to visit us every week."
During the interview, the reporter observed that "Internet + medical health" services such as "Smart Public Health" not only provide convenience to patients with chronic diseases, but also improve the work of doctors.
Walking into the file information room of the health service station, the residents' health files from the past few years are packed into two large cabinets.
Lu Qiuhong said: "In the past, there were a lot of paper materials for a physical examination. When filling out the form, if there was a smear, it was all rewritten, and it had to be entered on the computer once after writing. It would take a week at the fastest to get the report."
"It's different now. The health management data of 375 type 2 diabetic patients, 580 hypertensive patients, and 1,230 elderly people in Guijingwan community are all collected into the system, effectively meeting residents' medical needs for 'minor illnesses in the community'." Data Run more, everyone less detours.
Lu Qiuhong said, "A physical examination in the morning and a report in the afternoon will be available to the masses."
Liu Jinji, deputy director of the Liuzhou Municipal Health Commission and director of the Administration of Traditional Chinese Medicine, said, "As of October this year, all 128 grassroots medical institutions in Liuzhou have been equipped with tablet computers to provide residents with online services such as signing agreements, health consultation, chronic disease follow-up, Two-way referral and other services. Residents’ electronic health records have been opened to individuals, and patients with chronic diseases can check their own health records to understand the dynamic changes in their health status.”
"Next, based on the regional national health information platform, we will continue to strengthen the construction of a smart public health management system, strengthen the sharing of regional health information, better regulate the health management of major chronic diseases, and promote the quality and efficiency of public health management," Liu Jinji said. .
contracted family doctor
Optimize health management
At 5:30 p.m., after seeing the last outpatient, Yang Hua, a general practitioner at the Community Health Service Center of Bozhou Road Street, Luyang District, Hefei City, Anhui Province, packed up his outpatient box and went straight to Changyuan New Village.
"Dong dong dong", Aunt Zheng answered from the door, "Here we come! Is it Dr. Yang?"
The 69-year-old Aunt Zheng not only suffers from high blood pressure and diabetes, but also has a bad heart. She is a frequent visitor to the community health service center in Bozhou Road Street.
In 2017, the center launched the paid contract service of family doctors. Aunt Zheng became the first batch of residents who signed the contract and chose Yang Hua as her family doctor.
"My condition is so stable, thanks to Dr. Yang." Aunt Zheng said that before, it took half a day to go to the hospital every now and then to register and queue.
"Nowadays there is a family doctor, who can be contacted at any time when he is not feeling well on weekdays. There is a monthly check-up, a follow-up visit once every 3 months, and a comprehensive physical examination every year. Any problems can be detected and treated early. "
"This year, our team has signed contracts with more than 3,000 residents." Yang Hua said that after signing the contract, these residents will enjoy the basic medical care, public health and agreed health management services provided by their team, including the establishment of health records, chronic diseases Implement effective health interventions for key populations such as patients, and help contracted patients contact two-way referrals, etc.
"Many residents in the jurisdiction have signed contracts with our team for five or six consecutive years. Usually when someone in the family is sick, they will come to me for consultation."
Now, Luyang District has established more than 80 family doctor service groups composed of general practitioners, community nurses, public health personnel and community volunteers, contracted to manage nearly 300,000 residents.
Li Jinmei, deputy director of the Luyang District Health and Health Commission, told reporters that since 2017, the number of outpatient and emergency visits in centers (health centers) in Luyang District has risen from 315,300 in 2016 to 932,300 in 2021, a growth rate of 195.7%. From January to October, the outpatient and emergency visits of seven community health service centers in the region exceeded 100,000, and the rate of first visits at the grassroots level reached 61.5%.
"We incorporate the number of contracts, service quality, and residents' satisfaction into the performance appraisal of family doctor service personnel. At the same time, we actively establish a service incentive mechanism, and clearly use 70% of the family doctor's contracted services and related visits, rounds, etc. for rewards Participate in family doctor service personnel." Li Jinmei said that in the next step, Luyang District will continue to improve the service capabilities of family doctors, and strive to allow residents to enjoy high-quality and convenient medical and health services at their doorstep.
Our reporter Zhu Dawei Zhang Yunhe Li Junjie