Medical network - on January 11, on January 9, "" much starker choices-and graver consequences-in" deepening medical and health system reform plan "website. Among them, about the main content of the drug supply security system construction has five parts.
During the period of "much starker choices-and graver consequences-in", will be implemented with whole process reform, pharmaceutical production, circulation, to break with medicine cure, construction conforms to the situation of national drug policy system, straighten out the drug prices, promote medicine industry structure adjustment and transformation and upgrading, to ensure drug is safe and effective, reasonable price, adequate supply.
We will deepen reform of the drug supply field. To promote enterprise to improve innovation and research and development ability, and promote traditional Chinese medicine (TCM) modernization and standardization of production, achieve pharmaceutical medical instrument quality at or near the international advanced level, make the Chinese standard and Chinese brand. Accelerate the generic drug quality and consistency evaluation of curative effect, encourage drug clinical value oriented innovation. Establish and improve the shortage of drug monitoring and warning and grading coping mechanism, continue to conduct small dosage, clinical necessary, market supply drugs designated production pilot.
Second, we must deepen the reform of the medicine circulation system. To speed up the construction of drug circulation the national unified open, competitive and orderly market pattern, form a new modern circulation system. Speed up the development of pharmaceutical logistics, encourage regional drug distribution of urban and rural integration. Promote circulation enterprises to smart medical service transformation. Popularization and application of modern logistics management and technology, standardizing medical electricity development, perfect the system of Chinese modern circulation network and traceability.
3 it is to improve the system of medical disposable materials centralized purchasing drugs and high value. To carry out the public hospital drug classification procurement, adhere to the principle of concentration belt quantity purchase, encourage the cross-regional joint procurement and joint procurement specialist hospital. Implementation of drug purchase "two votes" reform (production enterprise to open an invoice of enterprises and circulation enterprises to open an invoice) medical institutions. We will improve the mechanism of drug price negotiations, and gradually increase the number of countries to negotiate drug varieties, and make health care policy cohesion, etc. To carry out the high value medical consumables, inspection detection reagent, centralized purchasing large medical equipment.
Four is to consolidate improve the system of basic drugs. Consolidate the government grass-roots medical institutions and village clinics system for basic drugs, basic drugs in the directory, logo, price, distribution, equipped with using unified policy. Both on Chinese and western medicine in the national list of essential medicines.
Five is to improve the national drug policy system. To take comprehensive measures to cut off the hospitals and medical personnel and medicine, material between the interests of the chain. Through various channels to buy medicine mode, explore outpatient patients to retail pharmacies can be obtained with a prescription to buy medicine. We will further improve the drug price formation mechanism, and gradually build price management system in conformity with the characteristics of drug market in China. Establish and improve the health care medicine pay standards. Improve the system of management of medical institutions and retail pharmacy pharmacists, pharmacy practice value. Strive for to 2020, establish the ex-factory price of basic information traceability system, forming one mega pharmaceutical circulation enterprises with annual sales of more than 500 billion yuan, pharmaceutical wholesale enterprises with annual sales accounted for over 90% of the total amount of wholesale market.
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During the period of "much starker choices-and graver consequences-in" is the overall train of thought of reform?
"Much starker choices-and graver consequences-in" during the reform work, will continue holding the great banner of socialism with Chinese characteristics, fully implement the party's 18 large and 18 sixth plenary session of 3, 4, 5, spirit, with marxism-leninism, MAO zedong thought, deng xiaoping theory and "three represents" important thought, the concept of scientific development as guidance, in-depth study and implement general secretary xi series of important speech spirit, closely around as a whole to promote "five one" the overall layout and coordination to promote "comprehensive" four strategic layout, conscientiously implement the party central committee and the state council decision deployment, firmly set up and implement the innovation, the coordination, the development of the green, open, sharing ideas. Adhere to the people as the center of the development of ideas, adhere to the right of health and health work policy, sets up the concepts of health, to promote the health and health field theory innovation, system innovation, management innovation, technological innovation, speed up the establishment conforms to the situation of the basic medical and health system, realize the development mode by treating centered to on health as the center, promoting the modernization of medicine and health management system and management ability, to promote the health of China construction, build a well-off society in an all-round way, implement the "two" one hundred goals and the great rejuvenation of the Chinese nation provide solid foundation for the Chinese dream.
In the process of reform, will adhere to people's health as the center, adhere to the basic, strong base, building mechanism, adhere to government-led combined with play a role of market mechanism, push forward structural reforms, supply side insist on medical treatment, health care, medical reform of linkage, adhere to highlight key, pilot demonstration, gradual.
"Much starker choices-and graver consequences-in" during health reform to achieve the main goal of what?
"Much starker choices-and graver consequences-in" during the reform work, will pay attention to keep the policy continuity and stability at the same time, according to people's health needs and the new changes of social and economic development, highlight the forward-looking, creative and pay attention to long-term goal and the key combination, already planning the next five years of work, also designed the administration's breakthrough, phased out of order.
By 2017, the basic formation of a systematic policy framework for the basic medical and health care system. Gradually improve the policy system of hierarchical diagnosis and treatment, the modern hospital management system and accelerate the construction of comprehensive supervision system of universal health care system more efficient, further improved the use policy for producing and distributing medicines.
To 2020, generally a comparatively perfect public health service system and medical service system, perfecting the medical security system compares a standard, drug supply security system and the comprehensive regulatory system and comparison of the scientific management system and operational mechanism of medical and health institutions. After continuous efforts, basic to establish the basic medical and health system covering both urban and rural residents, the realization everyone will have access to basic medical and health services, basic to meet the needs of people's multi-level medical and health care, higher than that of 2015 residents life expectancy in China 1 year old, the maternal mortality rate dropped to 18/10, infant mortality rate dropped to 7.5 ‰, children under the age of five mortality rate dropped to 9.5 ‰, the main health indicators in high-income countries, personal health spending accounts for the proportion of the total health expenses dropped to 28%.
During the period of "much starker choices-and graver consequences-in" reform work overall architecture is what?
During the period of "much starker choices-and graver consequences-in", deepening the health care work will fully implement the conference spirit, the national health and health with its national conditions to establish the basic medical and health care system as the key point, in the classification diagnosis and treatment, the modern hospital management, universal health care, drug supply security and comprehensive regulation of the five new breakthrough on the system construction. At the same time, promote the reform of related areas as a whole, mainly including: the use of talent fostering and the sound incentive evaluation mechanism, speed up the formation of multiple medical pattern, promote the public health service system construction, etc.
What are the main content of the grading system construction?
The classification system of "much starker choices-and graver consequences-in" during construction, residents will be on a voluntary basis, first option at the grass-roots level, policy guidance, innovation mechanism, on the basis of signing to the family doctor service as main fulcrum, encourage all practical carry out various forms of hierarchical diagnosis model, promote grass-roots first option, two-way referral, acute slow partition, the upper and lower linkage of new medical order.
One is the consummate medical and health service system. Layout optimization of medical and health resources, clear medical and health institutions at various levels and of function orientation. Improving the capacity of remote medical service, longitudinal flow of informationization means to promote health resources. Promote large hospital and grassroots health institutions, general practitioners and specialists of resource sharing and business collaboration. Will be fully into the army medical institution classification diagnosis system. Give full play to the traditional Chinese medicine "cure not ill", the important function of the major disease treatment and rehabilitation.
Second, improving the capacity of grassroots medical and health services. Strengthening rural hospitals, community health service center of basic medical service ability construction, to strengthen the construction of public hospitals at the county level comprehensive ability and discipline construction. Supply by encouraging large hospital physicians, retired doctor clinic, and strengthen the counterpart support, implementation of telemedicine, promote the establishment of medical association and so on, the technology of big hospital to the grassroots. We will further improve the basic management and operation mechanism.
3 it is to engage in public hospitals in diagnosis and classification. Pay to further improve and implement health care and medical service price policy, arouse the enthusiasm of tertiary public hospital in hierarchical diagnosis and initiative, guide the tertiary public hospital patients complicated complex and emergency and severe cases, moves the stabilization and recovery in patients with common disease, frequently-occurring disease and disease. Promote the construction of the medical association, and the combination of health care, remote medical treatment, etc, realize the organic combination of medical resources, through up and down.
Fourth, promote the formation of diagnosis and treatment, rehabilitation, long-term care service mode continuously. Clear medical institutions in slow partition service process, establish a sound mechanism of collaboration, smooth hospital, grassroots medical and health institutions, chronic disease rehabilitation hospitals and nursing homes referral channels between medical institutions, the formation of "slight illness at the grassroots level, to the hospital, rehabilitation back to basic" reasonable medical pattern.
5 it is scientific and reasonable guide the masses go to a doctor. To establish and perfect the system of signing the family doctor service, by improving the basic-level service capacity, payment, price controls, for the convenience of huimin, measures such as encouraging urban and rural residents signed a contract with a doctor or family physician team at the grass-roots level. Improve the two-way referral program, establish and improve the referral guidance catalogue, key open referral channel down, gradually achieve different levels and different categories orderly referral between medical institutions. To conform to the provisions of the continuous calculation of hospitalized patients with referral starting line. By 2017, gradually improve the policy system of hierarchical diagnosis and treatment, more than 85% of the cities to carry out the pilot. By 2020, the hierarchical diagnosis model gradually formed, the classification system of basic establishment conforms to the national conditions.
What are the main content of modern hospital management system construction?
During the period of "much starker choices-and graver consequences-in", further deepening the reform of public hospitals at the county level comprehensive, accelerate reform of the urban public hospitals. Implemented at all levels by 2017, all kinds of public hospital reform, preliminary establish decision-making, implementation, supervision and coordination, the management system of checks and balances, mutual promotion and governance mechanism. With Chinese characteristics by 2020, basic establishment of clear responsibilities, scientific management, perfect management, efficient operation and effective supervision of modern hospital management system, establish maintenance public welfare, to mobilize enthusiasm and ensuring the sustainable operation mechanism and scientific and rational compensation mechanism.
It is a perfect public hospital management system. To properly handle the hospitals and government relations, separating and separated, promote hospital management mode and operation mode transformation. Perfect public hospital corporate governance mechanism, the implementation of the internal personnel management, organization setup, income distribution, deputy recommendation, appointment or dismissal of cadres in the middle, such as annual budget execution autonomy. To establish and perfect the system of public hospital comprehensive budget management, cost accounting system, financial reporting system, the chief accountant system, third party auditing system and information disclosure system.
2 it is to establish a standardized and efficient operation mechanism. Cancel the drug addition (excluding Chinese medicine yinpian), through the adjustment of medical service prices, increasing government investment, reform of payment, reduce hospital operating costs, etc., to establish scientific and reasonable compensation mechanism. Strengthen classified guidance, straighten out the different level medical institutions and medical service price comparison between relations. Let go of the special medical services, and other market competition more fully, stronger demand for personalized medical service price, set by the medical establishment of autonomous.
Three is to establish a accord with the characteristics of the health care industry personnel and compensation system. Innovation of public hospital management mode, in some large and medium cities third rate reform of public hospitals to carry out the preparation of management, personnel management pilot. The implementation of public hospital autonomy of choose and employ persons. Combined with the actual reasonable public hospital compensation levels, gradually improve staff spending accounts for the proportion of business spending. Shall, in accordance with the relevant regulations, public hospitals can explore ways to establish the target yearly salary and compensation agreement.
Four is to establish quality as core, public welfare oriented hospital evaluation mechanism. Institutions examination should include social efficiency, service, quality and safety, the integrated management and sustainable development, pay attention to the health emergency, counterpart support and function to carry out the classification diagnosis and treat implementation such as public welfare work. Medical staff appraisal outstanding position workload, service quality, behavior standards, technical difficulty, degree of risk and the service object satisfaction indicators, such as head of the inspection should also include the employee satisfaction, etc. Five is to control public hospital medical expense unreasonable growth. Set the national medical expenses growth control goals. In a city with districts for the unit to the price of the public hospitals within their respective jurisdictions, the medical service efficiency, all the information such as health care costs. To carry out the system of prescription comment.
What are the main contents of construction system of universal health care?
"Much starker choices-and graver consequences-in" during the construction of universal health care system work, will be in accordance with the basic, out line, the principle of sustainable, around the capital source diversification, security system standardization, management service socialization three key links, increase the intensity of reform, to establish universal health care system run efficiently. By 2017, the basic implementation meet the requirements of referral long-distance medical hospitalization expense settlement directly. By 2020, basic medical insurance rates steady at more than 95%.
Basic health care is a perfect stable sustainable financing and reimbursement proportion adjustment mechanism. To improve medicare payment ginseng, and gradually establish a stable and sustainable multi-channel fund-raising mechanism, with the level of economic and social development, the parties bear ability. Sound to the level of financing to adapt to the dynamic adjustment mechanism of the treatment of primary health care. According to the classification, as a whole to adjust, budget management, Shared accountability assessment basic train of thought, increase fund level as a whole. Advance basic health nationwide network and long-distance medical direct settlement, to reduce the "errands", "mat endowment". Establish different referral policy measures, the long-distance medical direct settlement and improve medical resources sinking, promote the construction of medical association, establishing the hierarchical diagnostic system to connect and coordinate.
Second, deepening the reform of medical insurance payment. Improve the medical insurance payment mechanism and benefit regulating mechanism, implement of fine management, stimulate the medical institutions regulating behavior, control costs, reasonable endogenous power of patients and referral. Fully implementing by macro-reforms primarily, by the man's head, according to the bed, and total prepaid the compound payment method of combining a variety of payment methods to pay according to the disease diagnosis related group (DRGs) way.
Three is the integration of basic medical insurance system. In urban and rural residents basic medical insurance coverage and financing policies, to ensure treatment, medical insurance directory, fixed management, fund management, on the basis of "six reunification", speed up the integration of the basic medical insurance management institutions. Orgnaization of unified basic medical insurance management, can carry out pilot the establishment of medical insurance fund management center. Accelerate the insurance cover separated, promote corporate health agencies and professional level.
Four is major workplace disease of security mechanism. Based on the full implementation of urban and rural residents of a serious illness insurance, to reduce the starting line, improve the proportion of reimbursement, reasonable compliance measures such as the scope of medical expense, raise a serious illness insurance with the precision of payment. Major workplace disease medical relief work comprehensively, low-income families of elderly, minors, severely disabled, seriously ill patients, such as low-income rescue object, and because of sickness poor family illness into relief scope.
Five is to accelerate the development of commercial health insurance. Active play to the commercial health insurance institutions in actuarial technology, professional services, and risk management advantages, such as participation in the insurance agency services, encourage and support form the new pattern of multiple handling, multi-party competition. Speed up the development of medical liability insurance, accident insurance of medical treatment, to explore the development of a variety of forms of insurance of medical practice. Rich health insurance products, strengthen the guarantee of health insurance.
The main content of the drug supply security system construction have?
During the period of "much starker choices-and graver consequences-in", will be implemented with whole process reform, pharmaceutical production, circulation, to break with medicine cure, construction conforms to the situation of national drug policy system, straighten out the drug prices, promote medicine industry structure adjustment and transformation and upgrading, to ensure drug is safe and effective, reasonable price, adequate supply.
We will deepen reform of the drug supply field. To promote enterprise to improve innovation and research and development ability, and promote traditional Chinese medicine (TCM) modernization and standardization of production, achieve pharmaceutical medical instrument quality at or near the international advanced level, make the Chinese standard and Chinese brand. Accelerate the generic drug quality and consistency evaluation of curative effect, encourage drug clinical value oriented innovation. Establish and improve the shortage of drug monitoring and warning and grading coping mechanism, continue to conduct small dosage, clinical necessary, market supply drugs designated production pilot.
Second, we must deepen the reform of the medicine circulation system. To speed up the construction of drug circulation the national unified open, competitive and orderly market pattern, form a new modern circulation system. Speed up the development of pharmaceutical logistics, encourage regional drug distribution of urban and rural integration. Promote circulation enterprises to smart medical service transformation. Popularization and application of modern logistics management and technology, standardizing medical electricity development, perfect the system of Chinese modern circulation network and traceability.
3 it is to improve the system of medical disposable materials centralized purchasing drugs and high value. To carry out the public hospital drug classification procurement, adhere to the principle of concentration belt quantity purchase, encourage the cross-regional joint procurement and joint procurement specialist hospital. Implementation of drug purchase "two votes" reform (production enterprise to open an invoice of enterprises and circulation enterprises to open an invoice) medical institutions. We will improve the mechanism of drug price negotiations, and gradually increase the number of countries to negotiate drug varieties, and make health care policy cohesion, etc. To carry out the high value medical consumables, inspection detection reagent, centralized purchasing large medical equipment.
Four is to consolidate improve the system of basic drugs. Consolidate the government grass-roots medical institutions and village clinics system for basic drugs, basic drugs in the directory, logo, price, distribution, equipped with using unified policy. Both on Chinese and western medicine in the national list of essential medicines.
Five is to improve the national drug policy system. To take comprehensive measures to cut off the hospitals and medical personnel and medicine, material between the interests of the chain. Through various channels to buy medicine mode, explore outpatient patients to retail pharmacies can be obtained with a prescription to buy medicine. We will further improve the drug price formation mechanism, and gradually build price management system in conformity with the characteristics of drug market in China. Establish and improve the health care medicine pay standards. Improve the system of management of medical institutions and retail pharmacy pharmacists, pharmacy practice value. Strive for to 2020, establish the ex-factory price of basic information traceability system, forming one mega pharmaceutical circulation enterprises with annual sales of more than 500 billion yuan, pharmaceutical wholesale enterprises with annual sales accounted for over 90% of the total amount of wholesale market.
What are the main content of the comprehensive supervision system construction?
During the period of "much starker choices-and graver consequences-in", will further improve the medical health legal system, speed up the transformation government function, perfect and medicine and health care regulation mode that can meet the needs of career development, improve the comprehensive regulatory efficiency and level, promote the regulation legalization and standardization, establish and improve the responsibilities clear, collaboration, operation specification, scientific and effective comprehensive supervision long-acting mechanism.
One is to deepen reform of medicine and health care field "pipes". According to the new, decentralization, combined the pipes, optimize service demands and promoting medical health system reform of administrative examination and approval. Shift supervision idea, innovating the mechanism of supervision and regulation, pay more attention to strengthen the supervision of things after the event.
The second is to build diversified supervision system. Perfecting the government regulation, the third party broad participation, medical and health institutions self-management and the diversity of social supervision for added comprehensive regulatory system. Using informatization technology to all outpatient treatment behavior and expenses, hospitalization medical institutions to carry out the whole monitoring and intelligent audit. Establish a mechanism of social work, take the initiative to accept social supervision.
Three is to strengthen the industry comprehensive regulation. Exercise ShuDeHua supervision, establish and improve the comprehensive regulation guarantee mechanism. For random inspection object, randomly selected law enforcement inspectors "double random inspection", spot check and investigate the results to the public in a timely manner. Establish violations "blacklist" system, to enter the "blacklist" of institutions and personnel in accordance with the law in accordance with the rules seriously. Strengthen the supervision of medical health programs and medical advertising.
Four is guide third-party evaluation and self-discipline. Encourage qualified third party actively carry out or participate in the evaluation standard of consulting, technical support, evaluation, evaluation to promote medical institutions is dominated by the government to gradually shift to an independent third party evaluation. Strengthening industry self-discipline, promote the organization to establish and perfect industry industry management standards and guidelines. In 2020, the medical and health institutions at various levels and of the supervision and inspection to achieve 100% coverage.
As a whole to push forward the reform of related content have?
While focus on the five system construction, push forward three aspects of work:
One is the use of talent fostering and the incentive sound evaluation mechanism. From increasing salary treatment, development space and the environment, social status and other aspects, to mobilize the broad masses of medical staff enthusiasm, initiative and creativity, give play to the role of the main medical personnel reform. Improve the system of education after graduation, in 2020, bachelor degree or above of all new medical position clinicians are resident standardization training. Allow the regulation and control of medical and health institutions to break through the current institution wage, allow the medical service revenue after deducting costs and in accordance with the provisions, extraction of various funds is mainly used for reward.
Second is to speed up the formation of multiple medical pattern. Encourage social forces to set up health services, expand the scale of health service related supporting industries. To speed up the development of social do medical. Promote the development of medical and pension, endowment health industry. Promote health and tourism integration, accelerate the healthy development of tourism industry. Promote the development of the Internet with health, wisdom, health industry. Promote the development of traditional Chinese medicine health services, implementation of traditional Chinese medicine health preservation culture creative transformation, innovative development.
3 it is to promote the public health service system construction. To promote the government to buy public health services. Establishing and perfecting the incentive mechanism of public health professionals, researchers and operating funds according to the standard of staffing, funding, service task to complete and arrange the inspection situation by the government budget in full.
How to guarantee to carry out the "much starker choices-and graver consequences-in" reform plan?
Implement "much starker choices-and graver consequences-in" safeguard measures of the health reform plans, mainly classified into the "seven strengthened".
One is to strengthen organization and leadership. Place by the party committee and government is mainly responsible for comrades or a is mainly responsible for comrades to reform leading group leader, give full play to the leading group for reform of overall coordination effect, promote the reform of medical treatment, health care, medical linkage unity.
The second is to strengthen responsibility implementation. Implement the leadership responsibility, security responsibilities of governments at all levels, management responsibility, supervision and responsibility. Increasing government investment in health, to 2020, the full implementation of the government's public hospital of in line with the regional health planning investment policy, gradually repay and eligible public hospital for a long time to resolve the debt.
Three is to strengthen reform exploration. Respect and promote grass-roots initiative, fully decentralization, encouraging local forge ahead, adjust measures to local conditions and bold exploration.
Four is to strengthen science and technology support. Continue to organize national science and technology research and development of major projects and key projects, promote scientific and technological innovation ability.
Five is to strengthen international cooperation. For China's global health strategy, combined with the "area" construction, deeply involved in global health governance.
Six is to strengthen supervision. Establishing and perfecting the supervision evaluation system, give full play to the role of the third-party evaluation, strengthen the results using and incentive accountability. Enhance monitoring the real-time and accuracy.
Seven is to strengthen publicity and guide. Strengthen policy interpretation, timely response to social concern, a reasonable guide social expectations, raise people's awareness and participation to the reform, improve the enthusiasm and initiative of medical staff in the reform. |
