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| China has one of the world's highest medical quality and accessibility |
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| Author：中國銘鉉 企劃部 Release Time：2017-8-24 11:04:34 Number Browse：717 |
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Recently, the national health and family planning commission (hereinafter referred to as the national health and family planning commission) has held media communication meetings on the progress of medical quality and service accessibility in recent years.National health development planning commission medical administration deputy director of the hospital authority yan-hong guo, total medical service in our country in the world, medical quality and medical service capacity significantly increased, medical quality and accessibility improvement among the world top.
In may this year, international journal the lancet published in 195 countries and regions, the medical quality and accessibility of rankings, 25 years from 1990 to 1990, the third highest ranking improvement in China, is one of the largest country in the medical treatment quality improvement.The HAQ (medical quality and accessibility) index rose to 74.2 from 49.5 25 years ago (global average 53.7, us 81.3);Rise from 110th to 60th.At the same time, the gap between the quality of medical services in China's domestic regions has been narrowed from 6.7 in 1990 to 1.2 in 2015 (the difference in the quality of medical services between the global regions in 2015 was 20.1).
The quality of medical quality in China has steadily improved
Guo said that in the long run, China's total medical service is the highest in the world and continues to rise, and the medical service quality management tasks are onerous.After years of exploration, China has gradually formed a new pattern of multiple co-governance of government regulation, institutional autonomy, industry self-discipline and social supervision.With the rapid development of medical technology, the improvement of medical quality in China has been widely used in modern medical technology with the characteristics of individualization and minimally invasive.In terms of individualization, the diagnosis and treatment of diseases no longer only stop at the etiology and pathology, but make a big step towards the genetic level of patients and pathogens.At the same time, the multi-disciplinary diagnosis and treatment model (MDT), which is centered in patients, is constantly advancing to provide patients with a more comprehensive, rational and scientific diagnosis and treatment scheme.
According to the introduction, in recent years, China's medical quality security level has been steadily improved.Inpatient mortality has declined steadily and steadily at a lower level.In 2015, the total mortality rate of hospitalized patients in tertiary public hospitals and secondary public comprehensive hospitals were 0.71% and 0.48% respectively, respectively, down 0.03 percentage points and 0.06 percentage points respectively from 2014.The hospital mortality rate was 0.38% and 0.21% respectively, among which the tertiary public general hospital was 0.03 percentage point lower than in 2014 and the secondary public comprehensive hospital was the same as in 2014.
The efficiency of medical services has been continuously improved, the capacity of medical services has been greatly enhanced, the utilization rate of antimicrobial agents of medical institutions has decreased by about 50%, and the rise of bacterial resistance of medical institutions has been curbed.
In terms of medical services and sex, it is not fully estimated that there is an average of 82.7 percent of the county-level visits in county areas, up 2.3 percentage points from the end of 2016.About 50% of the county hospital to carry out complex surgery, such as cerebral tumor surgery, cervical spine surgery, into the county hospital discharge diagnosis coincidence rate, before and after surgery in patients with diagnosis coincidence rate, pathology and clinical diagnosis coincidence rate more than 92%.In the first half of this year, the proportion of medical treatment of primary medical institutions increased by 4.7% on average, and the number of patients referred to lower medical institutions by superior medical institutions increased by 15.1% year on year.
A number of technologies are among the top in the world
Chinese academy of medical sciences dean assistant professor Zheng Zhe fuwai hospital, the Chinese cardiovascular disease report data show that in the past decade, cardiovascular surgery in China since from 80000 cases of growth to nearly 210000 cases, including the classic treatment of coronary heart disease surgery - bypass surgery for breakthrough in 40000 cases;The number of medical centers that can perform heart surgery has grown from 484 to 734.Nationwide studies suggest that the early stage of the national center for cardiovascular disease in our country is mainly the overall hospital mortality of heart bypass surgery center has been reduced to 2.2%, this is our country development overall cardiovascular surgery made gratifying achievements.
Fuwai hospital in June, Chinese academy of medical sciences in the journal circulation: cardiovascular quality and results of the first about China and the United States of coronary artery bypass grafting (hereinafter referred to as bypass surgery) treatment comparing the results of the study.Research results that: although the society and people have a big difference between China and the United States, but the two countries in recent years, urban areas mainly heart bypass surgery center hospital mortality has, objective to verify the the great progress of cardiovascular surgery of our country.This is also the first national and national subspecialty clinical efficacy comparison study in China's cardiovascular field.
Beijing university people's hospital, director of the thoracic surgery, professor wang junwork, chairman of the international society for esophageal diseases in Asia, said: "the past comes to thoracic surgery, you want to up are dozens of centimeters of incision, is a major surgery, because the past of thoracic surgery done 80% are open chest surgery, thoracoscope is a supplement.But now more than 80 percent of the surgeries performed in the thoracic surgery are done through the endoscopy, which is just a supplement to the thoracoscopic surgery.
"Now, it takes only two or three and a half centimeters of a small knife to get the lung cancer surgery done.""The proportion of lung cancer cases that are currently under surgical treatment is 35 percent higher than in the past, with a 43 percent increase in the five-year survival rate," wang said.The postoperative chemotherapy was not required.The quality, safety and efficacy of the operation were significantly better than the previous surgery.In particular, more than 90 percent of patients with early lung cancer have no recurrence.Because of the small trauma, the patient's working ability and quality of life are greatly guaranteed.
"The proportion of thoracoscopic surgery in our central lung cancer has reached 95% in recent years.The whole country is over 50%.That is more than in Europe and the United States, and the number of cases of advanced lung cancer is much higher than in Europe and America.Minimally invasive surgery in Chinese thoracic surgery has reached the world's leading level."Said professor wang.
Peking union medical college hospital, director of the national center for anesthesia professional quality yu-guang huang, director of the anesthesia, says prof medical industry is a high-risk industry, in the hospital, anesthesia platform high risk and high risk industry, the professional, so now the progress of China anesthesia discipline, let the patient, especially feel real benefit to patients.Due to the advances in surgical anesthesia, the patient's medical treatment and sex can be improved greatly.
"The global assessment of the patient's overall condition is divided into 1 ~ 5 levels, with higher classification and higher mortality.The proportion of patients greater than 3 reached 13.9% in our hospital.If it is greater than 3, the mortality rate is 20 times greater than that of patients under level 3.According to 2012 data from the lancet, the death rate in China is far lower than the average in developing countries.The average level in developing countries was 140 per million people in 2000, and our country was in double digits.After 2000, our narcotic death rate was 12/1 million, which is well below the average of developing countries.""Said huang.
Establish a high quality control system
Tiantan hospital affiliated to the capital university of medical sciences, the executive vice President of the national neurology professor yong-jun wang of the professional quality control center, over the past 20 years, the increase in the number of stroke disease, but the decline in mortality, morbidity were little changed."The decline in death rates is a result of our quality control and advances in medical technology. The increase in the number of cases is mainly caused by an aging population and an increase in the population base.""Wang said.
According to wang's introduction, China has established a very good quality control index for stroke, which has 13 items."After the establishment of the index system, under the leadership of the national health and family planning commission, we established the national medical quality system for neurology.In each province, the system has a provincial-level center for quality control, and the state has a national center of quality control, which forms two levels of quality control and forms a basic quality control method for provincial governments.In addition, a quality platform for routine monitoring of 1,800 hospitals in the country was established.The system should be one of the most sophisticated quality control systems in the world."Wang said.
"From the data, the death rate of stroke in China has declined in the past 15 years, and the rate of relapse and international parity has been the same," wang said.In particular, in April last year, the journal of inner science published the recurrence rate of stroke in the world's leading national stroke. China and France, the United States and Singapore were basically a level.
Zhejiang medical university first affiliated hospital of diagnosis and treatment of infectious diseases, deputy director of state key laboratory of professor xiao yonghong said: "China's family planning department of public health in the drug-resistant bacteria control and antibiotics attaches great importance to the rational use, promulgated in 2004, the use of antimicrobial agents principle, and carrying out a series of work.After 2011, special treatment for the rational use of antimicrobial agents was carried out, and the achievements of the past six years were outstanding.
According to xiao, the use of antimicrobial drugs in China has fallen sharply and the proportion of antimicrobials in medical institutions has fallen from 19.7 percent in 2011 to 11.2 percent last year.The use of antibacterial drugs in hospital has also achieved remarkable results.The ratio of antimicrobial drug use, the ratio of antimicrobial drug use in outpatient patients and the proportion of surgical cleaning interface were also significantly reduced.In 2010, the rate of antimicrobial drug use in hospitalized patients was 67.3%, the outpatient utilization rate was 19.4%, and the surgical cleaning incision rate was 95%.However, after a few years of special remediation, by 2016, the proportion of antimicrobial drug use in hospitalized patients was only 37.5%, the outpatient utilization rate was 8.7%, and the utilization rate of clean incision was 42.4%.
"With the more standard and reasonable use of antimicrobials, the rise of drug-resistant bacteria in recent years has been very well contained, according to the monitoring data," xiao said.The trend of super resistant bacteria (MRC) or staphylococcus aureus is very obvious.We now have a lower level of MRC than in the United States.The most recent us monitoring of hospitals was 44 per cent, India 48 per cent, Greece 40 per cent and Portugal 48 per cent.And we only have 35.8 percent, which is equal to Italy, Spain and other countries.The data is still falling.
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