Medical network - on January 11, "" much starker choices-and graver consequences-in" deepening the reform of medical health system planning (hereinafter referred to as "planning") is based on around since the new reform pilot, the systematicness of the reform of our country, is standing at a new historical starting point of reform of major layout in the next five years. Comprehensive knowledge system to understand and grasp the spirit of the reform trend, to understand the health trend, grasp the key points of policy, is of great significance to do a good job of reform over the next five years.
A, "planning" in terms of guiding ideology and basic principles for the development, perfection and innovation, the major embodies the characteristics in the new period of reform and the new understanding of the reform
"Planning" will reform as an important part of comprehensively deepen reform, is the "five one" the overall layout and the "four comprehensive" an organic part of the strategic layout, first proposed the health sector to "four innovation", namely the theory innovation, system innovation, management innovation, technological innovation, to transform health care as a way to realize development, perfecting the management system, improve the governance ability of important ways.
In terms of basic principles, "the plan" proposed "to promote the reform of supply side structural," reasonable division of the government, society and individual responsibility, promoting social work; Emphasized the "insist on medical treatment, health care, medicine linkage reform" and "stick to highlight key, pilot demonstration, gradual", further clarify the reform should follow the target, focus, direction and implementation path.
Second, put hierarchical diagnosis in reform key tasks, is adjustment of medical resource allocation system, to alleviate the supply and demand balance, build a new pattern of health reform, solve those outstanding problems that the masses go to a doctor has strategic significance
"Planning" will be grading diagnosis and treatment in the first, to reform with the necessity and significance of reality.
New reform in 2009, the surrounding public hospital carried out a series of work, "the basic mechanism, strong base, built" achieved success, stage of urban and rural residents basic medical security, medical needs quick release, the past eased "difficulty and high cost of treatment", and presents a new form, namely "big hospital visit difficult", "high proportion of patients' out-of-pocket costs", "big hospitals are overwhelmed, overstretched, relatively few grassroots medical consultations". For this kind of situation, hierarchical diagnosis as the key of the reform of planning is very necessary.
"Planning" grading diagnosis system is proposed, first of all, from the perspective of the optimization of medical service system, the focus is on improving the capacity of grassroots medical services, improve the basic management and operation mechanism, arouse the enthusiasm of tertiary public hospital in hierarchical diagnosis and initiative, treatment and rehabilitation through innovation - a long-term care service pattern in a row, "two-way referral" channel. At the same time, the combination supporting measures, such as family doctors signed scientific and reasonable guide the masses go to a doctor. Can tell, the full implementation of the reform is a system layout, to alleviate the contradiction between supply and demand, to control the unreasonable rise in medical costs, is of strategic significance to the healthy development of the medical service system.
Three, to establish modern hospital management system reform is the hub of engineering, related to the operation mechanism of transformation, also is the key and difficult point for coordinated reform, increasingly highlight the importance of reform of public hospitals
Public hospital is the main body of our country medical service system, bear the most medical service work, and in teaching research and social services, including emergency response plays a leading and exemplary role. Implemented at various levels and of public hospital comprehensive reform in 2017, the goal of the reform is to establish the new system of modern management system, break "to the medicine cure" at the same time, establish a medical service price compensation operation mechanism, it is not only for the reform of public hospitals, to enhance the level of modern management ability and at the same time, the establishment of harmonious relationship between social work has far-reaching influence.
"Planning", points out that in the medical system reform, strengthen the government in the direction, policies, guide, planning, evaluation of macro management, strengthen supervision. At the same time, in the establishment of the management to delegate. The logical relationship between the public hospital reform steps, implementing path and key policy points system planning, the step is medicine apart as a starting point, in order to do medical service price adjustment, innovation management, rationalize human relations, salary system reform, strengthen the performance management, etc.
These reform movements are interlinked, continuous, continuous improvement, any hesitation could reform to make big marketing ".
"Planning" in accord with the characteristics of the health care industry works personnel and pay system part of a special mention: "to work time outside labor more high-level medical talents, and public welfare goal task heavy, to carry out the family doctor to sign the public medical institutions approved in total performance salary to give tilt", for the performance management has created favourable prerequisites.
Four, more in-depth understanding of the role and status of the health care system, stress the medicare payment guide and regulate the behavior of the medical institutions and doctors, to motivate staff cost control "endogenous power"
Pattern of universal health care, the health care system to play a fundamental role in the guide medical resource allocation, promote ginseng protect personnel to fairly enjoy primary medical treatment by health care is the goal, through the guidance and regulation of medical institutions to provide health insurance payment is reasonable, quality service means. Therefore, the status of health care in health care more and more important.
"Planning" is put forward, according to the basic, the out line, the principle of sustainable, around the capital source diversification, security system standardization, management service socialization three key links, intensify reform. Improve the medical insurance payment mechanism and benefit regulating mechanism, stimulate the reform of medical institutions and benign development of endogenous power.
"Planning" is put forward for the first time: clear health care treatment determination and adjustment of policy permission, basis and decision-making process. At the same time, the long-distance medical direct settlement and promote the health care plan as a whole have specific requirements, which will further convenient ginseng protect personnel, at the same time, the management and service put forward higher requirements.
Five, the drugs security reform with new connotation, marked the pattern of "comprehensive governance" upstream and downstream is accelerating
Reform in the field of medicine is an important part of overall health. Look from the income structure of medical institutions, drug and high value medical consumables accounted for about half of the reform of the drug consumables is the unavoidable problem, the problem is not solved, public hospital transformation mechanism is impossible. Therefore, pharmaceutical production, circulation, use three links of comprehensive reform is imperative.
"Planning" for the first time the pharmaceutical production, circulation, use the planning system. Specifically the production quality is given priority to, encourage innovation and research and development requirements, among them, the proposed "out curative effect is not exact, risk is greater than the benefits of varieties" shows the in-depth reform of determination.
Circulation explicitly put forward the "push drugs circulation enterprise merger and reorganization", put forward the implementation of drug purchase link of centralized purchasing reform of "two votes", indicated that the reform will be a breakthrough in the field of circulation of production. This is the experience of the pilot reform of public hospitals in recent years, it is concluded that, the medicine and high value medical consumables to comprehensive treatment, upstream and downstream linkage control.
The future reform on the basis of 3 d linkage, upstream and downstream integrated governance pattern has been formed. The first mention of planning "to explore in the selection and adjustment of basic drugs into the evidence-based medicine and drug economics evaluation method", indicates the medicine reform not only to push deeper, elaborating the development direction of management is also important.
Six, consolidated supervision is the inevitable extension of reform and development, regulation is service, supervision is the guarantee
From the perspective of reform, once the effective reform measures and will to solidification of the new system and policy, establish the corresponding supervision system at the same time, make sure not to walk partial; And from a development point of view, due to the particularity of medical service industry, the development of the industry, service upgrade need regulation means and power matching, otherwise it is easy to appear problem, especially the formation of the pattern of diversity in do medical, objectively requires a unified comprehensive corresponding and perfect supervision system.
"The plan" put forward: "to perfect the government regulation, the third party broad participation, medical and health institutions self-management and the diversity of social supervision for added comprehensive supervision system". Improvement, improve the mode of public medical institutions supervision put forward higher requirements, specific arrangement of regulatory way, means, such as establishing discipline violations "blacklist" system, to strengthen the regulation of non-profit and for-profit medical institutions, etc.
At the same time, the planning evaluation is put forward to promote medical institutions is dominated by the government to gradually shift to a third party evaluation, vigorously develop the third party evaluation institution, the new regulatory powers to join embodies the concept of social work, and also adapt to the trend of specialization of the medical and health industry supervision. "The plan" is also proposed to non-public medical institutions into the regulatory, dependency and strive to achieve the industry regulation, supervision, overall supervision system was further improved and perfected.
"Planning" to promote the reform of related areas as a whole for the deployment, among them the use of talent fostering and the incentive evaluation mechanism has a high "gold content" the support of policy, put forward to allow 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 personnel incentives; Handle in speed up the formation of multiple medical pattern part for public hospital cooperating with social power, commercial health insurance participation in health reform to broaden the channels; In terms of public health service system construction, to strengthen the collaboration mechanism, enrich the content, so that the vulnerable groups and residents get more public health services. Can look forward to "planning" in the reform to deep at the same time, will bring more reform dividends for residents. |
