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National press conference to further promote medical reform experience in Fujian Province and Sanming City held in our city

2019-12-08 15:20 source: China Network font size: big, medium and small reading: {{pvCount}} times


The National Health Committee held a special press conference on December 6 in Sanming, Fujian Province to introduce the medical reform practices, progress and effectiveness of Fujian and Sanming cities.

Moderator Cheng Yi, Deputy Director of the News Network Division of the Propaganda Department of the National Health and Health Commission:

Media friends!

good morning guys!

Welcome to the 44th press conference of the National Health and Health Commission this year. Recently, the State Council's Leading Group for Deepening the Reform of the Medical and Health System issued the "Notice on Further Promoting the Experience of Deepening the Reform of the Medical and Health System in Fujian Province and Sanming City." The "Notice" reaffirmed the medical and health system reform practices in Fujian Province and Sanming City in recent years. It is proposed to give full play to the demonstration, breakthrough and leading role of typical experience in the overall reform, to promote the development of medical reform in depth, and further promote the experience of medical reform in Fujian Province and Sanming City. Yesterday afternoon, all the reporters present have already carried out relevant research with us in Sanming. I believe that everyone has some intuitive feelings. At today's press conference, we will focus on the medical reform practices, progress and effectiveness of Fujian Province, Sanming City and Youxi County, and will introduce you in detail.

Below, I would like to introduce the guests of today ’s press conference. They are:

Zhu Hongbiao, First Class Inspector, Department of System Reform, National Health and Health Commission

Huang Ruxin, Secretary of the Party Group of Fujian Provincial Health and Health Committee

Zhang Yuanming, Deputy Mayor of the People's Government of Sanming

Yang Yongsheng, Secretary of CPC Youxi County Party Committee

I am Cheng Yi from the Publicity Department of the National Health and Health Commission. In the following, first, Comrade Zhu Hongbiao was asked to introduce the practices and experiences related to medical reform in Fujian Province and Sanming City.

Zhu Hongbiao, First Inspector, Department of System Reform, National Health and Health Commission:

Ladies and gentlemen, media friends!

good morning guys! Thank you for your long-term care and support for medical reform.

Since the 18th National Congress of the Communist Party of China, under the strong leadership of the Party Central Committee and the State Council, relevant departments in various places have made solid progress in medical reform, and have achieved significant initial results. At present, medical improvement has entered the deep water area and the tackling period has reached a critical stage of hard bones. On the one hand, it is necessary to strengthen the confidence in reform, adhere to the direction of reform, carry forward the spirit of struggle, and push forward the medical reform work in a down-to-earth manner. On the other hand, it is necessary to lead by way of example, use the power of example to promote the solution of the pain and blockage of the masses to see a doctor for medical treatment, and to implement the task of medical reform in a spirit of nails. Fujian Province and Sanming City, with a spirit of commitment and struggle to overcome difficulties, innovate institutional mechanisms, break through the barriers of interests, strengthen the reform of medical care, medical insurance, and medicine, have solved many difficult problems and established a relatively complete policy system. And implementation path, the direction is correct, the path is clear, the measures are effective, and the effect is obvious, which has become the benchmark for national medical reform.

The core experiences of medical reform in Fujian and Sanming are:

The first is to establish an efficient and effective medical reform leadership system and organizational advancement mechanism. The Fujian Provincial Committee is mainly responsible for comrades as the leader of the medical reform leadership group, the provincial government is mainly responsible for comrades as the first deputy leader, and a government responsible comrade is in charge of medical, medical insurance, and medical work. The medical reform work is included in the performance evaluation of government target management. Drive cities and counties to form a strong work promotion mechanism.

The second is to deepen the joint reform of "three doctors" in medical treatment, medical insurance and medicine. In accordance with the idea of changing cages and changing birds and the path of space, structure adjustment, and convergence, we will vigorously deepen the "three doctors" joint reform, the true connection and the real move, the implementation of joint price procurement of pharmaceutical consumables, and the freed up space will be mainly used for adjustment The price of medical services, optimizing the income structure of hospitals, and establishing a benign operating mechanism for public hospitals.

The third is to innovate the incentive mechanism for salary distribution. Sanming deepened the reform of the salary system and implemented a target annual salary system and an annual salary calculation system for all employees, which inspired the enthusiasm of medical staff for their dedication and dedication to serving patients. In 2018, the proportion of staff expenditures of public hospitals in Sanming City level 2 and above to business expenditures was 46.5%. Fujian Province fully implements the target annual salary system for deans. The annual salary of the dean is borne by the financial department and is distributed according to the results of performance evaluation. The dean manages the hospital on behalf of the government.

The fourth is to strengthen the supervision and management of medical institutions. Sanming strengthened the supervision of medical services, strictly controlled the administration of medicines in medical institutions, and standardized the catalogue of centralized procurement of medicines in public hospitals. Focus on monitoring the increase in the average cost of hospital operations, outpatient and inpatient stays, the use of antibacterial drugs and auxiliary drugs, and increase the reporting and disclosure of irrational drug use. Fujian Province has strengthened the effective connection of the performance appraisal of third-level public hospitals, the evaluation of the target annual salary system for deans, and the evaluation of the effects of comprehensive reforms of public hospitals, and has strengthened the overall application of evaluation results.

Fifth, reform and improve the management of medical insurance funds. Sanming City has implemented a reform of collection and payment according to disease diagnosis related groups in all public hospitals at level 2 and above, established a collective bargaining and negotiation mechanism between medical insurance agencies and medical institutions, and reasonably determined medical insurance payment standards. Fujian Province explores the establishment of a provincial-level overall adjustment and adjustment mechanism for employee medical insurance funds to reasonably balance regional burdens. The reform of charging by disease type was implemented, and the number of disease types in all coordinated regions of the province exceeded 700. Sixthly, up-and-down linkages promote the sinking of high-quality medical resources. Sanming City has established a compact county-level medical community in each county (city). Medical insurance funds and basic public health services are paid for the total amount of the medical community on a per-capita basis. Fujian Province uses the total amount of medical insurance as a link to form a compact county-level medical community in more than half of the provinces (cities).

Today, we are here to hold a press conference, the purpose of which is to further promote the experience of medical reform in Fujian Province and Sanming City, and promote the national medical reform to achieve deeper and more effective results by giving play to the role of typical lead and demonstration.

thank you all!

Moderator Cheng Yi, Deputy Director of the News Network Division of the Propaganda Department of the National Health and Health Commission:

Thank you inspector Zhu. Now let's comrade Huang Ruxin to introduce the progress of medical reform work and related experience in Fujian.

Huang Ruxin, Secretary of the Party Group of Fujian Provincial Health Committee:

Good morning, media friends!

First of all, I would like to thank all my media friends for their long-term interest and concern in Fujian medical reform. In the new round of medical reform, especially since the 18th National Congress of the Communist Party of China, Fujian Province has seriously implemented the spirit of General Secretary Jinping ’s series of important speeches and important instructions on health and medical reform work, taking the pilot of comprehensive medical reform as an opportunity, and trying first in Sanming. On the basis of this, from the three dimensions of high position, focus, and continuity, we comprehensively summarized and promoted the experience of medical reform in Sanming, vigorously deepened the "three doctors" joint reform, and made new breakthroughs in key areas and key links. The main initiatives are:

I. Adhering to the health-first strategy and strengthening the leadership promotion mechanism for medical reform

Establish a "three one" medical reform leadership system, that is, adhere to the "first leaders" of party and government at all levels as the group leader and the first deputy group leader of the medical reform. The functions of the "three doctors" department; play the role of an organization, that is, the management committee of a public medical institution, on behalf of the government to perform medical duties; establish a medical reform team proficient in business and innovative. At the same time, adhere to taking health as the center, taking medicine as the entrance, taking medical insurance as the engine, and taking medical treatment as the main body, and strive to promote the "three doctors" to the full union and deep action, and enhance the sense of mass reform.

2. Adhere to the principle of high quality and reasonable price, and improve the procurement and use mechanism of pharmaceutical consumables

Establish an integrated platform for the procurement, distribution, settlement and supervision of pharmaceutical consumables in the province. On the basis of the pilot implementation of centralized drug procurement and use in Xiamen, the province will follow up in June this year. Information on the purchase price of sunlight for medical equipment and high-value medical consumables is shared across the province, and the average price reduction is 22.6% through the platform “sun price”. At the same time, "Tengcang Bird Exchange" dynamically adjusted the price of medical services. In 2019, the price was adjusted 10 times throughout the province, and more than 11,000 items were adjusted.

3. Adhere to the unification of fairness and efficiency, and reform the basic medical insurance management mechanism

Take the lead in completing the reform of the medical insurance management system, and explore the establishment of a provincial-level overall coordination mechanism for urban employee medical insurance funds based on the overall medical insurance city-level overall planning. In 2019, the provincial transfer fund was raised according to the actual collection of 30% of the year. In the first three quarters, a total of 7.513 billion yuan was raised, and 7.206 billion yuan was allocated to all the pooling areas. Six pooling areas benefited from the amount of 604 million yuan. Reform of the medical insurance payment method, the province has more than 700 types of disease payment by disease type, Nanping City and three other provincial and municipal hospitals have steadily advanced the DRG collection and payment pilot. At present, Sanming City C-DRG collection and payment of discharged patients Accounting for 73.63%. The 41 county medical communities in the province have all implemented medical insurance funds in a package. Sanming, Zhangzhou and other places have achieved "Village to Village" for medical insurance.

4. Adhere to the principle of public welfare and improve the new mechanism of medical and health operations

Party committees and governments at all levels have increased their investment in health care. Since 2016, a total of 23.3 billion yuan has been invested and 19,300 new beds have been added. The accessibility of basic medical and health services has improved significantly. Select 44 hospitals to carry out pilots of provincial modern hospital management system, launch "combined punches" such as target annual salary system, total salary verification, hospital performance evaluation, etc., to achieve full coverage of public hospital salary system reform. In recent years, medical staff salary income Both increased by 12.3%. Reasonably increase the supply of high-quality medical resources, actively create regional medical centers, high-level hospitals, and high-level clinical disciplines, and strive to stay in the province if there is difficulty in serious illness; combine the implementation of the World Bank medical reform project, and accelerate the construction of an integrated medical and health service system, 70% of the province The above counties (cities) have formed close-knit medical communities and entered substantive operations. In the first half of the year, the number of discharges from primary medical institutions in the province's medical community increased by 21.8% year-on-year, and the number of outpatient and emergency services increased by 21.2%.

V. Persist in coordinating related reforms and strengthen the building of supportive forces for medical reform

Strengthen the construction of medical and health personnel teams, implement the GP special job plan, and train "localized, direct train" college-level medical personnel for township health centers and other projects to ensure the enrichment and stability of the grassroots talent team. At the end of 2018, the number of practicing (assistant) physicians and registered nurses in the province was increased by 0.33 and 0.52 respectively compared with the end of 2014. Promote the construction of the "Internet + Medical and Health" model province, and the province's special network of health and government affairs will be covered. The pilot of comprehensive reform of the Provincial CDC was launched to promote the medical reform to expand into the public health field.

At present, our province is thoroughly implementing the decision-making and deployment of the Party Central Committee and the State Council, implementing the spirit of the Fourth Plenary Session of the 19th Central Committee of the Party, deepening medical reform from a higher starting point, and continuously improving the level of health and governance. At present, the Provincial Medical Reform Leading Group has studied and adopted the "Opinions on Comprehensively Promoting the" Sanming Experience "and Deepening the Reform of the Medical and Health System" and 8 supporting documents (referred to as "1 + 8"), which will soon be introduced for implementation. We will further build an upgraded version of the Fujian medical reform, and actively work to promote fewer diseases and healthier people.

Thank you again for your media friends.

Moderator Cheng Yi, Deputy Director of the News Network Division of the Propaganda Department of the National Health and Health Commission:

Thank you Secretary Huang. Now, let's comrade Zhang Yuanming to introduce Sanming's experience and methods of deepening the "three doctors" linkage reform.

Zhang Yuanming, Vice Mayor of the People's Government of Sanming City:

Dear media friends, ladies and gentlemen, friends!

First of all, on behalf of the Sanming Municipal People's Government, I would like to express my heartfelt thanks to friends in the media for their long-term interest in Sanming medical reform. Since 2012, Sanming City has adhered to the joint reform of "three doctors" in medical care, medical insurance and medicine, and has explored and formed a number of valuable experiences and practices. Looking back on more than 7 years of reform and exploration, the thinking and main practices of Sanming Medical Reform can be summarized in the following aspects:

First, on the target task. Implement the decision-making and deployment of the Party Central Committee and the State Council, and focus on "one change, two priorities", and promote the shift of health care from "centering on treating diseases" to "centering on people's health", and make efforts to solve the problem of difficult and expensive medical treatment for the masses. problem.

2. On the value orientation, highlight the "three regressions". Let public hospitals return to the public welfare nature. By abolishing the policy of directly linking medical staff's performance wages and hospital income, it is clear that the government's six inputs will be borne by the government. The total hospital salary calculation will be based on medical service income, which will derail the hospital from commercialization. . Let doctors return to the role of doctors and doctors, by implementing the target annual salary system and annual salary calculation system for all hospital staff, break the distribution pattern of staff salaries and departmental income generation, and curb doctors' “improvement and manufacturing of patients” and income over-treatment urges. Let the medicine return to the function of curing diseases. By canceling the drug bonus, implement “one product, two regulations”, “two-vote system”, “key auxiliary drug monitoring”, and centralized procurement of pharmaceutical consumables, and continue to squeeze the price of pharmaceutical consumables.

Third, in the path of reform, adhere to the "three medical linkages." In terms of medicine, it has broken the mechanism of supplementing medicine with medicines, reformed the procurement and distribution of medicines, established a "Sanming Alliance" for medicine consumables purchases, reduced the overly high prices of medicines, and made room for adjustment of medical service prices for "cage replacement". In terms of medical insurance, rationalize the medical insurance management system, implement the "three guarantees in one", "recruitment and procurement", physician code system, and promote reforms such as "packaged payments" and C-DRG collection and payment, and give play to the leading role of medical insurance in reducing drug prices. And the incentive and restraint role of medical institutions in controlling costs. In the medical field, we will accelerate the establishment of a modern hospital management system, integrated medical service system, and comprehensive supervision system. We will implement "general hospital system" management and "annual salary system" performance rewards, establish a medical and medical insurance linkage information management platform, and improve the overall efficiency of the medical service system. .

Fourth, in terms of reform results, "a trilateral win-win situation" has been achieved. Ordinary people should benefit, increase the reimbursement rate for medical treatment, reduce the per-capita out-of-pocket expenses, and make the masses more affordable. The average cost of hospitalizations for medical insurance for urban employees decreased from 6,553 yuan in 2011 before the reform to 5,847 yuan in 2018, and the average number of inpatients per resident increased from 4,082 yuan to 4,869 yuan, an average annual increase of only 2.55%. Doctors have incentives to implement the "two allowances" according to the characteristics of doctors' occupations, improve the salary of medical staff, and enhance their sense of professional gain and recognition. Compared with before the reform, the average annual salary of the dean increased from 112,000 yuan to 323,300 yuan in 2018, and the average annual salary of medical staff increased from 42,200 yuan to 113,400 yuan in 2018. The fund is sustainable, reducing waste under the premise of safeguarding the basic medical needs of the masses, and preventing uncollected income. With the declining support ratio year by year, the urban employee medical insurance fund turned losses into profits and maintained a balance for 7 consecutive years.

Fifth, in organizational security. Strengthening the leadership of the party and government, the Party Central Committee, the State Council, the provincial party committee, and the provincial government are concerned and supportive of the promotion. Sanming's persistent leadership of the party committee and government is the key to successful medical reform. Emphasis on departmental coordination and unify the functional departments related to the "three doctors" under the control of a city leader to form an efficient reform decision-making and promotion mechanism. Strive for social support, timely release policy interpretations to the public, publicize the operation of hospitals and medical insurance, take the initiative to go out, exchange medical reform experience with academics and peers, and mobilize all sectors of society to care, participate and support medical reform.

Thank you again for your media friends.

Moderator Cheng Yi, Deputy Director of the News Network Division of the Propaganda Department of the National Health and Health Commission:

Thank you, Mayor Zhang. Next, please invite Comrade Yang Yongsheng to introduce Youxi County's experience and methods to promote the construction of county medical communities and promote the sinking of medical resources.

Yang Yongsheng, Secretary of the CPC Youxi County Party Committee:

Dear media friends!

Taking the opportunity of today's press conference, first of all, I would like to express my heartfelt thanks to the leaders, guests and friends of the news media who have cared for and supported the development of Youxi's health and wellness business for a long time!

In 2017, the county established a close-knit medical community, Youxi County General Hospital, implemented the integrated management of county-level public medical institutions, and built a "four-in-one" working alliance of management, responsibility, benefits, and services, so that people can fully enjoy medical reform Bring convenience and precision services. Our approach is mainly divided into "two 3s" to promote:

The first "3" is to form a compact medical community and build a regional health management organization. Mainly divided into "three steps":

The first is to build an organization. In accordance with the "one team, two brands, two sets of finance, integrated management" model, taking county-level general hospitals as the leader, maintaining the corresponding functional system of county-level Chinese medicine hospitals such as third-level and second-tier Chinese medicine hospitals, and combining 15 township health centers, The Chengdong Community Health Service Center and 212 village health clinics form the compact medical community of the General Hospital, which was put into operation in April 2017.

The second is strong management. The president-in-charge system under the leadership of the Party Committee of the General Hospital is implemented. It has 18 party branches including the original county hospital, traditional Chinese medicine hospital, and township branches. The General Hospital was fully empowered with personnel, salary, financial and operational management autonomy, and comprehensively implemented 6S management, striving to create a satisfactory hospital and a humanistic hospital. The hospital has implemented the "three early warnings" of honesty and clean medicine, disputes, and evaluation. The basic medical and health institutions within the medical community maintain "three unchanged" administrative affiliation, basic functions, and financial investment. The county general hospital has a township branch. The county general hospital directly manages the branch's personnel, finances, and materials, and manages the duties, management functions, and public health services at the grassroots level. Establish a public village health center, implement the "seven unified" management of personnel, finance, medicine, business, performance, information, and pensions, and form a unified and standardized general health service system.

The third is to promote promotion. Carry out university cooperation to improve service capabilities. Establish information systems such as remote consultations, realize the interconnection and interoperability with provincial and municipal medical information, and continuously improve the level of informatization. Taking the packaged payment of medical insurance funds as a bond of interest, the city implemented a "total contract, over-expenditure, and balance retention" to the county general hospital, established a "three sinking" mechanism for medical resources, talents, and diseases, and improved the effectiveness of the "three sinking" .

The second "3" is to change the concept of health services and build a health work structure. Mainly divided into "three steps":

The first is to implement a four-level co-protection project for national health. Establish a "one group, one contract, two confirmations" mechanism (one group, that is, a compact medical community; one contract, that is, the county-level medical insurance fund to coordinate the contract to the general hospital; two determinations, that is, the remaining medical insurance funds are directly included in the hospital medical services Sexual income, determining health promotion funding from the cost of medical institutions), and promoting hospitals to focus on treating diseases and focusing on people's health. The "one disease, two sides" system is tried out in medical institutions, that is, doctors issue a diagnosis and treatment prescription and a health education prescription at the same time after diagnosing the health status of a patient or a medical examiner.

The second is to implement "integrated" management of chronic diseases, and graded diagnosis and treatment are well established. Established 4 chronic disease management centers, and included patients in the "country and village" "integrated" management according to "grading, classification, segmentation, and sub-standards" to improve chronic disease management.

The third is to implement the national health responsibility system. Establishing a health responsibility system leading group with the party and government “first leaders” as the group leader, detailing task indicators for 33 departments and 15 towns, consolidating working meetings, monitoring and evaluation, job reporting, and supervision and assessment mechanisms, and solidly promoting health education, Gather talents, technology, resources and other advantages to build a protection network that connects, covers and maintains the health of the people.

thank you all!

Moderator Cheng Yi, Deputy Director of the News Network Division of the Propaganda Department of the National Health and Health Commission:

Thank you, Secretary Yang. Next, we enter the questioning section. According to the usual practice, please inform the media you represent before asking questions.

China Population Daily reporter:

What is the effectiveness of Youxi County since the construction of a compact county medical community (general hospital) in 2017? What are the obvious changes?

Yang Yongsheng, Secretary of the CPC Youxi County Party Committee:

Thank you for this media friend. In 2017, we have achieved initial results since we established a compact medical community.

First, the level of county-level medical services has improved. In 2018, the number of consultations and treatments at grassroots medical and health institutions reached 1,158,400, accounting for 60.78% of the total. The number of consultations and treatments increased by 12.05% over 2017, and the county visit rate reached 90.8%.

Second, the income structure of hospitals is optimizing. County-level public hospitals 'medical income accounted for 40.37%, and the township branch hospitals' medical income accounted for 33.19%. The county general hospital's income content further improved, and various indicators were gradually optimized year by year.

Third, the burden of medical treatment for the masses has been reduced. In 2018, the urban hospitalization expenses of county-level hospitals were paid by the individual for 1702.9 yuan, 29% of the deductible; urban and rural residents were deducted by 1346.29 yuan, 28.4%.

Fourth, the balance of county-level medical insurance funds was realized. Since 2017, the medical insurance fund has a balance every year.

Fifth, the national health orientation has gradually taken shape. Our county has officially implemented the health responsibility system, and the party committee and government must take responsibility for the health of the people. We say that the illness comes from the mouth, including the patient's emotional stability and health common sense. The county now popularizes health common sense in all aspects, while creating a healthy environment, including playing music on the square, and taking responsibility for health in all aspects. Do a good job so that the common people also become their healthy "goalkeepers".

Xinhua News Agency:

This time, the conference was held in Sanming, Fujian, and inspector Zhu. What do you think should be studied and promoted when learning and promoting the experience of medical reform in Fujian and Sanming?

Zhu Hongbiao, First Inspector, Department of System Reform, National Health and Health Commission:

Learning to promote the experience of medical reform in Fujian and Sanming, focusing on the essence of learning, grasping the key points and key points.

The first is to learn the people-oriented spirit that the party and government leaders attach great importance to and fulfill their duties, firmly establish the people-centered development concept, take medical reform as an important content to improve people's livelihood, adhere to the "top leader" to assume leadership and promote responsibility, and one leader in charge of "three "Medicine" responsibility to ensure efficient decision-making and effective implementation of medical reform policies.

The second is the breakthrough and innovative spirit of learning system, the whole, and the coordinated advancement of reforms. Adhere to the overall planning, comprehensive advancement, and progressive expansion. Provincial, city, and county relevant units work together to coordinate the "three doctors" of medical health insurance and medicine. The United Union moved deeply, and city hospitals, county-level hospitals, and primary medical institutions played a game of chess to promote reform, which formed the overall regional benefits of the reform.

The third is to learn the spirit of struggle against fear and continuous reform, not to bow your heads in the face of difficulties, and to continue advancing reform. Over the past 8 years, the Sanming Medical Reform has continued to overcome difficulties and overcome obstacles. From the treatment of chaos and waste, to the establishment of articles of association, and the establishment of a system, to the treatment of disease and great health, it has gradually deepened and made solid progress with remarkable results.

The fourth is to learn the team spirit of courage, initiative and initiative, establish a reform management team with compassion, ability, courage and ability to fight, adhere to the correct direction of medical reform, grasp the key links of reform, strengthen the confidence and determination of reform, and work together Keep up your mind and work hard to push forward the reform. The key to learning and promoting the experience of medical reform in Fujian and Sanming is to learn their spirit of responsibility, innovation, struggle, and enterprising spirit, to explore breakthroughs based on local conditions, to implement the reform measures with nails, and for a long time, medical reform must succeed.

Chinese Journal of Health:

Secretary Huang mentioned just now that Fujian Province has established a provincial-level co-ordination system for employee medical insurance funds. Could you tell us more about the situation and its main characteristics?

Huang Ruxin, Secretary of the Party Group of Fujian Provincial Health Committee:

In order to solve the problems of large differences in coastal and mountainous dependency ratios and inadequate medical security, our province will set up a provincial-level co-ordination system for employee medical insurance funds in 2019.We mainly build a co-ordination and balance mechanism from three aspects:

The first is to clarify the overall fund allocation method and balance the maintenance ratio gap. The allocation of the transfer fund is based on two factors, including the number of insured persons (including the number of employees and retirees) and the fund collection rate. The retirees are based on the per capita medical expenses of the insured retirees in the province and the provincial participation rate. The ratio of per capita medical expenses of insured employees is converted and participates in distribution.

The second is to implement overall two-way capping adjustments to avoid "whipping bulls." In order to avoid the excessive pooling of funds in some regions, resulting in a new imbalance, the ratio of net surrender and net allocation is restricted. That is, the part of the net paid-in amount exceeding 9% of the fund income of the current year will be returned; the part of the net paid-in amount of more than 20% of the fund income of the year will be retained for the province's risk adjustment fund.

The third is to establish an incentive and restraint mechanism for medical reform to prevent eating "big pot rice." That is, the funds from the net disbursement of regional income are concentrated at a rate of 5%. At the end of the year, secondary allocations are made in the province based on the results of medical reform assessments, in order to guide localities to continue to deepen medical reform, gradually improve the balance of regional medical insurance funds, and stimulate their "blood-making" functions.

Fujian Health News:

Exploring the establishment of a public hospital salary system in line with the characteristics of the medical and health industry is one of the key tasks of deepening medical reform. What innovations have Fujian Province made in this regard in recent years?

Huang Ruxin, Secretary of the Party Group of Fujian Provincial Health Committee:

It is important to promote the reform of the salary system of public hospitals in the deepening of medical reform. If the enthusiasm of medical staff is not mobilized, medical reform will be difficult to achieve. Fujian Province earnestly implements the "permission of medical institutions to break the current level of wage adjustment in public institutions, allow medical service income to deduct costs, and draw funds from various funds in accordance with regulations, which are mainly used for personnel rewards," proposed by General Secretary Jinping internship at the National Health and Health Conference. The spirit of instructions, and actively promote the pilot reform of the salary system.

The first is to establish a target annual salary system for deans. The target annual salary of the dean is composed of two parts: basic annual salary and management performance annual salary. It is paid in full by the finance. The management performance annual salary is linked to the dean's annual evaluation results. It is linked to financial subsidies, medical insurance payments, total salary, and hospital evaluation. A mechanism in which one person is responsible, and everyone in the hospital has a responsibility and works together. At the same time, we have expanded the target annual salary system to the secretary of the party committee of the public hospital and the chief accountant, which is also fully borne by the finances.

The second is to implement the reform of total salary management. Within the approved total salary, the hospital will distribute it independently and promote the establishment of a reasonable increase mechanism for total salary.

The third is to reform the internal performance allocation method of the hospital, and establish an internal performance evaluation system that takes job workload, service quality, medical ethics, and patient satisfaction as the main indicators. The evaluation results are linked to the salary of medical staff, so as to achieve better results and better performance. Excellent performance.

Fourth, in accordance with the thinking of "making space, adjusting structure and ensuring convergence", actively and steadily promote the reform of medical service prices, gradually improve the hospital's income structure, and provide guarantee for the healthy operation of public hospitals and the reform of the salary system. Through reforms, medical personnel are guided to increase their incomes reasonably through technology and labor, and put the pay system on a rational track.

People's Daily reporter:

Mayor Zhang just mentioned that the medical reform of Sanming has entered a stage of great health transition from "treatment of disease" to "treatment of disease". What are the new measures in the next step to promote "health Sanming"?

Zhang Yuanming, Vice Mayor of the People's Government of Sanming City:

In promoting the "Health Sanming", we focus on the following areas:

The first is to make every effort to promote Health Sanming. Regarding the promotion of Health Sanming as the “first-line project” of the municipal party committee and government, the Health Sanming Construction Leading Group was established, and 32 key tasks and division of responsibilities were identified. Seven actions such as popularizing health education, promoting healthy behaviors, and promoting scientific diets Plan to promote health knowledge into schools, families, rural areas, and communities, and improve people's health literacy.

The second is to speed up the construction of the county's comprehensive health information platform in combination with the construction of "e Sanming" and promote the development of "Internet + medical health". Strive to achieve the initial interconnection of information within the general hospitals (medical unions) by 2020.

The third is to strengthen the integrated management of chronic diseases. We have formulated a policy that allows urban and rural residents to enroll insured patients to register for two special diseases of hypertension and diabetes at the same time, and enjoy the benefits of overlapping treatments to alleviate the burden of medical expenses on patients with chronic diseases.

The fourth is to explore the expansion of the use of personal accounts for employee medical insurance. Support the development of the cause of aging, promote the integration of medical care, explore the mutual assistance of family members in personal accounts, and allow personal accounts to purchase long-term care insurance.

The fifth is to explore the reform of disease prevention and control institutions. Explore the integration of the CDC into the regional health management organization system and guide the technical forces of CDCs to participate in health management and health education.

Sixth, promote the inheritance and development of traditional Chinese medicine. Bring into play the role of traditional Chinese medicine in disease treatment, prevention and special rehabilitation, rely on Sanming's rich resources of medicinal plants, and encourage the development of special medical products.

Medical reporter:

I want to ask Secretary Yang, how does the medical insurance department define the remaining amount of the county medical community medical insurance fund balance? How is the medical community member unit allocated? How to motivate them during the allocation process?

Yang Yongsheng, Secretary of the CPC Youxi County Party Committee:

The Municipal Medical Insurance Bureau implements a fixed package payment of the county medical insurance fund to the county general hospital, and the internal balance must be strengthened by strengthening management. If the management is not in place, there may be no balance. The remaining funds are mainly used for public health, popularization of health knowledge, promotion of healthy behaviors, and other future expenditures. The distribution is based on a comprehensive evaluation of the annual reasonable use of medical expenses by each medical institution, the completion of hospital income, especially the proportion of medical income, graded diagnosis and treatment, chronic disease management, and basic public health. The county has made a lot of practical explorations in this regard, forcing the general hospital to do large-scale health work in the medical community and in various hospitals. By then, the people will be healthier, see fewer illnesses, and spend less, and the medical insurance fund will also balance. More, to achieve a virtuous circle. The purpose is to keep the people from getting sick. Now I think our county has done a good job and can realize the balance every year. The medical community has made a reasonable distribution. At the same time, there are still some areas that need further efforts, that is, to further strengthen the reform of township branches, let them change their minds, focus on health, and better serve the health of the people.

China Reform News reporter:

Hello, Secretary Yang, there is so much balance in the medical insurance fund every year. Is there a change in the reimbursement ratio for ordinary people? Has the income of our township health centers changed?

Yang Yongsheng, Secretary of the CPC Youxi County Party Committee:

The reimbursement ratio of the people has increased year by year, and the reimbursement ratio varies within the county and outside the county. The reimbursement ratio of the hospitalized county-level hospitals in the county according to the approved disease amount reaches 70%, and the township branch hospitals reimbursement ratio of the total hospitalization reaches 80%. Urban and rural residents and urban employees who are hospitalized in county-level hospitals all realize personal payment of 30% of the approved disease amount. It can be said that Youxi County is one of the cheapest places for ordinary people in China to see a doctor. According to the procedure, referrals outside the county are reimbursed for 55% of the hospitalization. At present, the income of township branches and public health clinics is increasing year by year. The village doctors of public village health clinics subsidize 100 yuan per person per month. Last year, the average income of public health clinics in the county reached 41,000 yuan. The village health clinics are divided into 3 categories according to different categories. Some villages have a population of less than 500 people and the basic medical income will be different. This year, our county can ensure that the annual income of each village doctor reaches 35,000 yuan. Motivation will also increase. There are currently 212 public village health clinics and 286 village doctors in the county.

CCTV English Channel Reporter:

I want to ask Secretary Yang, how does Youxi County ensure that villagers in remote areas can learn about the benefits of so many medical insurance policies? What specific measures are there for sinking resources?

Yang Yongsheng, Secretary of the CPC Youxi County Party Committee:

In terms of publicizing medical insurance policies, the party committee, the government, and the two village committees all have a common responsibility. They require full coverage and publicity, and spread the policy to millions of households. At the same time, the county's 250 administrative villages held 212 public village health clinics, and several nearby villages co-organized a village health clinic. Basically, people can enjoy the medical insurance reimbursement policy nearby. At the same time, the village health office runs the door of the home and is also responsible for the promotion of medical insurance policies. Regarding the sinking of resources, the county general hospital implements the system of resident in villages and villages, and implements three sinks of talents, diseases and resources. Talent sinking is divided into four areas:

First, doctors in county-level hospitals must work in the countryside for half a year before they can be promoted to titles; second, the large department's bag-packing branch; third, the head nurse's residency; and fourth, the administrative department's rural supervision. Sinking of disease types: Namely, 15 disease types were identified and continued to be diagnosed and treated in county-level hospitals. Doctors 'performance and disease types were reduced by 30%, and in township branch clinics, doctors' performance and disease types were increased by 30%. Resource sinking: mobilizing and utilizing various medical resources to sink to townships and villages. At the same time, township branches and villages organize all professionals to carry out supervision in basic medical care, basic public health, family doctor contracting, chronic disease management, and "seven unified" management of village health centers.

Moderator Cheng Yi, Deputy Director of the News Network Division of the Propaganda Department of the National Health and Health Commission:

The question you just asked is also a question that our National Health and Health Commission pays more attention to in its publicity work, especially in the interpretation of health poverty alleviation policies. In response to the fact that people in the past did not understand the national health and health poverty alleviation policies very comprehensively and incompletely, our National Health and Health Commission summarized the good experiences and good practices of various places, such as village doctors who went to the village to enter the households and went to poor people in the village Explain policies at home, teach health knowledge, and especially carry out targeted propaganda in combination with the diseases suffered by the masses. This effect is very good; in some places, health knowledge is combined with local dramas to attract the masses to come and watch the drama. At the same time, I learned a health policy and was very welcomed by the masses; there are other places that use the big speakers in the village to regularly broadcast some health knowledge. Of course, there are many such examples, and there are other good measures. Through these measures, we can use our good policies for health and poverty alleviation, such as paying first consultation and paying for treatment, such as one-stop settlement, etc., to make the masses well-known to the masses, and to better benefit the masses. I'll add these to your question.


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