Improve the service capacity of grassroots medical and health institutions, optimize and standardize the diagnosis and treatment system

Since the beginning of this year, the province has focused on improving the service capacity of primary health care institutions, further optimized and perfected the grading diagnosis and treatment system, and promoted the establishment of a rational medical treatment order and pattern for “primary diagnosis, rapid division and treatment, two-way referral, and grading diagnosis and treatment”. What kind of work will our province do in improving the service capacity of primary health care institutions? With this question, the reporter interviewed the relevant person in charge of the Provincial Medical Reform Office.

Q: The lack of grassroots medical and health talents is a short-term development for grassroots medical institutions. What work will be done in the province's general practitioner training and stable talent team?

A: This year, our province will continue to strengthen the free order orientation to train general practitioners. In 2016, we will continue to implement 300 free general order orientation training programs for undergraduate general practitioners, further implement free order-oriented graduates to be appointed according to the contract, and give priority to order-oriented medical graduates to participate in standardized training and recruitment of residents. The implementation of the three-year high-ranking rural doctors' free order orientation training program for village clinics, 400 students were enrolled during the year. Strengthen the training of all technical personnel's skills, continue to train 50 full-time physicians, and launch 130 standardized trainings for “5+3” general practitioners and “3+2” assistant general practitioners. Adopting medium and long-term training to carry out 7 major categories of key professional skills training programs.

In order to stabilize the talent team of grassroots medical and health institutions, the province will improve the talent introduction mechanism. Optimize and adjust the recruitment conditions and methods for personnel, and give full inclination to the hard and remote areas; adopt a flexible approach to recruit high-level and shortage-type talents for grassroots medical and health institutions; and strengthen local talent training. Encourage provincial and municipal (state) health professional and technical personnel to move to the grassroots level of the county. The order-oriented training will be arranged to the township hospitals and community health service centers. If the service period is less than 8 years, the personnel of the township hospitals and community health service centers will be openly recruited; if the service period is less than 5 years, the departments at all levels will be prepared. If it is not verified, the health and personnel departments may not approve the transfer. Further improve the talent evaluation mechanism. Formulate the “Implementation Opinions on Further Reforming and Perfecting the Evaluation of Professional Titles of Grassroots Health Professionals in Qinghai Province”, and establish a separate senior professional title review team for grassroots health professionals. Those who have obtained senior professional titles at the grassroots level should be limited to the appointment of grassroots medical and health institutions. In the job title evaluation, the township health center and community health service center title review cancels the requirements of foreign languages ​​and papers, scientific research projects do not make hard rules, and focus on practical skills, professional ability and mass satisfaction evaluation.

Q: How will the province improve the construction of hardware and software facilities in primary health care institutions?

A: Our province will further strengthen the standardization of grassroots medical and health institutions. Renovate and expand 7 county-level medical institutions in batches, gradually improve the auxiliary facilities of 15 county-level medical institutions; allocate equipment for township hospitals in batches, renovate and expand 10 township hospitals, and improve the facilities of 200 hospitals [Equipped with equipment for 30 community health service centers; equipped with 2248 village clinics in the province in batches, such as first-aid kits for outpatients, and other “village clinic health clinics”, equipped with mobile health service tents for 1705 village clinics in six ethnic autonomous prefectures. Supporting equipment, newly built 362 village clinic business rooms. It is planned that by the end of 2016, the standardization construction rate of county-level hospitals in the province will reach 75%, and the standardization construction rate of community health service centers and township health centers will reach 60% and 95% respectively, and the standardization construction rate of village clinics will reach 100%.

Our province will further enhance the ability of remote consultation. By the end of 2016, the existing provincial, city (state), county (city, district) three-level remote consultation information platform will be extended to township center health centers, community health service centers and other township health centers with conditions; Before, the construction of the remote consultation information system for primary health care institutions was basically completed. By strengthening the construction of remote consultation information, the two-way referral network system was opened, and an online green referral channel based on the remote consultation system was established to promote the informationization of graded diagnosis and treatment. Focusing on the functional orientation of township hospitals and community health service centers, we will establish a health education and disease diagnosis and treatment mechanism focusing on the management of common diseases, frequently-occurring diseases and chronic patient groups, and establish an information service team that cooperates with grassroots general practitioners and superior hospital experts. .

Q: How will the province guide patients to the first consultation at the grassroots level?

A: In the pilot work of comprehensive medical reform, the province will explore the pilot work of canceling the general outpatient clinics in the three-level public hospitals in Xining area, and guide patients to the first consultation at the grassroots level. Gradually reduce the number of general outpatients in tertiary hospitals and fully implement the appointment diagnosis and treatment services. Strengthen the construction of specialist specialists outpatient clinics, improve the level of diagnosis and treatment of difficult diseases, strengthen emergency emergency services, set up a bed for observations that is compatible with the amount of hospital treatment, gradually increase the source of appointment referral services, and tilt to the primary health care institutions to accelerate The resources of the tertiary hospital experts have effectively subsided. Improve the work of contracting services for general practitioners (rural doctors). In the city, we will actively promote the GP service team and the family-responsible doctor contract service, and focus on promoting the signing service for rural doctors in the farming and pastoral areas. The contracted service is targeted at people with chronic diseases and severe mental disorders, the elderly, pregnant women, children, and disabled people, and gradually expands to the general population. Establish a relatively stable contractual service relationship by signing a service agreement with residents for a certain period of time. It is planned that by the end of 2016, the signing rate of all urban and rural residents will be no less than 30%, and the signing rate of key populations shall not be less than 65%. The filing rate of standardized electronic health records for urban and rural residents has reached 97%.

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