The State Council issued a document: 1/5 of the hospital outpatient service transferred to the grassroots level


Release time:

2015-09-12


Yesterday, the general office of the State Council officially issued the guidance on promoting the construction of hierarchical diagnosis and treatment system. At present, policy formulation will have clear goals and figures. Then, let's take a look at the goals and figures that need our attention:
Goals to be achieved in 2017
An important point in time: 2017. According to the national plan, the goals to be achieved in 2017 are as follows:
By 2017, the pilot work of graded diagnosis and treatment should meet the following standards:
1. the compliance rate of primary medical and health institutions ≥ 95%, and the proportion of diagnosis and treatment in primary medical and health institutions to the total diagnosis and treatment volume ≥ 65%;
Counties with a population of more than 300000 in the 2. pilot area have at least one second-class general hospital and one second-class Chinese medicine hospital, and the rate of consultation in the county has increased to about 90%, basically realizing that serious illnesses do not leave the county;
3. every 10,000 urban residents have more than 2 general practitioners, each township health center has more than 1 general practitioner, and the contracted service coverage rate of urban general practitioners is ≥ 30%;
The proportion of primary medical and health institutions preferred by 4. residents who fell ill for 2 weeks ≥ 70%;
5. telemedicine services cover more than 50% of the counties (cities, districts) in the pilot areas;
6. integrate the existing medical and health information system, improve the hierarchical diagnosis and treatment information management function, and basically cover all 2. tertiary hospitals and more than 80% of township health centers and community health service centers;
The annual growth rate of referrals from 2. tertiary hospitals to primary medical and health institutions and chronic disease medical institutions in 7. is more than 10%;
8. all community health service centers, township health centers and 2. tertiary hospitals to establish stable technical assistance and division of labor and cooperation;
The standardized diagnosis and treatment and management rate of urban hypertension and diabetes patients in 9. pilot areas has reached more than 40%;
Community health service centers, township health centers, community health service stations, and village clinics that provide Chinese medicine services in the 10. account for 100, 100, 85, and 70 percent of similar institutions, respectively.
The proportion of total diagnosis and treatment in similar institutions is ≥ 30%. So, first of all, the proportion of diagnosis and treatment in primary medical and health institutions to the total diagnosis and treatment volume is ≥ 65%; what does this mean?
According to the statistics of the Health Planning Commission, from January to May 2015, the total number of medical and health institutions nationwide reached 3.11 billion. Among them: 1.22 billion person-times in hospitals, an increase of 5.4 percent over the same period last year; 1.8 billion person-times in primary medical and health institutions, an increase of 1.6 percent over the same period last year; and 1.01 billion person-times in other institutions.
According to the current statistics, the diagnosis and treatment volume of primary medical institutions accounts for 57.9 of the total diagnosis and treatment volume. To reach 65%, from the current diagnosis and treatment volume, it needs to reach 202000, which means that the number of 22000 diagnosis and treatment should be increased by 2017.
How much does this 22000 of diagnosis and treatment account for the current proportion of outpatient clinics in public hospitals? According to statistics, public hospitals have 1.08 billion visits, which means that 20.3 per cent, or one-fifth, of the diagnosis and treatment volume needs to be transferred from large hospitals to the grassroots.
Which will be transferred to the grass-roots level? From the point of view of opinion, there is no doubt that it includes chronic diseases, common diseases, frequently-occurring follow-up visits and chronic diseases with clear diagnosis and stable conditions, and other general outpatient clinics to divert patients with chronic diseases.
90% cannot be diagnosed and treated in the county.
Another figure that needs special attention is that the rate of consultation in the county has increased to about 90%, basically realizing that serious illnesses do not leave the county.
To achieve the goal, it is necessary to greatly improve the level of diagnosis and treatment in county-level hospitals. So, what measures are to be introduced in the opinions?
The opinion pointed out that the focus is to strengthen the construction of clinical Junior College related to common diseases and frequently-occurring diseases in the county, as well as infectious diseases, psychosis, emergency first aid, critical care medicine, nephrology (hemodialysis), obstetrics and gynecology, pediatrics, traditional Chinese medicine, and rehabilitation, and improve the county Comprehensive service capabilities of public hospitals.
Under the premise of having the ability and ensuring safety, the restrictions on the clinical application of medical technology in county-level public hospitals should be appropriately released. At the same time, county-level traditional Chinese medicine hospitals focus on strengthening the Junior College of internal medicine, surgery, gynecology, pediatrics, acupuncture, massage, bone injury, tumor and other traditional Chinese medicine characteristics, as well as the construction of clinically weak Junior College and medical technology departments, so as to improve the diagnosis and treatment ability and comprehensive service ability of dominant diseases of traditional Chinese medicine.
This means that the county-level hospital market will achieve great development, especially the pharmaceutical companies whose products cover the above-mentioned key departments should make more preparations.