From 2017 to 2030, the health reform "health bonus" is worth looking forward to
On January 9th, the medical network continued to expand and deepen the reform of public hospitals, and increased 100 pilot cities for medical treatment. The coverage rate of medical insurance reached 95%... The new round of medical and health system reform entered the eighth year, and the medical reform has shifted from a good foundation. Improve quality, shift from single breakthrough to comprehensive advancement, face the deep ills of the system and mechanism, and promote the reform of key areas and key links to bring "health dividends" to 1.3 billion people.
From the prelude to 2017, to the end of the "13th Five-Year Plan" in 2020, and to the "Healthy China" in 2030, what reforms in the health reform of the people's livelihood have made us look forward to? What kind of picture will the “Healthy China” show in the future?
Graded diagnosis and treatment: 70% of the country's pilot projects to establish a reasonable medical order
Graded diagnosis and treatment is a re-adjustment of the medical resources pattern, and is regarded as a tool for effectively improving people's medical experience and rationalizing medical order. At present, the graded diagnosis and treatment has been rolled out in 200 public hospitals for comprehensive reform of public hospitals. More than half of the counties in the country have carried out pilot projects at the grassroots level, and the rate of visits within the county has reached more than 80%.
The State Council's "Guiding Opinions on Promoting the Construction of Graded Diagnosis and Treatment System" pointed out that in 2017, China will conduct pilot medical treatment trials in more than 85% of the cities and towns, and the proportion of general outpatient visits in urban tertiary hospitals will be significantly lower than that of medical and health institutions. The compliance rate of grassroots medical and health institutions will exceed 95%, and the proportion of primary and secondary medical and health institutions in total medical treatment will exceed 65%.
By 2020, the grading diagnosis and treatment service capacity will be comprehensively improved, the guarantee mechanism will be gradually improved, and a graded diagnosis and treatment system in line with national conditions will be basically established. By 2030, a rational medical order will be formed at the grassroots level for first diagnosis, two-way referral, upper and lower linkage, and rapid division and treatment, and a mature and comprehensive classification and treatment system will be established.
“Forming a grading diagnosis and treatment system adapted to the national conditions is part of the overall design of China's medical reform.” Fu Hongpeng, a researcher at the China Health Development Research Center of the former Ministry of Health, said that as the top priority of this round of medical reform, grading diagnosis and treatment has a long way to go, and it is necessary to give full play to the medical insurance policy. The role of adjustment and guidance, the implementation of "three medical linkages", support the construction of grassroots medical institutions, with "basic strong" escort classification diagnosis and treatment problems.
Family doctor: contract coverage rate of more than 30%, forming a 15-minute basic medical service circle
As an important driving force for the gradual diagnosis and treatment of "rusty gears", family doctors are the basic link for patients to "see well." The State Council Medical Reform Office issued the "Guiding Opinions on Promoting Family Doctors' Contracting Services", stating that in 2017, the coverage rate of family doctors' contracting services will reach over 30%, and the coverage rate of key population contracted services will reach over 60%. Basic medical services cover common diseases and The diagnosis and treatment of Chinese and Western medicine, rational use of drugs, medical treatment guidance and referral appointments.
By 2020, we will strive to expand the family doctor contract service to the entire population, and form a long-term stable contractual service relationship with residents, and basically achieve full coverage of the family doctor contract service system. By 2030, improve the family doctor contract service, improve the "treatment-rehabilitation--long-term care" service chain, the basic medical service circle of 15 minutes is basically formed, and the grassroots generally have the ability of residents' health gatekeepers.
As an important starting point for establishing a family doctor's medical treatment system, how to develop grassroots medical personnel? Xu Junfeng, director of the Beijing Municipal Health and Family Planning Commission, suggested that the team of health-care “gatekeepers” should be strengthened. In addition to strengthening orientation training, it is necessary to tilt in terms of income distribution, promotion of titles, evaluation and promotion, and use incentive mechanisms. Treatment is reserved." The "Healthy China 2030" Planning Outline states that by 2030, there will be 3 practicing (assistant) physicians per 1,000 permanent residents and 4.7 registered nurses. China will basically achieve equalization of quality medical resources.
National Health Insurance: "medical insurance roaming" comprehensive coverage, medical insurance system mature stereotypes
At present, China has established a medical insurance network covering 96.5% of the country through employee medical insurance, new rural cooperative medical insurance, and urban residents' medical insurance. It has also gradually improved the medical security system through major illness insurance, commercial insurance, and charity assistance. In the past, the situation of "small illness, serious illness, etc." In addition, at the end of 2016, the national medical treatment settlement system has passed preliminary acceptance.
The relevant person in charge of the Ministry of Human Resources and Social Security said that in 2017, China will basically realize the direct settlement of hospitalization expenses for medical treatment in other places that meet the referral regulations, establish a relatively complete system of major illness insurance, achieve full coverage of major illness insurance, and ensure the fairness of medical insurance for urban and rural residents. Significantly improved.
In 2030, the universal medical insurance system will be matured, and the medical insurance management service system will be perfect and efficient. The multi-level medical security system supplemented by basic medical insurance and supplemented by various forms of supplementary insurance and commercial health will be improved.
Any of the leaders of the China Modernization Research Center of the Chinese Academy of Sciences said that while reforming medical insurance management and payment methods, improving the insurance insurance premium participation policy, and achieving a sustainable balance of medical insurance funds, it is also necessary to speed up the promotion of basic medical insurance for medical treatment in different places and enhance the medical insurance treatment. "Sex", let more than 200 million people in different places in the country resettle retirees and floating population, no longer reimbursement for medical treatment "pads" or "running broken legs."
Medical control fees: personal expenses accounted for less than 30%, from the source stuck in the "moisture" black hand
The key to getting the general public to see the disease is to straighten out the price of medicine, which is also an important breakthrough in the medical reform system engineering. Since 2012, the personal health expenditure of residents has accounted for the lowest level of total health in 20 years. The public hospitals in 200 medical reform pilot cities have cancelled drug additions, and the market-based drug price formation mechanism has been gradually established.
Reducing the personal medical expenses of the insured patients will effectively reduce the burden of medical treatment for residents. The State Council issued the "Guiding Opinions on the Comprehensive Reform of Urban Public Hospitals", clarifying that by 2017, China will eliminate the use of medicines to supplement medicines, and the proportion of personal health expenditures to total health expenditures will be reduced to less than 30%, and the proportion of public hospitals in pilot cities will be reduced. (excluding traditional Chinese medicine decoction pieces) overall reduced to about 30%; 100 yuan medical income (excluding drug income) consumption of sanitary materials fell below 20 yuan.
Health services and security will continue to increase. Liang Wannian, director of the National Health and Family Planning Commission's System Reform Department, said that by 2020, the proportion of personal health expenditure to total health expenditure will fall to 28%, and by 2030, this proportion will fall to around 25%. At the same time, the relevant departments will strengthen the price supervision of drug prices and high-value medical consumables, establish a drug price information detection and information disclosure system, and seize the “moisture” from the source.
Liang Wannian said that to achieve medical control fees to eliminate "expensive medical treatment", it is necessary to make room for regulating medical treatment, reduce the cost of medicines and consumables, dynamically adjust the price of medical services, and construct a reasonable compensation mechanism and payment method to make public hospitals truly return to public welfare. Sexual orbit.