Classified diagnosis and treatment become the first important task of health care reform — finance -www.haole55.com

Grading treatment into health care reform "the first priority" — Finance — people.com.cn original title: diagnosis and classification into health care reform "the first priority" in the "state of war", the hospital medical staff to maintain a high load working state, the long-term basic medical institutions at the same time, a deserted house…… "Economic Information Daily" reporter learned that, in order to reverse this pattern, hierarchical diagnosis and treatment has been established as the first priority and priorities of the current round of medical reform. Wei Planning Commission recently intensive referral multi-level diagnosis and treatment experience, around the restrictions on excessive expansion of large hospitals, improve grassroots health services and other aspects of the introduction of a series of measures, and will further promote. Experience health planning commission intensive promotion of classified diagnosis and treatment of typical Health Planning Commission recently held a press conference to introduce more health care reform experience. Conference content shows that grading diagnosis and treatment has become the first priority and priorities of the current round of medical reform, and in practice, the emergence of a number of typical and bright spots. "Internet + medical" is the buzzword of the pharmaceutical industry in Sichuan province at present, with the Internet force, launched the "Da Jianyi platform, established two centers, build three systems" program, remote diagnosis, chronic disease management, have become the Internet with the starting point of the grading treatment. According to the head of the Sichuan Provincial Health Planning Commission, "a platform" is the first in the country to build "healthy Sichuan" convenient service cloud platform, access to 350 hospitals, import 70 million health records, 40 million new rural cooperative medical records, monthly supply of more than 90 million sources. "Two centers" is the establishment of Sichuan internet medical management guidance center, Sichuan University West China Hospital and provincial people’s hospital two provincial internet medical center. The three system is to establish a filing system, CA certification system and patient name reservation and record keeping system. Since September last year, the province’s online appointment registration of 4 million 953 thousand people, online payment of 1 million 796 thousand people, inspection results query 3 million 347 thousand people, remote consultation, imaging and ECG diagnosis of 827 thousand people, chronic disease management services 132 thousand person times. If the Internet can integrate the medical needs of a city and province into a platform, then the medical association is an important way to implement hierarchical diagnosis and treatment for the hospital. Yanan, Shaanxi province and Henan county become the typical of this area. Affiliated Hospital of Yan’an University in Yanan city as the general hospital, to absorb the city and county public hospitals as the branch, the establishment of the Yanan medical group. Compared with 2014, the number of outpatients, discharged patients and surgical cases decreased by 12.9%, 6.52% and 10.3% respectively in 2015. In the first quarter of 2016, outpatient visits decreased by 9.8% compared with the same period last year. Three county-level public hospitals in Mu county set up Counterpart Assistance and collaborative development relationship with 13 home level medical institutions, build cooperative wards, establish two-way referral green channel, and provide efficient and efficient referral service for patients. The township medical institutions referral to medical institutions at the county level with more than 13 thousand cases, county-level medical institutions under the transfer of patients in 3150 cases. In addition, the three quarter of this year, Wei Planning Commission has investigated in many places, selected Fujian, Xiamen, Jiangsu

分级诊疗成医改“第一要务”–财经–人民网 原标题:分级诊疗成医改“第一要务”   大医院处于“战时状态”,医务人员长期保持高负荷的劳动状态,与此同时,基层医疗机构门可罗雀……《经济参考报》记者了解到,为扭转这一格局,分级诊疗已被确立为本轮医改第一要务和重中之重。卫计委近日密集推介多地分级诊疗经验,各地在限制大医院过度扩张、提升基层卫生服务能力等方面推出一系列措施,并将进一步推广。   经验 卫计委密集推广分级诊疗典型   卫计委近日召开新闻发布会,介绍多地医改经验。发布会内容显示,分级诊疗已成为本轮医改第一要务和重中之重,并在实践探索中涌现一批典型和亮点。   “互联网+医疗”是目前医药行业的热门词汇,四川省借助互联网发力,推出“搭建一个平台,成立两个中心,构建三项制度”的方案,远程诊疗、慢病管理,都成为互联网结合分级诊疗方面的切入点。   据四川省卫计委负责人介绍,“一个平台”就是在全国率先建成“健康四川”便民服务云平台,接入350家医院,导入7000万份健康档案、4000万份新农合档案,每月提供90余万个号源。“两个中心”就是设立了四川省互联网医疗管理指导中心、四川大学华西医院和省人民医院两家省级互联网医疗中心。“三项制度”就是建立了备案制度、CA认证制度和患者实名预约及就诊记录保存制度。去年9月以来,全省网上预约挂号495.3万人次,线上支付179.6万人次,检查检验结果查询334.7万人次,远程会诊、影像和心电诊断82.7万人次,慢性病管理服务13.2万人次。   如果说互联网可以把一个市、省的医疗需求整合到一个平台,那么医联体对于医院来讲就是落实分级诊疗的重要方式。陕西省延安市、河南省牟中县成为这方面的典型。   延安市以延安大学附属医院为总医院,吸纳市县公立医院为分院,组建了延安医疗集团。与2014年相比,2015年总医院的门诊人次、出院人次和手术例数分别降低了12.9%、6.52%和10.3%。2016年第一季度,门诊人次比上年同期降低了9.8%。   牟中县的三家县级公立医院分别和13家乡级医疗机构建立对口帮扶、协同发展合作关系,共建协作病区,建立双向转诊绿色通道,为患者提供高效快捷的转诊服务。乡级医疗机构向县级医疗机构转诊的病人近1.3万余例,县级医疗机构下转病人3150例。   此外,今年三季度,卫计委曾在多地调研,选择了福建省厦门市、江苏省淮安市等一批分级诊疗试点典型。   核心 分级诊疗已被确立为“第一要务”   分级诊疗一般是指按照疾病的轻、重、缓、急及治疗的难易程度进行分级,不同级别的医疗机构承担不同疾病的治疗。以“基层首诊、双向转诊、急慢分治、上下联动”模式,让一部分常见病、慢性病的诊疗分流在基层医院,从而提高优质稀缺医疗资源的配置效率。   据了解,分级诊疗目前已经在事实上被确定为本轮医改的第一要务和重中之重。根据近日举行的全国卫生与健康大会上确定的医改工作思路,医改要建成五个制度,排在第一的是分级诊疗制度,第二是现代医药管理制度,第三是全民医保制度,第四是药品供应保障制度,第五是综合监管制度。   2017年将成为分级诊疗推进的关键时间节点。根据《国务院办公厅关于推进分级诊疗制度建设的指导意见》,2017年分级诊疗政策体系逐步完善,医疗卫生机构分工协作机制基本形成,优质医疗资源有序有效下沉,体现在核心的任务量要求是基层医疗卫生机构建设达标率≥95%,基层医疗卫生机构诊疗量占总诊疗量比例≥65%。到2020年,分级诊疗服务能力全面提升,保障机制逐步健全,布局合理、规模适当、层级优化、职责明晰、功能完善、富有效率的医疗服务体系基本构建,基层首诊、双向转诊、急慢分治、上下联动的分级诊疗模式逐步形成,基本建立符合国情的分级诊疗制度。   《经济参考报》记者了解到,长期以来,我国许多大医院快速扩张,对于医疗资源的虹吸效应日趋明显。如何强化基层,同时做到消减过度膨胀的大医院体量,引导优质医疗人才和患者向基层的双回归,仍有很多难题待解。   根据华中科技大学教授方鹏骞编撰的《中国医疗卫生事业发展报告2015――中国公立医院改革与发展专题》,新医改以来,尽管基层诊疗人次一直占多数,但大医院的上升速度却更快。2014年,基层医疗机构的服务比例从59.1%下降到57.4%,而大医院从37.5%上升到39.1%。住院服务方面,大医院与基层医疗机构的差距仍在扩大。到2014年,大医院的住院量近四倍于基层医疗机构。   下沉 “强基层”方案成共识   有医改专家认为,分级诊疗制度在推进过程中仍然面临不少困难,其中最根本的问题是,基层医疗机构的技术水平相对薄弱,患者不够信任,影响了分级诊疗的实施。   “基层能力不强仍是一大短板,下一步将更大力度地补短板。”江苏省卫计委主任王咏红表示,在进一步加强基层机构建设的同时,下一步将深化完善基层机构运行机制改革,提升服务能力,充分调动基层机构和人员积极性。在分级诊疗制度上,将全面推行市区一体化、县乡村一体化改革,尽快使所有基层医疗卫生机构全部加入医联体,并建立双向转诊绿色通道。   达到“强基层”的目的,基层必须有患者认可的医生。卫计委体改司司长梁万年表示,今年将着力医联体的建设和家庭医生签约两个方面,落实分级诊疗。一是医联体的建设,把基层强起来,让老百姓放心去,把大医院的优质资源真正下沉到基层。二是实行家庭医生签约。“基层首诊,就是要把健康责任实行连续性的、责任式的管理,这种服务模式必须建立。”他说。   在这一领域,互联网医疗可以发挥巨大作用。业内人士建议,尽快出台相关政策,支持互联网医院链接基层医疗结构,鼓励民营力量进入基层医疗领域。同时,将互联网医院远程诊疗费纳入医保,实现在线医保支付,为互联网医院普及提供有利条件。   社科院公共政策研究中心主任朱恒鹏对《经济参考报》记者表示,大医院门诊当中有百分之六七十并不需要到大医院来看,有一部分人通过互联网问诊或者咨询就可以解决问题,这样就可以减少一部分盲目到三甲医院看病的患者。此外,到三甲医院复诊的人次超过60%,通过互联网又可以截留相当一部分。这不仅仅是帮老百姓节省了成本,也帮医生节省了大量的成本,让他们有更多时间为需要他们的患者服务。   此外,按照目前医改思路,公立医院规模的过度扩张将受到严格控制,让公立医院回归本位,就是要做好疑难杂症的诊断和治疗,同时要承担医疗中心和人才培训中心的功能。   同时,加快医疗服务价格调整,基于药品加成取消后的“腾笼换鸟”为医疗服务价格调整腾出空间,尽力以收益补足大医院的“分流”损失。 (责编:孙阳、杨曦)相关的主题文章: