Orderly medical system will ease the difficulty of seeing a doctor

Reporter: During the 12th Five-Year Plan period, Li Qiu-Meng will actively deepen the reform of the medical and health system, further increase health investment, and establish and gradually perfect the medical and health service system that matches the “world city” orientation of Beijing. The community hospital will be fully implemented. 24 Hours of service eased the problems of seeing a doctor and paying attention to the doctor from the four major aspects, effectively controlling and reducing the cost of medical treatment.

On the basis of a clear classification of medical institutions, the wealth-minimizing theory puts different levels and categories of medical institutions in their respective positions. After the division of labor is clear, it will guide patients to orderly seek medical treatment, while at the same time alleviate the current large hospitals difficult to see the doctor, hanging experts difficult questions.

■ Key points Planning content An orderly and orderly medical system will form the “Twelfth Five-Year Plan” period. This city will explore the establishment of mutual referral mechanisms and service models in which the middle-tier medical institutions are in close contact with major hospitals and communities, and promote the formation of an orderly medical service system. .

During the “Twelfth Five-Year Plan” period, the city will establish a medical service system for division of labor and cooperation among regional medical centers (medical centers), specialist hospitals, rehabilitation hospitals, nursing homes, and primary-level medical institutions to enhance overall service capabilities and levels.

At the same time, from this year onwards, in the two-way referral and appointment service between the community and the major hospitals, the appointment for the new clinic will be promoted from the tertiary hospital to the secondary and suburban hospitals, so that the community referral rate will be during the "Twelfth Five-Year Plan" period. It reaches 90%.

The health department made it clear that during the “Twelfth Five-Year Plan” period, the city will complete the construction of all residents’ electronic medical records and residents’ health records. By then, a unified information health management platform will synchronize with patients' referral between the community and large hospitals to reduce the cost and waiting time for repeated inspections.

With the development of new urban areas such as Tongzhou and Shunyi, the city will adjust the distribution of existing medical resources and move out of the city's nearly saturated high-quality medical resources while rationalizing the distribution of medical institutions in the suburbs.

Planning content 24-hour convenience service promotion in the city The city will continue to innovate the primary medical service model and fully implement new models such as family doctor-type services and mountain-based services.

At present, the 24-hour round-the-clock service provided by the city's eight district community hospitals will also be promoted to community health service agencies in the city. At the same time, the qualified community health service center will appropriately increase day observation beds to facilitate the people's medical treatment, but it can also enable critically ill patients to receive timely treatment in large hospitals.

During the “12th Five-Year Plan” period, the city will strengthen the building of medical services for the elderly. On the one hand, increase the number of resources for the elderly to provide medical services and improve service quality in the community, and strengthen the ability of grass-roots health agencies to serve the elderly from the aspects of chronic disease management, rehabilitation care, and health promotion; on the other hand, it will accelerate Rehabilitation care service capabilities.

The content of the zero-difference medicine list of the planning content community expands the situation that some medicines cannot be bought in the community. During the “Twelfth Five-Year Plan” period, according to the needs of the citizens and the Ministry of Health's adjustment of the grass-roots medicines list, the variety of community medicines will be increased in a timely manner.

Last year, the Beijing Municipal Bureau of Health implemented uniform tendering and procurement of medicines at grade two and above hospitals, and nearly 6,000 medicines in nearly 200 hospitals had the same price in the same city. The health department stated that the overall bidding procurement price has dropped by an average of 16% compared with the previous six bidding models. It is expected that within the first round of procurement cycle (this year and next year), patients will be saved more than RMB 7 billion in drug charges.

At the primary health care institutions, there are currently 519 varieties and 1,500 items of community-standard drugs listed in the basic medicine list in the city, all of which are sold at zero margin, with an average price reduction of 30.45%.

Regarding the situation that some of the medicines reported by the public cannot be purchased in the community, the health department said that during the “12th Five-Year Plan” period, according to the needs of the public and the Ministry of Health’s adjustment of the grass-roots drug list, the variety of drug use in the community will be increased in a timely manner.

■Dialogue ·Deputy director of the Municipal Health Bureau and press spokesman Mao Yu Medical Institution clearly defined the difficulty in seeing a doctor. Jinghua Times: How to understand “to build a medical and health service system that matches the world's cities”?

Mao Yu: It is in accordance with the function and position of Beijing as a world city, according to the regional pattern of planning, various types of medical institutions at all levels to carry out rational distribution, effective division of labor and collaboration. That is, on the basis of a clear classification of medical institutions, medical institutions of different levels and categories are assigned to each other. For example, a community hospital is a health gatekeeper for residents, and a tertiary hospital is mainly responsible for the treatment of patients with severe diseases, while regional medical centers and Rehabilitation and nursing homes play a pivotal role. At present, the arbitrariness of patients is strong. Once the division of labor at all levels and types of medical institutions is clear, it will also guide patients to orderly seek medical treatment, while at the same time alleviate the current large hospitals difficult to see the doctor, linked to the problem of difficult experts.

Jinghua Times: How to create a diversified pattern of medical services in attracting high-quality overseas medical resources to Beijing?

Mao Yu: During the 12th Five-Year Plan Period, this Municipality will study the implementation of suggestions to encourage and guide social forces to organize medical institutions, create an environment to attract overseas high-quality medical resources, and strengthen the guidance, management, and supervision of social capital to start medical institutions, and gradually improve medical care. Institutional access withdrawal mechanism. Gradually increase the proportion of social capital to the medical and health institutions, promote market competition and market complementarities.

Jinghua Times: Pediatric Hospital where patients get together, what plans does this city have to meet the patient's needs?

Mao Yu: Considering that the loss of pediatricians in general hospitals is relatively large, we will make full use of the city's medical resources from the perspective of rational distribution, and guide experienced pediatricians by encouraging and guiding qualified physicians to conduct multi-location practice. Flow to general hospitals to ease the current situation where children are concentrated in two specialist hospitals and difficult to find on the 1st.

Jinghua Times: How will the general health of the residents be raised in response to the current status of many people with chronic diseases in the city?

Mao Yu: Comprehensively strengthen the construction of the disease prevention and control system, and continue to implement the city's basic and major public health service projects. The city will conduct a three-year monitoring of adult chronic diseases and their risk factors throughout the city to achieve dynamic monitoring of patients with chronic diseases. By 2015, the awareness rate of residents’ knowledge of chronic diseases will reach 70%, the awareness rate of self-blood pressure levels will reach 70%, and the awareness rate of self-glucose levels will reach 30%. The standardized management rates for hypertension and diabetes were 35% and 30%, respectively.

Jinghua Times: How will the city protect public health food safety against food hygiene incidents that have occurred in recent years?

Mao Yu: Establish and improve the food safety supervision and early warning system, and realize the safety supervision of the whole process of food production, circulation, and consumption. Strictly crack down on the production and operation of fake and shoddy foods, strengthen the crackdown on punishment, focus on high-risk food safety special rectification, and further increase the focus on daily food, meat, vegetables, fruits, dairy products, soy products, aquatic products and other key The level of food safety in the variety and cultivation, production, processing, distribution and consumption of key links.

â–  "My five years"

Toss 4 hours to open 10 minutes medicine to June this year, You Shifen suffering from rheumatoid for 8 years. Pain, once she could not walk independently, could only lie on her lover's back when walking up and down the stairs. Pain also caused her to travel around the major hospitals in spring, summer and autumn, seeking medical advice.

After being diagnosed with rheumatoid arthritis, You Shifen needs to go to the hospital every month to prescribe medicine. She only knows that the difficulty of queuing for hospital registration is no less than buying a train ticket for Spring Festival. When she mentioned the experience of taking medicine for the first time at the Union Hospital, she still had a hard time. You Shifen said that she had just been diagnosed with rheumatoid arthritis, and all the treatment drugs were hormones. If the dose is not controlled properly, not only can the disease condition be controlled, but on the contrary it will produce toxic and side effects, so I would like to hang a "flight" expert number.

“I haven’t even hung up after three days in a row. The hall is full of people sleeping on the floor and there are hundreds of them.” Although he had heard about the difficulty of seeing a doctor in large hospitals early on, when he was really integrated into the registered army, You Shifen felt that this was an individual effort and he was too “undermined” by himself.

After seeing a doctor, You Shifen is basically a full-time member. The children and their loved ones have a registered window. "As long as a few minutes arrive, they will not be able to hang on." She, who lives in Qinghe, "has often tossed for more than four hours, just for 10 minutes."

At the beginning of 2008, You Shifen's Xicheng District Exhibition Road Community Health Service Center and Peking University People's Hospital established a two-way referral relationship. She became the first beneficiary. Because the condition is stable, it only needs to go to the People's Hospital on a regular basis. Therefore, as long as she makes an appointment one day in advance through the referral system, she can directly see the People's Hospital’s expert number the next day. “No need to wait in line, no waiting for the call. It's easy to see."

Referring to the future treatment, You Shifen is a mixed bag, and it is happy that Ai Ruohua and other drugs commonly used in rheumatism have been included in the employee medical insurance reimbursement list. As a result, their monthly drug expenditure has been reduced from the original 800 yuan to about 200 yuan; the worry is that the community drugs do not yet include Ai Ruohua and other drugs. Once their own condition is serious, they will run every month. It is very difficult for the hospital to take drugs. "I hope that with the development of community hospitals, more commonly used drugs can be purchased here." When asked about the "Twelve Five" hope, she said.

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