In the past, the equipment of county hospitals was relatively backward, the diagnostic level of primary hospitals was uneven, and the linkage between hospitals was weak. The above incidents are difficult to handle, and people prefer to go to hospitals in big cities for medical treatment. At present, thanks to the reform of the county medical system, "serious illness does not leave the county, minor illness does not leave the countryside" has become the norm of Yuhang people.
Comprehensive service center of a hospital in Yuhang. Zhang Yuhuan photos
Prospective exploration and integration of medical and health system for more than ten years
In 20 18, Zhejiang province comprehensively rolled out the reform of county medical system, which was regarded as a new breakthrough to fill the shortcomings of primary medical service capacity. In just three months, Yuhang District has achieved the licensing of five medical institutions and the listing of all 20 branches, and the progress and intensity of medical institution reform are at the forefront in Zhejiang.
In fact, as early as the concept of "medical system" did not appear in Zhejiang, Yuhang, which is divided into cities and districts, began to explore the integration of medical and health service system. In 200 1 year, Yuhang tried to adjust regional health resources as needed in some towns and streets with relatively concentrated population, that is, a county-level hospital completely managed several branches and health service stations.
For example, Yuhang Fifth Hospital, upgraded from Linping Central Health Center, has four community health service centers and 18 community health service stations, so the institutional adjustment is also "advanced".
"In the past, no one had the experience of managing primary hospitals in county-level hospitals, and the unified deployment of personnel was the most complicated." Wu Yueping, then secretary of the Party Committee of Yuhang Fifth Hospital, said, "So we decided to get all the internal staff through and make a unified announcement for all external recruitment. The regulations are exactly the same as the training. Where there are not enough people, everyone is seconded to help each other. "
On this basis, Yuhang Fifth Hospital established a three-level vertical management system of district, town and village. With the development of reform, Yuhang proposed to build an integrated medical and health service system with "first-line direct access, global coverage and continuous service".
"Now the general hospital not only unifies the performance of management personnel, but also has information from top to bottom. Ordinary people want to do a high-end examination that only general hospitals can do. After paying the fee in the primary hospital, you can make an appointment directly to the general hospital for examination. The proportion of reimbursement for primary medical insurance is higher, which is undoubtedly a big plus. " Wang Zejun, president of Yuhang Fifth Hospital, said.
Wing-kuen Luk Lu Lin footballer, director of Yuhang District Health and Health Bureau, said that Yuhang has achieved the goal of graded diagnosis and treatment and medical reform through the overall coordination of personnel, finance and materials, the implementation of compensation mechanism reform and precise performance management.
A hospital in Yuhang made an appointment in front of the registration machine. Zhang Yuhuan photos
"Physical merger" forms "chemical reaction"
After completing the integration of medical service system, how to improve the medical quality in the county is the key to reform.
June 5438+February last year, Yuhang District Difficult Diseases Diagnosis and Treatment Center settled in Yuhang No.1 Hospital, and more than 80 nationally renowned experts from Beishangguang and other places conducted diagnosis and treatment of difficult diseases through regular consultations.
"This is a typical model of improving medical quality through' expert sinking' in the era of medical associations." Justin, president of the hospital, said, "How to make our doctors become experts is the goal of medical construction."
Xu Xiaoping, deputy chief physician of anorectal department of this hospital, has a deep understanding of this. Under the guidance of experts from the Second Affiliated Hospital of Zhejiang University School of Medicine, I am now proficient in laparoscopic surgery. "Last year, we only performed more than 100 colorectal cancer operations a year. Now there are 4-5 operations every week, and more than 94% of the operations use laparoscopy."
When serious and difficult diseases have a "solution", the people's sense of gain can be better reflected in minor and chronic diseases.
"China, help me to look at this physical examination form. Why are there a series of' arrows'! " In front of the clinic of Xinfeng Service Station of Nanyuan Street Community Health Service Center in Yuhang District, there are often a circle of aunts and grandmothers who come to consult. "Uncle Wang, although this upward arrow means exceeding the standard, it is not serious. Exercise more at ordinary times and don't be too nervous. " Zhou Guofang, the captain of the family doctor service team who has worked here for nearly ten years, is a general practitioner who can often answer questions for patients, which is an incomparable advantage for big hospitals in the eyes of the people.
At present, Yuhang has 4. 16 general practitioners per 10,000 people (calculated by registered population), which is nearly three times the number of general practitioners per 10,000 people in China.
Not only that, this year Yuhang also took the lead in "brushing his face for medical treatment" in the country. Through real-name authentication, face recognition technology can be used to realize the whole process of appointment registration, inspection and inspection.
"Few counties have spontaneously explored medical reform for more than ten years." Regarding Yuhang's road to medical reform, Ma, inspector of Zhejiang Health and Health Commission, commented that in the overall promotion process, Yuhang can be seen on the one hand to advance rapidly, and on the other hand, it also has its innovative significance, such as "brushing face for medical treatment", which has brought great convenience to the people.
Yuhang proposed that by 2022, the medical treatment rate at the grassroots level will reach over 65%, and the medical treatment rate at the county level will reach over 90%.
From the physical combination of medical service system to the formation of chemical reaction to improve medical ability, Yuhang has continuously increased people's sense of health acquisition through exploration, and also provided reference for the road of medical reform in other regions. (End)