China's first county medical regulations issued: improve the income of village doctors, security

Medicine Network December 2 - November 27, Shanxi Provincial People's Congress Standing Committee Office held a press conference, as the country's first local regulations on the construction of county medical and health community, Shanxi Province to ensure and promote the integration of county health care (hereinafter referred to as the "Measures") will be implemented on January 1, 2021.
6 chapters and 32 articles of the Measures, including general rules, integration optimization, service promotion, support protection, supervision and management and by-laws.
is a summary of the results of the pilot work on the construction of the medical and health community in Shanxi's close county area, which provides the rule of law guarantee for further safeguarding and promoting the integration of medical and health care in the county.
it is worth mentioning that the Measures provide innovative answers in improving the income level and treatment security of rural doctors.
The formation of county-level medical groups, the village health room into the management of Shanxi Provincial People's Congress Standing Committee education, science, education, health and industry committee director Li Fuming introduced, "Measures" many provisions are creative, such as the provisions of the county-level medical groups and their medical and health institutions to implement administrative, personnel, funds, performance, business, medicine "six unified" management, clear medical insurance fund payment methods and settlement management system.
The Measures clearly state that the people's governments of counties (cities and districts) shall integrate county-level hospitals, township hospitals (including relevant primary health care institutions retained after the withdrawal and township) and community health service centers organized by the government within their jurisdictions to form county-level medical groups.
the people's governments of counties (cities and districts) should steadily promote the integration of rural medical and health care and gradually integrate village health rooms into the management of county-level medical groups.
encourage medical and health institutions organized by social forces to participate in medical service cooperation between county-level medical groups.
-level medical groups shall handle the registration of legal persons of public institutions in accordance with the law.
medical and health institutions managed by county-level medical groups shall retain their legal personality and original names.
unified management of the administrative, personnel, funds, performance, business, pharmaceutical and other medical and health institutions of the county-level medical groups and their affiliated medical and health institutions, and exercise management autonomy in accordance with the provisions.
Measures for establishing a regular growth mechanism for rural doctors' income and old-age retirement benefits clearly specify specific requirements for stabilizing and raising the income of rural doctors, and provide a mechanism guarantee for the issue of retirement village medical benefits.
The Measures clearly state that the income of rural doctors consists of subsidies for basic public health services, special subsidies for essential drugs, job subsidies and other medical and health services-related subsidies and medical income.
people's government shall formulate standards for post-subsidy for rural doctors and establish a regular increase mechanism for the income of rural doctors and the living allowance for doctors in old-age retirement villages.
county (city or district) people's government in the accounting of rural doctors' subsidy funds, where in accordance with the service population accounting subsidy funds, the service population of less than 800 people, in accordance with the 800 people subsidy standard approved and supplemented.
according to this provision, the income of rural doctors and the subsidy for old-age care are adjusted and upgraded dynamically according to the actual development situation, and the regular growth mechanism can better stimulate the enthusiasm of rural doctors.
The people's government of the county (city or district) where rural general medicine and above are qualified to participate in basic old-age insurance for employees shall support village health room staff who have obtained the qualifications of practicing assistant physicians (including rural general practitioners) and have signed contracts with county-level medical groups, and shall participate in basic old-age insurance for employees in accordance with the provisions.
people's governments at or above the county level shall gradually raise the standard of subsidies for rural doctors who have not signed contracts with county-level medical groups to participate in basic old-age insurance contributions for urban and rural residents.
measures to arrange the corresponding treatment guarantee according to the different qualifications of rural doctors, but also to promote the transformation of rural doctors to practice.
The Measures for Improving County Service Capacity through Talent Sharing, Specialist Alliances, Telemedicology, etc. make it clear that urban three-level hospitals should help county-level medical groups improve their medical service capabilities by forming medical associations, talent sharing, technical support, specialist alliances, telemedicology, and organizing training.
County-level medical groups shall formulate a catalogue of disease diagnosis and treatment at the county and township levels within county-level medical groups, improve the norms for outward referral within county-level medical groups and at the county level, establish a two-way referral platform, open a green channel for two-way referrals, and optimize the referral service process.
should enhance the capacity of comprehensive services such as medical services and public health services, and strengthen capacity-building in response to public health emergencies.
In accordance with the urban and rural disease spectrum of the county, we shall strengthen health education and early intervention in chronic diseases at the grass-roots level, carry out patriotic health campaigns to guide the masses to develop a healthy and civilized way of life, formulate guidelines for the prevention and control of common diseases and multiple morbidity, establish a three-level management system for rural areas in chronically ill counties, and provide continuous services for screening, diagnosis, referral and follow-up.
county-level medical groups should promote the construction of intelligent medical care, carry out telemedicinal services such as tele-specialist outpatient clinics, tele-expert consultations, tele-emergency consultations and teaching training, and carry out online services such as chronic disease management, family doctor contracting and health consultation.
Medical institutions, after deducting costs for personnel to reward county-level medical groups, shall, on the premise of ensuring the service capacity of township hospitals, implement unified management, use and deployment of personnel within the total amount of preparation, and the adjustment of personnel establishment shall be reported to the county (city or district) institution preparation department for the record.
people's governments at or above the county level shall establish and improve personnel systems and remuneration systems that are adapted to the characteristics of the medical and health industries.
health care institutions can use medical service income for personnel incentives after deducting costs and withdrawing funds in accordance with regulations.
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