Development and Reform Commission and other departments printed and distributed the pilot work plan for the construction of Regional Medical Center

Recently, the national development and Reform Commission issued a notice on printing and distributing the pilot work plan for the construction of regional medical centers The following is the full text of the notice: FGS [2019] No 1670 People's governments of all provinces, autonomous regions and municipalities directly under the central government, ministries and commissions under the State Council, and organizations directly under the State Council: In order to implement the decision-making and deployment of the Party Central Committee and the State Council, implement the health China strategy in depth, promote the supply side structural reform in the field of health care, focus on solving the problem of difficult medical treatment for the masses, and promote the construction of regional medical centers, with the consent of the State Council, the "pilot work plan for the construction of regional medical centers" is hereby printed and distributed to you, please earnestly implement it National Development and Reform Commission National Health and Health Commission State Administration of traditional Chinese Medicine Secretariat of leading group of medical reform of the State Council October 23, 2019 The following is the full text of the scheme: In accordance with the work plan of the Party Central Committee and the State Council, this work plan is hereby formulated to further implement the health China strategy, promote the supply side structural reform in the field of health care, focus on solving the problem of difficult medical treatment for the masses, and promote the pilot construction of regional medical centers （1） Overall thinking Guided by Xi Jinping's socialist ideology with Chinese characteristics in the new era, we carried out the spirit of the nineteen and third Plenary Session of the nineteen and the Third Plenary Session of the party in China We adhered to the people's health as the center, mainly relying on the National Medical Center, giving full play to the national clinical medical research center, and selecting some high-quality medical institutions in the areas of Beijing, Shanghai and other medical resources rich areas Central and branch offices, promote the practice of doctors, and build a regional medical center in the areas where patients outflow and medical resources are relatively weak We should make full use of advanced technologies such as "Internet plus medical health", artificial intelligence and big data to promote the development of high-quality medical resources collectivization and branding, and better meet the needs of medical services for the masses （2） Expected objectives Through 3 to 5 years of efforts, we have built a number of high level clinical diagnosis and treatment centers, high-level personnel training bases and a high level of scientific research innovation and transformation platform in the shortage of high-quality medical resources, and nurture a group of medical groups with obvious brand advantages and high level services across regions Internet plus medical health cooperation platform based on high level hospitals has been built A group of specialized alliances with regional medical centers as the core, 2 the gap between the treatment level of key diseases in relevant regions and Beijing, Shanghai and other places has been significantly reduced, and the number of cross province and cross regional medical treatment has been significantly reduced, and breakthroughs have been made in promoting the construction of hierarchical diagnosis and treatment system （3） Basic principles First, adhere to the problem and goal orientation Focus on key diseases and weak areas, strengthen overall planning, pertinently make up for weaknesses, strengths and weaknesses, improve quality, accelerate the formation of "highland" of regional medical services, and minimize medical treatment in different places Second, priority should be given to the integration of existing resources We will encourage the pilot areas to select existing medical institutions with certain foundation and introduce high-level hospitals to carry out cooperation, make full use of existing facilities, equipment and talent teams, and expand the country's top quality medical resources Third, ensure the implementation of public welfare responsibility Regional medical centers should fully fulfill the public welfare responsibility of basic medical services Pilot areas should adhere to the public welfare nature of medical and health undertakings, implement the responsibility of the government to run medical services, and encourage social forces to run non-profit medical institutions Fourth, coordinate and promote the three medical linkage Give the regional medical center more flexible policies in terms of price, medication, talents, etc., explore the way and experience for establishing a modern hospital management system that can mobilize enthusiasm and ensure sustainability Fifth, resolutely and effectively prevent risks Scientific project planning and layout should be done well to avoid blind and disorderly expansion, and efforts should be made to achieve "three no's", that is, hospitals do not invest, governments do not increase the risk of debt, and patients do not increase the burden During the pilot period, in principle, no more than three regional medical centers will be built in each pilot province The construction and reform of Regional Medical Center has wide influence and high social attention According to the working idea of "selecting hospitals according to key diseases, selecting regions according to needs, hospital local cooperation and provincial and ministerial co construction", pilot construction is carried out first, and experience is constantly summarized and improved in the pilot （1） Key diseases Six specialties, including oncology, neurology, cardiovascular, pediatrics, respiratory and trauma departments, were constructed （2） Pilot area In consideration of the shortage of high-quality medical resources in the region, the lack of central level hospitals or domestic first-class hospitals that have reached the level of "national team", the large population base, the large number of hospitals transferred abroad, the superior geographical location, convenient transportation, and in line with the national strategic development needs, the pilot construction has been carried out in eight provinces and regions of Hebei, Shanxi, Liaoning, Anhui, Fujian, Henan, Yunnan and Xinjiang （3） Output hospital In principle, the output hospitals included in the pilot scope of regional medical centers should have leading medical technology level and high domestic popularity; have rich talent reserve, and will not dilute technical force due to the construction of regional medical centers; have outstanding clinical teaching ability and strong scientific research ability, and be able to train technical backbone and discipline leaders for the region, and undertake national level departments Research projects The 30 Pilot Export hospitals are mainly selected from Beijing and Shanghai, and a small number from Wuhan, Changsha, Guangzhou, Chengdu and Xi'an Except for some municipal hospitals in Beijing and Shanghai, the rest are all under the management of the National Health Commission, the State Administration of traditional Chinese medicine and the Ministry of education At the same time, actively reserve a number of high-level social medical institutions as follow-up pilots to ensure their fair participation （4） Construction mode The first principle is to ensure the public welfare of basic medical and health services, mainly relying on the existing local medical resources to carry out the construction According to the nature and characteristics of the output hospital, the local government can select appropriate construction and operation mode, effectively enhance the capacity of sustainable development, and strive to ensure the public welfare, risk prevention, high quality and development 1 The mode of public hospital mainly based on government investment, that is, the output hospital and the pilot area government cooperate to establish independent medical institutions and undertake the responsibilities of regional medical centers Construction funds are mainly raised by local governments, and investment within the central budget is arranged according to the situation The first batch of pilots all adopt this mode 2 The mode of social medical service mainly based on purchasing services, i.e the output Hospital of social medical service with corresponding technical strength, rich medical experience and good employment record, directly set up branches in the pilot area to realize the development of collectivization and branding, and the central budget investment will give appropriate subsidies to the construction of non-profit medical institutions The regional medical center will be included in the national pilot to establish and improve the modern hospital management system, increase policy support, strive to make breakthroughs and innovations in key links, and give full play to the leading role of demonstration （1） We will promote reform of the management system The regional medical center implements the president responsibility system under the leadership of the Party committee, and establishes and improves the decision-making mechanism of the hospital Party committee and the president's office meeting To explore the establishment of a medical group Council, and straighten out the relationship between the output hospital and the main body of running the hospital, pilot areas, social forces and other aspects Formulate hospital regulations, improve management system, strengthen performance appraisal, promote regional medical centers to change from scale expansion type to quality and efficiency type in development mode, improve the development quality of institutions; change from extensive management to fine management in management mode, improve service level and efficiency; change from focusing on facility construction to focusing on connotation development in investment direction, and promote the realization of modern level Integration of service, management informatization and mode collectivization （2） We will deepen reform of the personnel compensation system Allow regional medical centers to explore management measures and distribution policies in line with their own operation mode We will establish a dynamic adjustment mechanism for staffing, verify the number of Posts reasonably, and explore the delegation of the right to evaluate senior professional titles to regional medical centers Support regional medical centers to independently recruit and determine personnel structure according to national regulations and in combination with their own development needs, and implement the autonomy of personnel employment, so as to realize the ability of personnel to enter, work out and be able to go up and down We will implement the requirements of "two permits" and reasonably verify the salary level of regional medical centers The Regional Medical Center shall be fully granted with the right of distribution autonomy, and the salary level of medical personnel shall be determined according to the salary factors such as education years, working hours, knowledge and skill level, difficulty and complexity The salary structure mainly reflecting the post value shall be gradually established, the performance salary ratio shall be reduced, the expectation of medical personnel shall be stabilized, long-term incentive shall be emphasized, and the post salary system can be implemented if conditions permit Target annual salary system, agreement salary system and other ways The study explored that the standardized training certificate of resident doctors should be regarded as the master's degree certificate, and be treated equally in terms of enrollment, promotion, post employment and salary Establish a multi-channel funding guarantee and salary incentive mechanism to allow qualified regional medical center medical staff to obtain reasonable salary through multi-point practice and clinic operation on the premise of completing their post tasks （3） Improve the hospital compensation mechanism To explore the compensation mechanism that is in line with the functional orientation of regional medical centers, is conducive to mobilizing the enthusiasm of cost reduction and efficiency increase, and promotes the equalization of medical resources among regions We will fully implement the government's investment policy in regional medical centers, increase investment in the development of key disciplines and personnel training, and establish a fund guarantee mechanism for participating in the reform and payment of endowment insurance in institutions In accordance with the requirements of "total amount control, structural adjustment, rise and fall", reasonably formulate and dynamically adjust the price of medical services Implement the medical insurance policy that adapts to the development law of regional medical centers We will actively promote the reform of payment methods for medical insurance, and give priority to the reform of payment methods in regional medical centers, such as by disease and by disease diagnosis Establish negotiation and consultation mechanism between regional medical centers and medical insurance agencies, reasonably determine and dynamically adjust the total budget indicators of medical insurance funds and payment standards according to diseases （4） Encourage the use of innovative drugs and technologies We will give the regional medical centers necessary policies on the application of new technologies, encourage the development of clinical trials of innovative drugs and medical devices, and gradually expand the use of medical devices that are undergoing clinical trials and are used to treat serious life-threatening products that have not yet been approved for registration in China Regional medical centers are encouraged to give full play to the advantages of key departments, apply for temporary import according to law for a small number of clinically urgent drugs that need to be used in the region and have not yet been registered in China, and the state drug regulatory department will speed up the examination and approval Export hospitals and regional medical centers shall carry out or participate in the purchase of high-value medical consumables according to the relevant national and local requirements, so as to reduce the false high price （5） Improve the ability of sustainable development Support regional medical centers to carry out scientific and technological innovation and achievement transformation, and the income obtained is mainly used for personnel reward, which is included in the total salary of the unit in the current year, but not limited by the total amount, not included in the total amount base Encourage the construction of colleges and universities with regional medical centers as the core and relying on "double first-class", plan and arrange a certain number of medical colleges and scientific research institutions, promote the integrated development of medical education, research and production, and cultivate the backbone of medical technology in the region Support regional medical centers to launch "Internet plus medical health" service, formulate remote medical 7 treatment service price and medical insurance policy, and establish