Five departments issued the guiding opinions on the pilot project of promoting the development of clinics, which should be standardized and standardized

On May 13, the state health and Health Commission, the State Development and Reform Commission, the Ministry of finance, the Ministry of human resources and social security and the State Health Insurance Bureau formulated the opinions on the pilot project of promoting the development of clinics (hereinafter referred to as the opinions) To promote the healthy development of clinics is an important measure to deepen the reform of "management service" in the medical field and improve the medical service system It is of great significance to attract high-quality medical resources and meet the needs of people's multi-level diversified medical services The main work objective of the opinions is to comprehensively improve the standardization and standardization level of clinics, to play a greater role in providing common disease, frequently occurring diagnosis and treatment services and family doctor signing services for the grassroots level, to form more high-quality and high-level clinics, and to become an important supplement to the public medical service system Pilot arrangement: in 2019-2020, pilot work to promote the development of clinics will be carried out in 10 cities including Beijing, Shanghai, Shenyang, Nanjing, Hangzhou, Wuhan, Guangzhou, Shenzhen, Chengdu, Xi'an, etc according to the pilot experience, the construction and management policies of clinics will be improved and promoted nationwide The opinions put forward a series of innovative reform measures, including abolishing the restrictions on clinics set up by the planning of medical institutions, changing the examination and approval of clinic setting to the record system management; encouraging qualified doctors to open specialized or general practice clinics full-time or part-time; requiring clinics to establish an information system to record diagnosis and treatment information, and uploading diagnosis and treatment information to the medical service supervision information system, etc What is the background and opportunity for the launch of the opinions and how to interpret it? 1、 What is the background of the document? At present, there are nearly 220000 registered and operational clinics in China, with an average of more than 7000 clinics in each province The average number of practitioners is 2.6, including 1.4 doctors and 1.2 nurses The common diseases and frequently occurring diseases of internal medicine, Stomatology, internal medicine of traditional Chinese medicine, surgery of traditional Chinese medicine, orthopaedics and Gynecology account for more than 90% of the clinic business, and play an important role in the basic medical services But at the same time, the development of clinics is facing the main problems such as the shortage of human resources, the low capacity of medical services, and the difficulties in industry supervision To further clarify the role and function of the clinic and give full play to the important role of the clinic in the medical service system is an important content of adhering to the people-centered development concept, implementing the healthy China strategy and promoting the high-quality development of medical and health services It is important to improve the overall efficiency of medical services and meet the multi-level and diversified medical service needs of the people The meaning of the need Therefore, we need to further improve policies and measures to promote the healthy development of clinics What are the main contents of the document? The opinion is divided into five parts: the first part: General requirements The guiding ideology and work objectives for promoting the development of clinics are defined It is planned to use 2 years to carry out the pilot work of clinic construction in 10 cities including Beijing, Shenyang, Shanghai, Nanjing, Hangzhou, Wuhan, Guangzhou, Shenzhen, Chengdu and Xi'an, and improve the clinic construction and management policies according to the pilot experience The second part: optimize the licensing policy of clinic Simplify the access procedures of clinics, remove the restrictions on setting up clinics in the planning, and change the practice license of clinics to the record system management Revise the basic standards of the clinic, and adjust the key audit equipment, facilities and other hardware to audit the qualification and ability of doctors At the same time, doctors who have been practicing in medical institutions for more than 5 years and have obtained the qualification of intermediate or above titles are encouraged to open specialized clinics full-time or part-time The third part: improve the quality of medical services in clinics We should encourage the integration of clinics into the construction of medical consortia, support the large-scale and group development of clinics, and form a standardized management and service model The government is encouraged to include qualified clinics in the scope of medical institutions that can provide contracted services for family doctors by purchasing services We should encourage clinics to provide basic medical and health services, implement the same subsidy policy as the government's primary medical and health institutions in terms of personnel training for clinics providing basic medical and health services, and give appropriate support to the places where conditions permit for their development and construction expenditures such as infrastructure and equipment purchase for basic medical and health services To provide a good career development environment for doctors working full-time in clinics, and further improve the price, medical insurance and other relevant policies conducive to the development of clinics The fourth part: strengthen industry supervision Innovation of regulatory means, especially for clinics to carry out information-based regulatory requirements At the same time, the clinic is required to establish an electronic medical record system, standardize the writing and management of medical documents, and ensure the medical quality and safety of the clinic Emphasis should be placed on strengthening the management of clinical doctors The fifth part: guarantee the organization and implementation Clarify the division of labor of departments, put forward requirements from two aspects: strengthening organizational leadership and doing a good job in evaluation and summary, so as to provide support and guarantee for the solid promotion of the pilot work 3、 What innovative reform measures does the document have? First, simplify access procedures Remove the restrictions on clinics in the planning of setting up medical institutions, change the examination and approval of setting up clinics to the record system management, and report to the county (District) level administrative department of health and health where the clinics are held for the record, and carry out the practice activities after issuing the "practice license of medical institutions" The chain and group clinics operated across administrative regions shall be put on record by the health administration department at the next higher level, and those operated across provincial administrative regions shall be put on record by the health administration department of the province where they are located Second, adjust the setting standard It is emphasized that the functional orientation of the clinic is to provide residents with common and frequently occurring diagnosis and treatment services and family doctor signing services, and to ensure the service capacity and quality safety of the clinic is the foundation and premise of the clinic setting Therefore, the audit of clinic setting should be adjusted from the previous hardware such as key audit equipment and facilities to focus on the audit of doctors' qualification and ability Doctors who practice in clinics (excluding traditional Chinese medicine clinics) are required to obtain intermediate and above professional titles Third, stimulate the vitality of the stock Qualified doctors are encouraged to open specialist or general practice full-time or part-time We will encourage different specialists to set up partnership doctor groups of appropriate scale and hold joint specialist clinics We will encourage social forces to run chain and group clinics We will encourage clinics to be included in medical consortia, establish cooperative relationships with member units of medical consortia, independent medical testing centers, medical imaging centers, disinfection supply centers, pathology centers and other institutions, and share medical resources Fourth, innovation in regulatory means The clinic is required to establish an information system to record the diagnosis and treatment information, and upload the diagnosis and treatment information to the medical service supervision information system We will integrate the clinic into the local medical quality control system, rely on the information supervision platform, strengthen the supervision of clinic operation and medical service, realize real-time supervision, and ensure medical quality and safety The pilot cities are encouraged to include the opening status of clinics as the personal integrity record of the main person in charge of clinics into the personal integrity system, and establish a long-term mechanism of joint punishment 4、 What are the specific measures to promote the implementation in the next step? One is to promote the formation of working forces We will promote the reform and development of clinics as an important part of deepening the reform of "management services", deepening the reform of medical care and developing social medical services, strengthen communication and cooperation between departments, and improve supporting policies and measures According to the opinion, by the end of June 2019, the provincial health administrative departments in the places where the pilot cities are located should work together with the development and reform, finance, human resources, social security and medical insurance departments The specific implementation plan will be issued By the end of September 2019, the pilot cities will start the pilot work Second, do a good job in evaluation, summary and promotion Timely assess the pilot situation, strengthen work guidance, supervision and evaluation, timely promote the advanced experience of the pilot area, and summarize and issue policies and measures to promote the development of clinics nationwide This article is reprinted by yaozhi.com The copyright belongs to the original author The purpose of reprint is to transmit more information, which does not represent the view of this platform If the content of the work, copyright and other issues are involved, please contact our website message, we will delete the content in the first time.