In 5 years, there will be three major changes in public hospitals, involving every medical worker!

Medical Network News, June 10, June 7, the State Council Information Office held a regular briefing on the State Council’s policies and conducted a discussion on the "Opinions on Promoting the High-Quality Development of Public Hospitals" (hereinafter referred to as the "Opinions") released on the 4th.
Introduction
.

 

Realizing the "three transformations" is the goal of high-quality development of public hospitals

 

The "Opinions" clarified the overall requirements for promoting the high-quality development of public hospitals, that is, through five years of hard work, the development mode of public hospitals will shift from scale expansion to improvement of quality and efficiency, the operation mode will shift from extensive management to fine management, and resource allocation will shift from focusing on materials.
The factor shift pays more attention to human resources and technology factors, and provides strong support for better providing high-quality and efficient medical and health services, preventing and resolving major epidemics and sudden public health risks, and building a healthy China
.

 

In response to these "three changes", Li Bin, deputy director of the National Health Commission, said that after 40 years of reform and opening up, the construction of medical service systems, 20 years of hospital capacity building, and 10 years of deepening the reform of the medical and health system, public hospitals have come In the critical period of “quantity accumulation” turning to “quality improvement”, more attention should be paid to connotation development, technological development, capability level development, and service quality development to increase the “golden content” of development
.

 

The change of operation mode means that public hospitals should be good at using modern management concepts and management tools, management methods, and management techniques, and combine human-based management with system and standard -based evidence-based management; and use information technology to transform the hospital The basis of management is accurate to the department, to the diagnosis and treatment group, to each medical staff and key diseases, scientifically evaluate performance, and guide the hospital to return to its functional positioning
.

 

In addition, from the perspective of protecting and developing productivity, the focus of hospital resource allocation should be shifted from hardware construction to human resource development, starting with increasing salaries, expanding development space, and improving the working environment, so as to fully mobilize the enthusiasm and initiative of medical staff , Creativity; starting from solving major clinical difficult problems, promoting the output of new technologies, new products, new programs and new strategies for original disease prevention, diagnosis and treatment, and continuously promoting the advancement of medical technology
.

 

Mobilize the enthusiasm of medical staff in terms of salary and broadening of career development space

 

To achieve the high-quality development of public hospitals, it is necessary to establish and improve a new operating mechanism for the high-quality development of public hospitals, that is, to maintain public welfare, mobilize enthusiasm, and ensure sustainability
.
Among them, the majority of medical workers are the key
.

 

　　Xu Shuqiang, Director of the System Reform Department of the National Health Commission, mentioned the following four points in terms of protecting and giving full play to the enthusiasm, initiative and creativity of the majority of medical staff:

 

　　First, reasonably increase the salary level of medical staff
.
The characteristics of the medical industry are: long training period, high professional risk, high technical difficulty, heavy responsibility, and reasonable salary
.
Allow medical and health institutions to break through the current level of wage regulation in public institutions; allow medical service income to deduct costs and withdraw various funds as required to be mainly used for personnel rewards, establish a salary system that mainly reflects job responsibilities and knowledge value, and achieve job-based responsibility, The salary is determined by the post, the responsibilities and salary are real, and the assessment is fulfilled
.

 

　　Second, broaden the career development space of medical staff
.
Improve the medical staff training and training system, so that every medical staff has the opportunity to receive continuing education and vocational retraining, and accelerate the training of high-level compound medical talents
.
Reform and improve the talent evaluation mechanism, adhere to hierarchical and categorized evaluation, follow the characteristics of the medical industry and the law of talent growth, set reasonable evaluation standards, highlight moral ability and performance orientation, pay attention to clinical work quality indicators, explore the implementation of the achievement representative system, and eliminate the only papers, Only academic qualifications, only awards, only hats and other tendencies
.

 

　　Third, the medical staff to care for the physical and mental health
.
Establish a long-term mechanism to protect and care for medical personnel, improve the working environment and conditions, and implement a study, work, rest and paid vacation system
.
Encourage public hospitals to care for the growth of young medical staff by setting up youth learning funds and other methods
.
At the same time, strengthen the construction of the security team, improve the necessary security inspection facilities, bring the resolution of medical disputes into the track of the rule of law, improve the prevention and handling mechanisms of medical disputes, and severely crack down on medical crimes and violent medical crimes in accordance with the law
.

 

　　Fourth, improve the social status of medical staff
.
Establish a professional honor system for medical staff and create a good atmosphere in which the whole society respects doctors and protects health, so that the majority of medical staff can feel the pride of realizing value, the sense of accomplishment of contributing to the society, and the professional honor of being respected
.
At the same time, the majority of medical staff must abide by medical ethics and medical ethics, and win the trust and respect of patients and society with medical services full of humanistic care
.

 

　　In addition, regarding the establishment of a "sensitive and orderly" dynamic adjustment mechanism for medical service prices mentioned in the "Opinions", Huang Huabo, Director of the Medical Service Management Department of the National Medical Insurance Administration, stated that he is drafting a proposal on the "Deepening Medical Service Price Reform Pilot Program".
The implementation plan and the determination of pilot cities will further determine related paths and practices through pilots
.

 

　　 The phased results of the "dual center" construction are obvious, and 10 projects have been put into use in 8 provinces

 

　　The core content of the National Medical Center and Regional Medical Center is the expansion of high-quality medical resources and the balanced distribution of regions
.
To put it simply, it is to choose a number of national high-level hospitals as export hospitals from areas with relatively rich top quality medical resources such as Beijing, Shanghai, and Guangzhou, to provinces with very scarce quality medical resources, large populations, and relatively weak foundations.
Build branches such as branch hospitals or sub-centers
.

 

　　According to Sun Zhicheng, person in charge of the Social Development Department of the National Development and Reform Commission, the first batch of pilot projects selected Hebei, Liaoning, Shanxi, Fujian, Anhui, and Yunnan in accordance with the pilot program approved by the central government.
It has been completed and put into use successively, and has achieved obvious phased results:

 

　　First, the medical level of the region has been significantly improved in a short period of time
.
For example, Fudan Zhongshan Xiamen Hospital has more than 30 technologies to fill the medical gaps in the entire Fujian Province and Xiamen City; in the two years since the Yunnan Hospital of Beijing Fuwai Hospital was put into operation, the total number of operations for congenital heart disease has been in the southwest for two consecutive years.
Ranked first in the region, the mortality rate during hospitalization dropped from 5.
6% to 2.
6%
.

 

　　Second, the flow of medical treatment has been improved initially
.
Judging from the current monitoring data, the 10 pilot projects have played a significant role in retaining local and even surrounding patients
.
A regional medical center in Henan is the Zhengzhou Hospital of Beijing Children's Hospital
.
After opening, in 2020, outpatient visits to Beijing Children's Hospital in Henan Province dropped by 63.
1%, and hospitalization dropped by 51.
3%
.
After the Shanxi Hospital of Hua University of Science and Technology Tongji Hospital was put into operation, the patient transfer rate of this hospital dropped by 79.
3% year-on-year in 2020, and the number of departments with patient transfer dropped from 12 to 6
.

 

　　The third is to expand the brand influence
.
Exporting hospitals vigorously export brands, hospital culture, and hospital standards in accordance with homogenized management standards, and the attractiveness of the brand has also been actively released
.
For example, after the Fudan Zhongshan Xiamen Hospital launched the Fudan Zhongshan brand locally, it not only stabilized the local patients, but also produced obvious radiation effects on patients in the surrounding provinces such as Zhejiang, Anhui, Jiangxi and even Guangdong.
These places were transferred to The proportion of patients reached 40% of the total diagnosis and treatment volume
.

 

　　The fourth is to drive the input of medical resources
.
For each pilot project for the construction of a regional medical center, the National Development and Reform Commission has arranged an investment within the central budget to support its capacity improvement, which has also driven the local government where the project is located to invest in the regional medical center
.
In the first batch of 10 pilot projects, a total of 13,600 medical staff has been approved and a planned total of 15,200 beds, of which 6,300 are newly established and 6,500 are newly added
.

 

　　Fifth, the construction of the talent team has been accelerated
.
While absorbing the original teams of local hospitals, regional medical centers generally dispatch management teams, heads of major departments, and business backbones from exporting hospitals to the local area
.
At the same time, they also actively introduce talents in a variety of ways such as nationwide, social recruitment and entrusted training
.
The Huazhong Hospital of Fuwai Hospital has introduced 9 well-known experts such as Changjiang Scholars and 135 full-time medical technicians in Zhengzhou, and 5 of them are recommended candidates for the "Hundreds and Thousands" Talent Project and the State Council Special Allowance Experts
.
Fudan Zhongshan Xiamen Hospital, the backbone of the Zhongshan Hospital of Fudan University in the past, has been there for three years, with as many as 120 people, and more than 680 high-quality medical students are recruited from all over the country
.

 

　　Sixth, many explorations have been actively carried out
.
In accordance with the deployment of the work plan, we also use the regional medical center as a test field for the reform of the medical and health system
.
The Department of Physical Reform of the Health Commission has done a lot of work in this regard, including these hospitals into the reform pilot
.

 

　　It is reported that during the "14th Five-Year Plan" period, in accordance with the relevant arrangements of the State Council, the National Development and Reform Commission will further expand the scope of the pilot in two steps on the basis of the original eight pilot provinces
.
The first step is to include 12 central and western provinces with relatively scarce high-quality medical resources in the pilot scope in 2021; the second step is to cover the construction of regional medical centers in all provinces by the end of 2022, during the current government term Complete the nationwide planning and layout within
.

　　Medical Network News, June 10, June 7, the State Council Information Office held a regular briefing on the State Council’s policies and conducted a discussion on the "Opinions on Promoting the High-Quality Development of Public Hospitals" (hereinafter referred to as the "Opinions") released on the 4th.
Introduction
.

 

　　Realizing the "three transformations" is the goal of high-quality development of public hospitals

 

　　The "Opinions" clarified the overall requirements for promoting the high-quality development of public hospitals, that is, through five years of hard work, the development mode of public hospitals will shift from scale expansion to improvement of quality and efficiency, the operation mode will shift from extensive management to fine management, and resource allocation will shift from focusing on materials.
The factor shift pays more attention to human resources and technology factors, and provides strong support for better providing high-quality and efficient medical and health services, preventing and resolving major epidemics and sudden public health risks, and building a healthy China
.

 

　　In response to these "three changes", Li Bin, deputy director of the National Health Commission, said that after 40 years of reform and opening up, the construction of medical service systems, 20 years of hospital capacity building, and 10 years of deepening the reform of the medical and health system, public hospitals have come In the critical period of “quantity accumulation” turning to “quality improvement”, more attention should be paid to connotation development, technological development, capability level development, and service quality development to increase the “golden content” of development
.

 

　　The change of operation mode means that public hospitals should be good at using modern management concepts and management tools, management methods, and management techniques, and combine human-based management with system and standard -based evidence-based management; and use information technology to transform the hospital The basis of management is accurate to the department, to the diagnosis and treatment group, to each medical staff and key diseases, scientifically evaluate performance, and guide the hospital to return to its functional positioning
.

 

　　In addition, from the perspective of protecting and developing productivity, the focus of hospital resource allocation should be shifted from hardware construction to human resource development, starting with increasing salaries, expanding development space, and improving the working environment, so as to fully mobilize the enthusiasm and initiative of medical staff , Creativity; starting from solving major clinical difficult problems, promoting the output of new technologies, new products, new programs and new strategies for original disease prevention, diagnosis and treatment, and continuously promoting the advancement of medical technology
.

 

　　Mobilize the enthusiasm of medical staff in terms of salary and broadening of career development space

 

　　To achieve the high-quality development of public hospitals, it is necessary to establish and improve a new operating mechanism for the high-quality development of public hospitals, that is, to maintain public welfare, mobilize enthusiasm, and ensure sustainability
.
Among them, the majority of medical workers are the key
.

 

　　Xu Shuqiang, Director of the System Reform Department of the National Health Commission, mentioned the following four points in terms of protecting and giving full play to the enthusiasm, initiative and creativity of the majority of medical staff:

 

　　First, reasonably increase the salary level of medical staff
.
The characteristics of the medical industry are: long training period, high professional risk, high technical difficulty, heavy responsibility, and reasonable salary
.
Allow medical and health institutions to break through the current level of wage regulation in public institutions; allow medical service income to deduct costs and withdraw various funds as required to be mainly used for personnel rewards, establish a salary system that mainly reflects job responsibilities and knowledge value, and achieve job-based responsibility, The salary is determined by the post, the responsibilities and salary are real, and the assessment is fulfilled
.

 

　　Second, broaden the career development space of medical staff
.
Improve the medical staff training and training system, so that every medical staff has the opportunity to receive continuing education and vocational retraining, and accelerate the training of high-level compound medical talents
.
Reform and improve the talent evaluation mechanism, adhere to hierarchical and categorized evaluation, follow the characteristics of the medical industry and the law of talent growth, set reasonable evaluation standards, highlight moral ability and performance orientation, pay attention to clinical work quality indicators, explore the implementation of the achievement representative system, and eliminate the only papers, Only academic qualifications, only awards, only hats and other tendencies
.

 

　　Third, the medical staff to care for the physical and mental health
.
Establish a long-term mechanism to protect and care for medical personnel, improve the working environment and conditions, and implement a study, work, rest and paid vacation system
.
Encourage public hospitals to care for the growth of young medical staff by setting up youth learning funds and other methods
.
At the same time, strengthen the construction of the security team, improve the necessary security inspection facilities, bring the resolution of medical disputes into the track of the rule of law, improve the prevention and handling mechanisms of medical disputes, and severely crack down on medical crimes and violent medical crimes in accordance with the law
.

 

　　Fourth, improve the social status of medical staff
.
Establish a professional honor system for medical staff and create a good atmosphere in which the whole society respects doctors and protects health, so that the majority of medical staff can feel the pride of realizing value, the sense of accomplishment of contributing to the society, and the professional honor of being respected
.
At the same time, the majority of medical staff must abide by medical ethics and medical ethics, and win the trust and respect of patients and society with medical services full of humanistic care
.

 

　　In addition, regarding the establishment of a "sensitive and orderly" dynamic adjustment mechanism for medical service prices mentioned in the "Opinions", Huang Huabo, Director of the Medical Service Management Department of the National Medical Insurance Administration, stated that he is drafting a proposal on the "Deepening Medical Service Price Reform Pilot Program".
The implementation plan and the determination of pilot cities will further determine related paths and practices through pilots
.

 

　　 The phased results of the "dual center" construction are obvious, and 10 projects have been put into use in 8 provinces

 

　　The core content of the National Medical Center and Regional Medical Center is the expansion of high-quality medical resources and the balanced distribution of regions
.
To put it simply, it is to choose a number of national high-level hospitals as export hospitals from areas with relatively rich top quality medical resources such as Beijing, Shanghai, and Guangzhou, to provinces with very scarce quality medical resources, large populations, and relatively weak foundations.
Build branches such as branch hospitals or sub-centers
.

 

　　According to Sun Zhicheng, person in charge of the Social Development Department of the National Development and Reform Commission, the first batch of pilot projects selected Hebei, Liaoning, Shanxi, Fujian, Anhui, and Yunnan in accordance with the pilot program approved by the central government.
It has been completed and put into use successively, and has achieved obvious phased results:

 

　　First, the medical level of the region has been significantly improved in a short period of time
.
For example, Fudan Zhongshan Xiamen Hospital has more than 30 technologies to fill the medical gaps in the entire Fujian Province and Xiamen City; in the two years since the Yunnan Hospital of Beijing Fuwai Hospital was put into operation, the total number of operations for congenital heart disease has been in the southwest for two consecutive years.
Ranked first in the region, the mortality rate during hospitalization dropped from 5.
6% to 2.
6%
.

 

　　Second, the flow of medical treatment has been improved initially
.
Judging from the current monitoring data, the 10 pilot projects have played a significant role in retaining local and even surrounding patients
.
A regional medical center in Henan is the Zhengzhou Hospital of Beijing Children's Hospital
.
After opening, in 2020, outpatient visits to Beijing Children's Hospital in Henan Province dropped by 63.
1%, and hospitalization dropped by 51.
3%
.
After the Shanxi Hospital of Hua University of Science and Technology Tongji Hospital was put into operation, the patient transfer rate of this hospital dropped by 79.
3% year-on-year in 2020, and the number of departments with patient transfer dropped from 12 to 6
.

 

　　The third is to expand the brand influence
.
Exporting hospitals vigorously export brands, hospital culture, and hospital standards in accordance with homogenized management standards, and the attractiveness of the brand has also been actively released
.
For example, after the Fudan Zhongshan Xiamen Hospital launched the Fudan Zhongshan brand locally, it not only stabilized the local patients, but also produced obvious radiation effects on patients in the surrounding provinces such as Zhejiang, Anhui, Jiangxi and even Guangdong.
These places were transferred to The proportion of patients reached 40% of the total diagnosis and treatment volume
.

 

　　The fourth is to drive the input of medical resources
.
For each pilot project for the construction of a regional medical center, the National Development and Reform Commission has arranged an investment within the central budget to support its capacity improvement, which has also driven the local government where the project is located to invest in the regional medical center
.
In the first batch of 10 pilot projects, a total of 13,600 medical staff has been approved and a planned total of 15,200 beds, of which 6,300 are newly established and 6,500 are newly added
.

 

　　Fifth, the construction of the talent team has been accelerated
.
While absorbing the original teams of local hospitals, regional medical centers generally dispatch management teams, heads of major departments, and business backbones from exporting hospitals to the local area
.
At the same time, they also actively introduce talents in a variety of ways such as nationwide, social recruitment and entrusted training
.
The Huazhong Hospital of Fuwai Hospital has introduced 9 well-known experts such as Changjiang Scholars and 135 full-time medical technicians in Zhengzhou, and 5 of them are recommended candidates for the "Hundreds and Thousands" Talent Project and the State Council Special Allowance Experts
.
Fudan Zhongshan Xiamen Hospital, the backbone of the Zhongshan Hospital of Fudan University in the past, has been there for three years, with as many as 120 people, and more than 680 high-quality medical students are recruited from all over the country
.

 

　　Sixth, many explorations have been actively carried out
.
In accordance with the deployment of the work plan, we also use the regional medical center as a test field for the reform of the medical and health system
.
The Department of Physical Reform of the Health Commission has done a lot of work in this regard, including these hospitals into the reform pilot
.

 

　　It is reported that during the "14th Five-Year Plan" period, in accordance with the relevant arrangements of the State Council, the National Development and Reform Commission will further expand the scope of the pilot in two steps on the basis of the original eight pilot provinces
.
The first step is to include 12 central and western provinces with relatively scarce high-quality medical resources in the pilot scope in 2021; the second step is to cover the construction of regional medical centers in all provinces by the end of 2022, during the current government term Complete the nationwide planning and layout within
.