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All provinces, autonomous regions, municipalities directly under the Central Government and the Xinjiang Production and Construction Corps Joint Prevention and Control Mechanism (Leading Group and Headquarters) for Responding to the Novel Coronavirus Pneumonia Epidemic, and members of the State Council's Joint Prevention and Control Mechanism for Responding to the Novel Coronavirus Pneumonia Epidemic:
In accordance with the relevant requirements for further optimizing the implementation of the new crown pneumonia epidemic prevention and control measures, in order to do a good job in the health service of the new crown key population and protect the life safety and health of the people, the comprehensive group of the joint prevention and control mechanism of the State Council to respond to the new coronavirus pneumonia epidemic has studied and formulated the "New crown key population health service work plan"
.
It is now issued to you, please carefully implement
it in light of actual conditions.
The State Council responds to novel coronavirus pneumonia
Comprehensive Group of Joint Prevention and Control Mechanism for Epidemics
December 9, 2022
(Information disclosure form: active disclosure)
Work plan for health services for key populations of the new crown
According to the Notice on Carrying out the Health Survey of Key Groups of the New Crown (Guo Wei Mingdian [2022] No.
487) of the Comprehensive Group of the Joint Prevention and Control Mechanism of the State Council, the elderly (65 years old and above, the same below) with underlying diseases and their new crown virus vaccination status are investigated and registered
by category.
This plan
is now formulated for the health services of registered key populations.
1.
Clarify the principles for carrying out health services
Adhere to the principle of classification and grading, highlighting key points, and divide into three categories according to the situation of underlying diseases, new coronavirus vaccination, and post-infection risk degree: key groups (high risk), sub-key groups (medium risk), and general population (low risk), marked with red, yellow, and green respectively, with different colors and different service content
.
2.
Carry out categorical and grading services
(1) First-level services
.
1.
Serve the population
.
General population (low risk, green marked).
2.
Service Content
.
(1) Communities (villages) are responsible for mobilization and publicity, and guide those who have not completed booster immunization and meet the vaccination conditions after being evaluated by doctors to be vaccinated
as soon as possible.
(2) Give play to the role of neighborhood (township), community residents' (villager) committees and their public health committees, primary medical and health institutions, and family doctors, strengthen health education, advocate healthy lifestyles, and do a good job in personal health protection
.
(3) Provide consulting services
related to new coronary pneumonia.
Communities (villages) publicize the current new crown pneumonia prevention and control policies through small speakers, a letter, WeChat, SMS, APP, etc.
, and notify each key population family by the duty phone of primary medical and health institutions or the phone number of family doctors to assist in carrying out health education
.
(2) Secondary services
.
1.
Serve the population
.
Subkey population (intermediate-risk, yellow marked).
2.
Service Content
.
Secondary services are carried out in addition to primary services
.
(1) Asymptomatic or mildly symptomatic infected persons treated at home should take the initiative to report to the community (village), and contact the primary medical and health institutions in the jurisdiction, and the primary medical and health institutions will guide antigen testing, health monitoring, health consultation, medication guidance, etc
.
through the Internet, video, telephone, remote or offline methods in combination with actual conditions.
After assessment, provide wearable health monitoring equipment and finger clip pulse oximeter for infected people in need to carry out health monitoring, and refer as soon as possible if persistent high fever, dyspnea, finger oxygen saturation < 93
%.
Primary medical and health institutions follow up every 3 days, and the frequency of follow-up can be encrypted as needed until the end
of home treatment observation.
(2) Communities (villages) assist in the implementation of the management of home treatment of infected persons, provide guidance and assistance for medical treatment with regular medical needs, and assist in providing services
such as purchasing and delivering medicines.
(3) Tertiary services
.
1.
Serve the population
.
(1) Key populations (high risk, marked in red).
(2) Key groups
with urgent medical needs.
(3) Other groups of infants and pregnant women with emergency medical needs
.
2.
Service Content
.
Tertiary services are carried out in addition to secondary services
.
(1) The disabled elderly or elderly people with reduced mobility infection shall be admitted after evaluation by the expert team determined by the county (city, district) health department or the higher-level hospital
.
For those who can stay at home after assessment, under the guidance of higher-level hospitals, primary medical and health institutions provide necessary services
such as health consultation, health guidance, health monitoring, and antigen testing.
Where it is not suitable to stay at home after assessment, primary medical and health institutions shall guide and assist in
referral.
(2) Key groups (high-risk, red marked) infected people and people with urgent medical needs, community (village) and primary medical and health institutions to assist in referral, and emergency medical needs can also be treated through the emergency department
.
3.
Strengthen organizational safeguards
(1) Clarify the division of duties
.
Local joint prevention and control mechanisms take the lead and are implemented by relevant departments according to their duties
.
With the prefecture and city level as the unit, the health department determines designated (sub-fixed) medical institutions, sets up higher-level institutions and professional teams to provide technical support for primary medical and health institutions, guides medical and health institutions to provide health management and medical treatment for key groups according to the division of labor, and strengthens the training
of relevant institutions to carry out categorical and hierarchical services.
Civil affairs departments are responsible for guiding nursing homes, child welfare institutions and other key places to strengthen management, mobilizing communities (villages) to do a good job in managing key populations under the unified leadership of local epidemic prevention and control mechanisms, and guiding residents' (village) committees to cooperate with grassroots medical and health institutions to provide medicines, antigen tests, and contact higher-level hospitals around the elderly and other high-risk groups
.
Relevant departments should implement funding guarantees
for key population surveys, graded health services, and necessary equipment.
(2) Strengthen the reserve of
drugs and antigen testing kits in primary medical and health institutions.
All localities should strengthen supply security to ensure that grassroots medical and health institutions dynamically reserve traditional Chinese medicines, symptomatic treatment drugs such as antipyretics and cough suppressants, and antigen detection reagents according to 15-20% of the total population served in accordance with the list of traditional Chinese medicines recommended by the state and the province, and can increase
them in densely populated areas as appropriate.
County-level health departments should organize pharmacist teams to provide patients with medication guidance
such as contraindications, matches, and precautions for drug use.
(3) Improve the service level of
primary medical and health institutions.
The first is to strengthen the equipment allocation and upgrading of grassroots medical and health institutions
.
Accelerate the construction of fever clinics (outpatient clinics) in township health centers and community health service centers, and strive to increase the coverage rate to about
90% by the end of March 2023.
Complete equipment configuration, including oxygen therapy equipment, portable pulmonary function instruments, finger-clip pulse oximeters, wearable health monitoring equipment, etc.
; Upgrade the electronic health record information system, and encourage the provision of smart health stations
for densely populated communities or remote villages if possible.
The second is to effectively increase the manpower
of grassroots medical and health institutions.
To establish a system for doctors from relevant departments of urban secondary and tertiary hospitals to visit the grassroots level, the lead hospitals of the medical consortium (urban medical groups or county medical communities, the same below) should send doctors to the grassroots level
.
According to the increase in the population and service volume served, the staffing of primary medical and health institutions can be strengthened in a timely manner, and medical personnel retired in the past five years and health professional and technical personnel in other positions can be temporarily hired to enrich the primary medical and health institutions
.
Township health centers and community health service centers are allowed to hire personnel or entrust the task of non-medical and health services to them through third-party services
.
It is necessary to establish and improve the telemedicine service network, and extend the high-quality medical services of secondary and tertiary hospitals to the grassroots level through telemedicine
.
The third is to do the key population of family doctor contracting services
.
Accelerate the improvement of the coverage of contracted services for the elderly over 65 years old, achieve full coverage of contracted services for the elderly with underlying diseases, and do a good job in health management and health monitoring
in accordance with the principle of classification and grading.
Strengthen the contact between family doctors and contracted elderly people, and ensure that they or their families can contact family doctors
in a timely manner when they need medical treatment.
(4) Implement community (village) management responsibilities
for key populations.
Give full play to the positive role of grassroots governments and residents' (villagers' committees) and their public health committees, and assist in the daily publicity, education and service work
of key groups.
Establish a direct hotline between communities (villages) and medical institutions and pharmacies, and allocate or update medical vehicles in cities and townships in rural areas to guide and assist referrals
。
(5) Strengthen health
management efforts for key populations in rural areas.
All localities should strengthen guidance, support, and dispatch
for the health investigation and management of key populations in rural areas.
Designate designated (sub-fixed) medical institutions at the prefecture and city level, and clarify the process and path
of referral from township hospitals to designated medical institutions.
The county medical community leads hospitals to implement special personnel or special teams to provide necessary support
such as manpower, technology, and equipment to township health centers and village clinics in their jurisdictions to carry out services for key populations.
Villagers' committees and their public health committees coordinate and link with village clinics, mobilizing social organizations, social workers, volunteers, and social charity resources to assist key groups in their jurisdictions in purchasing and delivering medicines, and assisting in medical referrals; Guide villagers to improve their personal health awareness and do a good job in self-protection
.
(6) Strengthen the management
of nursing homes, child welfare establishments, and other key institutions.
All localities should guide nursing homes and child welfare establishments to formulate in-hospital categorical and hierarchical service plans with reference to this plan, establish coordination mechanisms with medical and health institutions and pharmacies in their jurisdictions, and clarify referral procedures
.
Medical personnel of nursing homes and child welfare establishments that have medical institutions or have established cooperative relationships with them provide categorical and hierarchical services
for key personnel.
Nursing homes and child welfare institutions should dynamically reserve traditional Chinese medicines, symptomatic treatment drugs such as antipyretic and cough suppressants, and antigen detection reagents
.
(7) Give play to the role of
medical alliances.
Actively give play to the role of the leading hospital of the medical community of the medical alliance, and strengthen the technical guidance
for the construction and operation of fever clinics (outpatient clinics) for its members.
Coordinate the deployment of personnel within the medical alliance, and assign professional forces to guide and support the daily diagnosis and treatment of
fever clinics (outpatient clinics) in primary medical and health institutions.
Smooth two-way referral channels, do a good job in connecting graded diagnosis and treatment, and lead hospitals should set up specialized treatment teams composed of respiratory, pediatric, intensive care, traditional Chinese medicine and other related departments to strengthen technical support, training, guidance and quality control
for grassroots units.
(8) Encourage the participation
of social forces.
Coordinate the efforts of all parties, encourage and guide social forces to participate in the guarantee of primary medical services, expand medical service resources, and meet the needs of the masses for medical and health services
.
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