Issued by the national health and Health Commission: by the end of the year, 100 pilot cities will start grid layout

On May 22, the national health and Health Commission issued a notice to carry out the pilot work of the construction of urban medical consortia, and issued the pilot work plan On the basis of provincial recommendation, the National Health Commission and the State Administration of traditional Chinese medicine will select and determine pilot cities The number of cities recommended to be divided into districts in each province shall not be less than 50% of the total number of cities; four municipalities directly under the central government, namely Beijing, Tianjin, Shanghai and Chongqing, may recommend urban areas to be included in the pilot program By the end of 2019, 100 pilot cities will start the grid layout and management of urban medical consortia in an all-round way, and each pilot city will have at least one medical consortia with obvious effect, initially forming a medical consortia management mode led by the city's tertiary hospitals and based on the basic medical institutions, with the participation of rehabilitation, nursing and other medical institutions By 2020, 100 pilot cities will have formed a grid layout of medical consortia and achieved remarkable results The ability of regional medical and health services has been significantly enhanced, and the efficiency of resource utilization has been significantly improved Medical consortia has become a community of services, responsibilities, interests and management, forming an orderly hierarchical diagnosis and treatment order The scope of the pilot city is clear The provincial health administration department, together with the provincial competent department of traditional Chinese medicine, comprehensively considers the city's medical needs, medical resource layout, local enthusiasm and other factors, and recommends the pilot city to the National Health Commission and the State Administration of traditional Chinese medicine The National Health Commission and the State Administration of traditional Chinese medicine select and determine pilot cities on the basis of provincial recommendation The three standard schemes of candidate cities specify the basic conditions of the candidate cities, and require the provincial health administrative departments and the competent departments of traditional Chinese medicine to select and recommend the candidate cities among the cities divided into districts according to the following requirements: the municipal Party committee and the municipal government attach great importance to it The municipal Party committee and the municipal government attach great importance to the development of health care and the construction of hierarchical diagnosis and treatment system, and establish a good coordination mechanism among departments, which can create a good policy environment for the grid construction of Urban Medical Association The city health work has a good foundation The scale of the city is suitable There are strong leading hospitals, rehabilitation, nursing and other medical institutions in the city The medical resources are relatively sufficient, the development is relatively balanced, the layout is relatively reasonable, and there is a geographical and resource base of "sub district and sub district" Have working basis According to the requirements of the notice on further key work related to the construction of hierarchical diagnosis and treatment system (gwyf [2018] No 28) issued by the State Health Commission and the State Administration of traditional Chinese medicine, the construction plan of the city's Medical Association was formulated, and the grid layout management of the city's Medical Association was started, which has the basis of pilot work The recommendation procedure of the pilot city is self-evaluation at the municipal level The municipal health administrative department and the competent department of traditional Chinese medicine conduct self-evaluation against the basic conditions of the candidate cities If the conditions are met, the candidate cities' recommendation materials (see Annex 2) shall be formed and reported to the provincial health administrative department and the administrative department of traditional Chinese medicine respectively Provincial recommendation The provincial health administrative department and the competent department of traditional Chinese medicine shall conduct the preliminary examination, fill in the recommendation form of candidate cities (Annex 3) according to the order of recommendation intention, and submit it to the national health and Health Commission The number of cities recommended to be divided into districts in each province shall not be less than 50% of the total number of cities; four municipalities directly under the central government, namely Beijing, Tianjin, Shanghai and Chongqing, may recommend urban areas to be included in the pilot program Determine the project unit The national health and Health Commission and the State Administration of traditional Chinese medicine shall, in accordance with the layout of medical resources, the needs of the masses for medical treatment and other factors, make overall planning in combination with the local will, determine the list of pilot cities and publish it to the society According to the work objective plan, by the end of 2019, 100 pilot cities will start the grid layout and management of urban medical consortia in an all-round way, and each pilot city will build at least one medical consortia with obvious results, initially forming a medical consortia management mode led by the city's three-level hospitals and based on the basic medical institutions, with the participation of rehabilitation, nursing and other medical institutions By 2020, 100 pilot cities will have formed a grid layout of medical consortia and achieved remarkable results The ability of regional medical and health services has been significantly enhanced, and the efficiency of resource utilization has been significantly improved Medical consortia has become a community of services, responsibilities, interests and management, forming an orderly hierarchical diagnosis and treatment order The grid of medical consortia should not be divided into several grids according to the geographical relationship, population distribution, medical needs of the masses, distribution of medical and health resources and other factors Integrate the medical and health resources in the grid, and establish a Medical Association led by a three-level public hospital or a hospital representing the medical level of the jurisdiction, with several other hospitals, community health service institutions, nursing homes, professional rehabilitation institutions as members Encourage public health institutions to participate The medical association is responsible for the health management, disease diagnosis and treatment, rehabilitation care and other work of the residents in the grid as a whole The head unit shall take overall responsibility In principle, the Medical Association grid should not cross the medical insurance co-ordination area We will encourage business collaboration among medical consortia Leading hospitals should actively attract medical institutions run by social forces to participate in medical consortia, and encourage medical institutions run by social forces to participate in medical consortia according to the principle of voluntariness On the basis of grid management of medical consortia, city level three public hospitals can establish medical consortia with county-level hospitals in the region through trusteeship and other forms to help improve the medical service ability and level of county-level hospitals Hospitals representing national, regional and provincial medical level mainly set up specialized alliance and telemedicine cooperation network, which can establish cooperation relationship with several medical consortiums across regions, form high-level medical consortiums with complementary advantages, and radiate and drive the improvement of medical service capacity and medical service homogeneity within and between regions We should encourage TCM hospitals to take the lead in establishing medical consortia and give full play to the important role of TCM in the prevention, treatment and rehabilitation of diseases We will actively support women and children's health care institutions at Prefecture and city levels as the leaders and county and district levels as the backbone to form a federation of women and children's specialist doctors To improve the six security mechanisms of urban medical consortia: 1 To implement the financial investment We will implement the responsibility of the government as the main body of running medical institutions, increase financial investment according to the needs of the construction and development of medical consortia, and continue to arrange financial investment funds for all medical and health institutions of the medical consortia in full according to the original channels in accordance with the "six investment" policy of public hospitals, the investment tilt policy of traditional Chinese medicine hospitals, the compensation policy of grass-roots medical and health institutions and the way of government investment We will encourage exploration and promotion of the reform of the compensation mechanism in primary medical and health institutions 2 Push forward the reform of medical insurance payment mode We should actively promote the reform of payment methods such as package payment of total medical insurance amount in the Medical Association as a unit, establish a reasonable sharing mechanism for surplus retention and over expenditure, and use the surplus medical income to carry out business work and improve the treatment of medical personnel, guide the Medical Association to standardize the diagnosis and treatment behavior, take the initiative to do a good job in health management and disease diagnosis and treatment, and improve the use performance of medical insurance fund We will improve the differentiated payment policies for different levels and categories of medical institutions In the same hospital referral within the Medical Association, the starting line shall be calculated continuously to guide the masses to seek medical treatment at the grass-roots level 3 Promote the reform of medical service price In accordance with the principle of total amount control, structural adjustment, rise and fall, and gradually in place, we will dynamically adjust the price of medical services, gradually straighten out the relationship between the price of medical services, gradually increase the proportion of technical labor income in medical services, and mobilize the enthusiasm of medical institutions and medical personnel We should do a good job in linking up with the policies of medical insurance payment, medical control fee and financial investment, so as to ensure the healthy operation of medical and health institutions, the affordability of medical insurance funds, and the non increase of the burden of the masses 4 Promote the reform of personnel compensation system We will promote the reform of the personnel system, and explore the overall use of the Medical Association within the total number of personnel We will implement the requirements of "two permits", establish a compensation system that meets the characteristics of the medical and health industry and the requirements of the development of medical consortia, and reasonably determine and dynamically improve the compensation level of medical personnel The medical staff's income is distributed independently by the Medical Association, and an internal distribution mechanism based on the post, with performance as the core, with more work, more pay, and excellent performance pay is established 5 Do a good job in the supply and guarantee management of drug consumables To establish a unified management platform for drug consumables within the Medical Association, with priority given to the allocation and use of essential drugs as the guide, to realize the connection of drug catalogue, the sharing of purchasing data, the free flow of prescriptions, and the integrated distribution and payment We will strengthen the leading hospital's guidance on the use of drugs in subordinate medical institutions, strengthen the management of drug supply and response to the monitoring of drug shortage, and gradually homogenize drug supply and pharmaceutical care 6 Strengthen comprehensive performance appraisal In accordance with the relevant requirements of the notice on printing and distributing the comprehensive performance appraisal work plan (Trial) (gwyf [2018] No 26), improve the comprehensive performance appraisal system of medical consortia, focus on the performance of responsibilities, function implementation, medical quality, completion of public health tasks, cost control, operation performance and public satisfaction and other assessment indicators, guided by public welfare , from single medical institution assessment to comprehensive performance assessment The assessment results are linked with financial subsidies, medical insurance reimbursement, total salary, etc In the internal assessment of the Medical Association, we should attach equal importance to both Chinese and Western medicine to ensure that the hospital of traditional Chinese medicine is assessed according to its characteristics and actual conditions.