[Policy Interpretation] The State Council issued a document: Public hospitals will face great changes!

The much-anticipated "Opinions on Promoting the High-quality Development of Public Hospitals" (hereinafter referred to as "Opinions") has finally come out!

The much-anticipated "Opinions on Promoting the High-quality Development of Public Hospitals" (hereinafter referred to as "Opinions") has finally come out!

On June 4, the General Office of the State Council issued the "Opinions", which clarified the goals, directions, and measures for the high-quality development of public hospitals, which is the fundamental follow for the reform and development of public hospitals in the new stage
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Official website screenshot

In fact, as early as February 19 this year, the "Opinions" were deliberated and approved at the 18th meeting of the Central Committee for Comprehensively Deepening Reform
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This official release is undoubtedly a major signal in the process of promoting the high-quality development of public hospitals

The "medical community" checked the "Opinions" and found that the document focused on six major tasks for the high-quality development of public hospitals, namely: building a new system for the high-quality development of public hospitals, leading new trends in the high-quality development of public hospitals, and improving public hospitals.
Hospitals develop high-quality new efficiency, activate new impetus for high-quality development of public hospitals, build a new culture of high-quality development of public hospitals, and uphold and strengthen the Party's overall leadership over public hospitals
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The following is the author's summary of relevant key policy deployments.
There are 15 points in total, and each point is very important
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01 Reasonably formulate and implement staffing standards for public hospitals, and establish a dynamic increase mechanism
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Implement the autonomy of employment in public hospitals, and make overall consideration of the treatment of internal and external personnel in the establishment

02 Implement the requirement of “allowing medical and health institutions to break through the current wage control level of public institutions, allowing medical service income to deduct costs and withdraw various funds in accordance with regulations to be mainly used for personnel rewards”, reasonably determine and dynamically adjust the salary level of public hospitals; Within the total salary, public hospitals can adopt a variety of methods to allocate independently, and can independently set up salary projects that reflect the characteristics of the medical industry, labor characteristics and job value, and encourage the implementation of an annual salary system for the main persons in charge
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03 Highlight the performance orientation of moral ability, increase the number and quality of clinical work, explore the implementation of a representative work system, and dilute the number of papers
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We will steadily delegate the authority to review professional titles, and explore pilots of tertiary public hospitals with reasonable job settings, complete personnel management, and willingness to conduct independent reviews to independently conduct senior professional title reviews

04 Establish a sensitive and orderly price dynamic adjustment mechanism, carry out regular price adjustment assessments, and adjust the price of medical services in a stable and orderly manner if the starting conditions are met, straighten out the price comparison relationship, support public hospitals to optimize the income structure, and increase the income of medical services (excluding drugs, The proportion of consumables, inspection, and laboratory income) in medical income
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Speed ​​up the review of new medical service price items

05 Establish a standard system for disease combination by using big data methods to form quantitative treatment standards, drug standards, and consumables standards for each disease group in terms of disease severity and resource consumption.
Perform monitoring and evaluation of performance, etc.
, guide the hospital to return to its functional orientation, improve efficiency, save costs, and reduce the burden on patients for medical treatment
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06 Based on the hospital's strategic development plan and annual plan goals, implement full-caliber, full-process, full-staff, and full-scale budget management, which runs through budget preparation, approval, execution, monitoring, adjustment, final accounts, analysis, and assessment.
Implement budget performance management in terms of quantity, quality, effectiveness, cost, benefit, etc.
, and regularly disclose hospital-related financial information, and actively accept social supervision
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07 Comprehensively carry out performance appraisal of public hospitals, continue to optimize the performance appraisal index system, and focus on assessing medical quality, operational efficiency, sustainable development, and satisfaction evaluation
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Reform the internal performance evaluation methods of public hospitals, based on the employment contract, focusing on the completion of job responsibilities, and linking the results of the evaluation with the salary distribution

08 To meet the clinical needs of major diseases to build clinical specialties, focusing on the development of clinical specialties such as critical illness, tumor, cardiovascular and cerebrovascular, respiratory, digestion, infection, pediatrics, anesthesia, imaging, pathology, laboratory, etc.

09 Promote the output of new technologies, new products, new solutions and new strategies for original disease prevention, diagnosis and treatment; strengthen scientific research to support the response to major epidemics and public health emergencies; promote the transformation of scientific and technological achievements, with the main benefits It is used to reward people who have made important contributions; improve the service invention system; accelerate the development of commercial health insurance, and promote the introduction of new medical technologies into clinical use

10 Promote the multidisciplinary diagnosis and treatment model; vigorously promote day surgery and increase the proportion of day surgery in elective surgery; carry out continued nursing services; open rational medication consultation or medication management outpatient clinics, and carry out precision medication services; vigorously promote the pre-hospital medical emergency network Construction and innovation of emergency and first-aid service models

11 Promote the in-depth integration of new-generation information technologies such as cloud computing, big data, Internet of Things, blockchain, and fifth-generation mobile communications (5G) with medical services; promote the construction of smart hospitals with the “trinity” of electronic medical records, smart services, and smart management And hospital information standardization construction; vigorously develop telemedicine and Internet diagnosis and treatment; promote the development and application of intelligent medical equipment such as surgical robots and intelligent auxiliary diagnosis and treatment systems; establish a drug traceability system, and explore the interconnection of public hospital prescription information and drug retail consumption information

12 According to grid layout management, the establishment of a close-knit group led by tertiary public hospitals or hospitals representing the medical level of the jurisdiction (including social hospitals and traditional Chinese medicine hospitals), and several other hospitals, primary medical and health institutions, and public health institutions as members An urban medical group that is responsible for integrated and continuous medical services such as prevention, treatment, rehabilitation, and health promotion of residents in the grid

13 Actively develop a compact county-level medical community led by county-level hospitals; improve the prevention and treatment capabilities of tumors, cardiovascular, cerebrovascular, respiratory, digestive, and infectious diseases, and increase the treatment rate of county-level hospitals; strengthen urban tertiary hospitals to county-level hospitals Corresponding assistance will gradually enable county-level public hospitals to reach the second-class level

14 Accelerate the establishment and construction of national medical centers, regional medical centers, provincial-level medical centers, and provincial-level regional medical centers in professional categories such as infectious diseases, trauma, and major public health events; On this basis, appropriate construction and development of multiple hospital areas, and rapid conversion of functions in the event of a major epidemic
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15 Each prefecture and city chooses a general hospital to improve the ability to treat infectious diseases, and improve the infrastructure and equipment of the existing independent infectious disease hospitals; rely on a county-level hospital in the county to strengthen the infectious disease department and be relatively independent The construction of infectious disease wards
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In addition, the "Opinions" also pointed out that the National Health Commission, in conjunction with the State Administration of Traditional Chinese Medicine, will establish an evaluation index system for the high-quality development of public hospitals, which is organically integrated with the performance evaluation of public hospitals; local governments shall implement high-quality development of public hospitals in their jurisdictions in accordance with the territorial principle.
Evaluation, fully consider the actual situation of various types of public hospitals at all levels, do not engage in "one size fits all" and so on
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After sorting out this document, I can't help thinking of what Fu Wei, director of the National Health Development Research Center of the National Health Commission, said before: To achieve high-quality development of public hospitals, we must consider not only from the level of individual institutions, but also from the level of system architecture; And the new system of high-quality development of public hospitals changes not only the hospital’s development concepts, models, and mechanisms, but also requires the government to innovate regional health governance models, expand hospital management autonomy, reform personnel management systems, innovate salary distribution systems, and standardize hospitals financial economic management
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This document can be described as dense and demanding.
It has pointed out the direction and path for the high-quality development of public hospitals.
Although there is still a long distance between the issuance of the document and the final landing, one thing can be confirmed:

All public hospitals and medical workers will enter a new stage of development
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