The era of dean is coming: more than 8000 county hospitals will face transformation

Source: economic observation network / Wen Wei 2015-4-7 "now we are also looking for the right subject matter." Guo Yue, President of Shanghai Renji Medical Group, said they would be more involved in the county-level medical field Perhaps, there are many capital people who have the same idea with Guo Yue When the pattern of county-level public medical market began to change dramatically, Guo Yue and others' idea was also realized quickly At present, this rapid change pattern has been opened On March 30, the State Council issued the outline of the national health service system plan (2015-2020), which was called the "slimming" guide for public hospitals by the medical community The plan proposes that, in principle, a county-level comprehensive hospital and a hospital of traditional Chinese medicine should be set up at the county level By 2013, there were 116 county hospitals in China If two public hospitals are reserved in each county, more than 8000 county-level hospitals will face the transformation of attributes and levels In the future, whether social capital enters county-level hospitals or county-level hospitals turn into community health service centers, the basic medical market pattern will be reconstructed "The county-level medical reform, especially the improvement of the service capacity of county-level hospitals, is the key to the final success of hierarchical diagnosis and treatment." From March 28 to 29, Zhuang Yiqiang, Deputy Secretary General of China Hospital Association, told the economic observer at the 2015 China hospital competitiveness forum hosted by alibi, Hong Kong From the perspective of medical reform, if we want to successfully solve the problem that it is no longer difficult and expensive for patients to get medical treatment, it is a good measure to divide patients into medical institutions at or below the county level When this pattern is re purchased, the operation mechanism and the overall effect of medical services will be improved At present, it is the best time for social capital to enter county-level hospitals Capital space this "national health service system planning outline (2015-2020)" has made a lot of attribute guidance adjustments for county-level public hospitals, and is also known as the "slimming" guide for public hospitals by the medical community In this "slimming" guide, for the first time, the number and scale of the construction of all kinds of public medical institutions at all levels are specified In principle, only one county-level general hospital and one hospital of traditional Chinese medicine should be set up According to relevant data, as of 2013, there are 1735 counties and 116 county-level hospitals in China Based on the number of these three dimensions, by 2020, only 3470 county-level hospitals will be retained in China, and the attributes of the remaining 8130 county-level hospitals will change Specifically, in the more than 8000 county-level hospitals, some county-level hospitals will welcome the entry of social capital, and some will be transformed into community health service centers The "slimming" guide also points out that one community health service center will be set up in each sub district office or in every 30000 to 100000 households By the end of 2014, there were 34000 community health service centers in the country's primary medical and health institutions According to the health and Family Planning Commission, thousands more need to be added if the goal is achieved In addition, the "slimming" guide also stipulates that by 2020, the number of beds per thousand people in China should reach 6, and that planning space should be reserved for social hospitals according to no less than 1.5 beds per thousand permanent residents It is understood that this is also the first time in China to put forward quantitative indicators for the development of the size of beds in medical institutions According to the health and Family Planning Commission, this goal meets the growing demand of the people for health services and the new situation of economic and social development With regard to the source of this indicator, the health and Family Planning Commission drew lessons from the number of beds per thousand when the per capita GDP of 29 OECD countries is equivalent to the level of China in 2020, and then comprehensively considered the factors of China's total population, aging, urbanization, etc., combined with the historical change trend of the number of beds in China Bed is the core resource element of the medical and health service system It is the main universal indicator to measure the health resources and service capacity among countries in the world In fact, it is also the most difficult point to make a plan "In March 2009, when the central government issued the guiding opinions on deepening the reform of the medical and health system, it pointed out that further improving the medical service system and adhering to the principle of public medical institutions as the leading and non-public medical institutions developing together, but the specific number and how to do should be determined by the detailed implementation rules." Zhuang Yiqiang said According to the "slimming" guide, China's population is expected to exceed 1.4 billion by 2020 In 2012, the Chinese urban development report released by the Academy of Social Sciences showed that the urban population in that year reached 691 million, so it is estimated that by 2020, the number of beds needed for grassroots social capital investment will be close to 1.04 million If the current average number of private hospitals is 800 to 1000 beds, this space will correspond to nearly 1500 hospitals with social capital attributes "And perhaps the reality of social capital participation will be more than that, and there may be about 3000." According to Zhuang Yiqiang, the "slimming" guide also refers to encouraging public hospitals and social forces to jointly organize new non-profit medical institutions in the form of joint venture and cooperation The setting of individual clinics is not limited by the planning layout, so there will be a certain number of clinics In fact, there will be a broad space for villages and towns in the future For example, if one village clinic is set up in each administrative village and one standardized township hospital is run in each township, by 2020, there will be an increase of 43000 village clinics and 4600 township hospitals Hierarchical diagnosis and treatment "it is a high probability event that the county retains two medical institutions." On the day before the State Council issued the "slimming" guide for public hospitals, Guo Yue told the economic observer that the county-level medical market would be a big market for capital to enter during the gap between the 2015 hospital competitiveness forum held by alibi And his Shanghai Renji Medical Group will also work in this field In fact, for capital, this should be a feast for policy prying The capital side has been waiting for a long time In 2013, some people close to the health and Family Planning Commission said that in order to prevent 90% of patients from leaving the county seriously ill, the reform level is intended to significantly promote the transformation of county-level public hospitals Later, the medical reform officials in some regions revealed that they were discussing and planning to promote the reform of social capital for public hospitals at the county level and other than women's and children's hospitals Starting from the medical system itself, in order to achieve 90% of the patients with serious diseases do not go out of the county, to achieve hierarchical diagnosis and treatment, we must change the inherent model and strengthen the capacity-building at the grass-roots level By 2013, the number of county-level hospitals in China had reached 116, with a service coverage of more than 900 million people This service accounts for almost 70% of the total number of residents in the country, while the number of hospitals accounts for 47% of the total number of hospitals in the country Although this proportion has been relatively high, the medical services undertaken by county-level hospitals do not match their functional positioning In 2013, for example, although the number of patients reached more than 900 million, it only accounted for 34% of the total number of patients in hospitals across the country, and the number of hospital admissions was only 6500, accounting for 46% of the total number of hospital admissions across the country If according to the policy expectation that 90% of patients are seriously ill, half of the goals have not been achieved According to the data of new rural cooperative medical system in 2013, the rate of out migration of patients in the county is far more than 20%, and there is still a gap from the goal of achieving 90% of the rate of medical treatment in the county Zhuang Yiqiang believes that the county-level medical reform, especially the improvement of the service ability of county-level hospitals, is the key to the final success of hierarchical diagnosis and treatment In hierarchical diagnosis and treatment, different levels of hospitals should be perfectly planned "Hierarchical diagnosis and treatment is the key point to solve the current situation of national inverted pyramid medical treatment To achieve hierarchical diagnosis and treatment, we must reform the entire medical structure and medical model " Zhong Nanshan, academician of the Chinese Academy of engineering, believes that only by continuously enhancing the medical strength at the grass-roots level, improving the medical quality and carrying out safety assessment, can county-level hospitals have the ability to keep patients, so as to truly avoid serious illness The threshold of entry and the reconstruction of the medical market pattern at and below the county level, whether it can meet the expectation of reform, may still need to be promoted and observed by the market On hierarchical diagnosis and treatment, 2015 sponsored by alibi in Hong Kong At the China Hospital Competitiveness Forum in, Chen Yong, President of Chaoyang Hospital, told reporters that from the perspective of the government, as a department that controls the whole social resources and taxpayers' money, it has the responsibility to make rational use and distribution of medical and health resources to better improve the utilization efficiency of the whole social resources and better meet the needs of patients From this premise, when the government allocates resources, it focuses on medical services at the lower level, close to the people, and common diseases Therefore, the allocation of the whole resources should be a positive pyramid, the network bottom should be extensive and substantial, and provide patients with a convenient, accessible, meet the needs and not waste such a medical service system From the perspective of serving patients, people need basic medical treatment Therefore, in the framework of medical service system, based on the Internet, it is necessary to have a wide coverage, balance the strength of the backbone including the specialty, and lead the development of the whole discipline Therefore, the practice of countless countries has proved that it is not only necessary but also feasible to establish such a hierarchical diagnosis and treatment system Hierarchical diagnosis and treatment has a positive effect on the optimization of the medical service market In the hierarchical diagnosis and treatment system, the service system of village, township, community and county hospitals will be effectively connected after the reconstruction of this pattern When patients are initially treated in towns or communities, they can be referred to the county level according to their condition After treatment at county level, patients can also be transferred to lower level institutions for rehabilitation This may be more effective in alleviating patients' medical expenses In this hierarchical diagnosis and treatment system, the reform of county-level hospitals will be an important link In the field of medical service, a healthy social capital will play a positive role in the integration of the whole medical service market Whether capital is benign or not depends on the goal of entry "When social capital invests in the medical industry, it can not only attract those commercial capital with strong profit-seeking nature, otherwise it may eventually lead to the phenomenon of" taking advantage of your illness and seizing your wealth " According to Zhuang, public hospitals account for about 20% in the United States, but about 65% of non-profit hospitals are run by non-profit funds, churches and charitable organizations China should also increase efforts to open a green channel for "non-profit capital" and "charitable capital" When social capital enters, it is necessary to distinguish the types of medical treatment, such as basic medical treatment (mainly common diseases and frequently occurring diseases), difficult and critical medical treatment, special medical treatment (personalized medical treatment, life style improvement medical treatment, such as cosmetic dentistry, etc.) In the county-level medical market, the national medical reform mainly focuses on basic medical care According to statistics from the health and Family Planning Commission, as of 2014, there were 12166 private hospitals in China, accounting for half of the medical institutions in many provinces and cities However, most of these hospitals are specialized in dentistry, dermatology, infertility and so on, and few are general hospitals "The real capital for hospitals will focus on the field of conventional diseases." Renji Medical Group