Learning experience report
From January 18th to January 23rd, the deputy mayor XX led the Municipal People's Congress Social Affairs Committee, the Municipal Office, and the Municipal Health Bureau. The responsible comrades and his party went to Liaoning Haicheng and Jilin Luhe to study and inspect the medical unit system reform and rural areas. The community health service reform work has been deeply touched and gained a lot.
I. Basic Overview Haicheng City is concerned with the reform of the property rights system of township hospitals. Haicheng is located in the southern part of Liaoning and the northern end of the Liaodong Peninsula. It is a pilot unit for comprehensive county system reform at the county level. The city has jurisdiction over 4 administrative districts and 1 economic and technological development. District, 27 towns, 576 administrative villages, with a total area of 2732 square kilometers and a total population of 1.11 million. Since the reform and opening up, Haicheng has given full play to its regional advantages and carried out all-round reforms with courage to practice and dare to be the first to be bold and discouraged, so that the economic and social undertakings will renew their vitality and vitality. Before the implementation of the comprehensive system reform, the entire medical and health sector was arranged by the government, the mechanism was rigid, the management was not good, the people were overstaffed, the efficiency was low, and some hospitals could not even guarantee wages. To this end, since 1996, the city has carried out the reform of the property rights system for 20 township hospitals in line with the principle of “improving the city level, invigorating the town level, and strengthening the village level”. The city’s approach is:
1. In-depth investigation and research, adhere to the hospital policy. Before the restructuring, the city first conducted in-depth investigation and research, and solicited opinions through the convening of employee symposiums and expert demonstration meetings, to find out the bottom, grasp the facts, formulate detailed implementation plans, and make them public. In the process of restructuring, the Municipal Asset Appraisal Office conducts a review of the production and verification of assets and assets of the health center, and conducts qualifications and ability reviews of the purchasers to ensure the smooth progress of the reform. In terms of restructuring, the city adhered to 20 medical units that were adapted to local conditions and implemented policies, and sold 12 bidding units, and sold 7 units and merged one.
2. Take a variety of methods to properly resettle personnel. The city mainly adopts three resettlement methods for employees who have retired before the reform: First, the town government continues to pay its retirement expenses with the original health care institution; second, the hospital and retired employees jointly insure and participate in social pension insurance; In the case of voluntary application by employees, a one-time resettlement fee will be paid. Two-way choices are made for the placement of working staff: first, continue to work in the hospital; second, open the clinic by themselves; third, self-employment. After the reform of the hospital, the after-care work and creditor's rights and debts will be handled uniformly by the town government. The proceeds from the sale of health centers are mainly used for staff placement, payment of pension insurance for employees, payment of retirement fees and reimbursement of debts owed by health centers.
3. Establish a management organization and implement medical protection. Before the reform of township hospitals, the city implemented the separation of medical defense. The town government set up a health management office to manage the preventive health care of the towns that were originally managed by medical units, and rationalized the management system of rural preventive health care.
4. Take practical measures to strengthen management services. In the leadership relationship, the city requires that the reformed health center must accept the leadership of the local party committee and government, and obey the supervision and management and business guidance of the municipal health administrative department; the president and vice president of the hospital must consult with the local government and the municipal health bureau. Appointed and reported to the Health Bureau for the record. In terms of service functions, the reformed health center is required to undertake tasks such as supporting the rural areas and guiding the primary health care work. In the event of major disasters, accidents, epidemics or other accidents, it must obey the dispatch of the health administrative department. In the use of personnel, non-health technicians are required to work in health technology, and external health technicians must have intermediate titles or above. In the basic medical guarantee of the hospital, it is required to set up departments and personnel according to the basic standards of the grade hospital. At the same time, the Municipal Health Bureau also set up a health law enforcement brigade to centrally manage the city's medical market, find problems and investigate and deal with them in a timely manner, and severely revoke business licenses, and truly change from "medical management" to "administrative medicine."
After the restructuring, the city's health industry has achieved considerable development and achieved remarkable results, which are embodied in the following five aspects:
First, the socialization of health care has increased significantly. According to statistics, in the first three years of the reform, the special investment of 20 health centers was less than 1 million yuan. After only one year of reform, the operators invested 9.235 million yuan, more than 9 times that of the previous three years. By the end of 2000, the total fixed assets of 20 health centers was 27.39 million yuan, an increase of 21.17 million yuan over the 6.21 million yuan before the restructuring, an increase of 340.
Second, the quality of health technicians has been significantly enhanced. At the end of 2000, there were 87 people in 20 health centers with intermediate and senior technical titles, an increase of 60 people before the reform. The newly introduced high and middle-level talents are mainly from the large hospitals in Anshan and Shenyang. At the same time of introducing talents, in order to enhance the development potential of health centers, investors also pay attention to cultivating talents, some are sent to medical schools for further study, and some are sent to higher-level hospitals for further study.
Third, medical conditions have improved significantly. Before the reform, the 20 health centers were basically large internal medicine, and the surgery only handled, sutured, and did not perform surgery. Among them, 15 hospitals have no rescue rooms and no necessary rescue equipment. After the reform, the health centers have strengthened the departments of surgery, obstetrics and gynecology, pediatrics, Chinese medicine, and orthopedics, and the number of clinical departments has increased from 3 to 11. The reformed health center has generally set up a rescue room, equipped with the necessary equipment and medicines, equipped with X-ray machines, B-ultrasound machines, electrocardiographs, and some equipped with dynamic electrocardiographs, EEG machines and other equipment.
Fourth, the level of medical charges has been significantly reduced. In order to win the market and enhance competitiveness, the reformed hospitals have reduced the level of medical charges. Many hospitals have clearly priced or promised a total amount of fees when patients are admitted to hospital, which greatly reduces the medical expenses of patients. According to the survey, before the reform, the cost of hospitalization for appendicitis surgery was about 1,500 yuan. After the reform, the charge level of most hospitals was between 700-900 yuan.
Fifth, the quality of health care operations has improved significantly. The average utilization rate of hospital beds in 20 hospitals increased from 9.6 before the reform to 40.7, and the number of outpatient clinics increased from 441 to 644 before the reform; in 2000, the total income reached 18.8 million, doubled before the reform. The first Fan Wen § network to organize the article...
About the promotion of rural community health service reform in Luohe City Luohe City is located in the eastern part of Jilin Province and belongs to the Mid-levels. The city governs 20 townships and 258 administrative villages with a total population of 470,000, of which the rural population is 299,000. In 2001, the fiscal revenue was 117 million yuan, and the per capita net income of farmers was 3,180 yuan, slightly higher than the provincial average. In recent years, the city has a loose relationship with the rural three-level health service network, low level of rural doctor service, farmers' expensive medical care, difficult medical treatment, etc., and actively promoted the reform of rural community health services, and achieved good results. Fully affirmed that Vice Premier Li Lanqing made important instructions: "The Party Committee and the government of Luohe City actively carried out the reform of rural community health services and explored a feasible way to develop rural health services suitable for local conditions." The main practices of the city are:
1. Adjust the layout of rural health institutions. Breaking the traditional pattern of "one village, one room", re-provisioning the original township and village health resources, and adjusting 265 village clinics and individual clinics to 218 village-level community health service stations, balanced in rural population relatives In concentrated areas, each station covers a population of 1,000-3,000 people. The service station is led by the township health center and undertakes the treatment and rehabilitation of farmers' health education, disease control, maternal and child health care, common diseases and injuries.
2. Reform the employment system. The hospital will select and hire the personnel who enter the service station, and implement the full-time appointment system and the last-serving system. A total of 26 health clinic doctors in the city have enriched their work at the service station, and 17 rural doctors with unqualified quality have been dismissed.
3. Strengthen vertical cooperation between health institutions at the city, township and village levels. The township and village health institutions shall implement integrated management of health services, and the health centers shall be fully responsible for the business training, supervision and management of the service stations, and implement counterpart assistance, strong and weak, strong and weak. The hospital also took out some funds to uniformly purchase medicines and disposable syringes for the service stations, and provided financial support to the service stations. Under the government's organization, the service station collects funds of gross income of 7 per month, and the township health centers provide corresponding funds as the rural community health service development fund, which is mainly used for equipment purchase of service stations and supervision, management and personnel of rural community health services. Training, etc.
4. Transform service concepts and service models. Become a home-based service, and become a simple medical treatment for the combination of preventive health care and medical care. According to the basic requirements of community-based, service farmers, meeting needs, and strengthening management, the service station conducts household surveys, establishes health records for 123,000 farmers, implements a family visit system, and regularly visits the elderly and chronically ill patients. Patients who are transferred back to the two-way referral and dying patients are visited at any time, and all-day waiting, telephone consultation and round-the-clock consultation are carried out, and patients are diagnosed and treated in time; two-way referral service is carried out, and the service station can not diagnose it in time. The treated patients were transferred to the hospital. After the patient's condition improved, they were transferred back to the service station to continue treatment. The hospital gave a certain percentage of the service fee to the service station from the medical income, and truly benefited the people.
Since the implementation of rural community health services in Luohe City, it has achieved good results, mainly in:
1. Through the rational allocation of rural health resources, a rural health service network covering the whole city with reasonable functions and facilitating the people and the people has been formed, which has strengthened the technical guidance and management capabilities of the hospitals and expanded the service functions of the township and village health institutions. It has enhanced the sense of competition, stimulated the vitality of business, realized the organic combination of rural community health services and primary health care, and ensured the implementation of preventive health care.
2. By strengthening the basic construction of service stations, enriching technical personnel and waiting for treatment 24 hours, the service quality has been improved and farmers have been facilitated. Since the reform, the number of patients in the city's health centers and service stations has increased by an average of nearly 10 percentage points. The income of health centers has increased year by year. The service stations have directly increased their income by 160,000 yuan. The average annual income of each village doctor has increased by nearly 400 yuan. It not only improved social benefits, but also increased economic benefits and stabilized the health care teams at the township and village levels.
3. Through the implementation of household visits, two-way referrals, health experience and other measures, not only can farmers enjoy convenient medical and health care services at home, but also greatly reduce the burden of farmers' medical expenses. According to incomplete statistics, since the two-way referral and the reduction of drug prices have been carried out, the per capita illness and surgical expenses of farmers have been reduced by about 150 yuan per person, and the cost of medicines has been reduced by about 20. At the same time, because the drugs at the service station are uniformly purchased by the hospital, the quality of the drugs is better guaranteed.
Second, revelation and suggestions Drawing on the experience of the two places, combined with the actual situation of Jiangdu, we suggest that in the next period, we must focus on the following two aspects of work.
1. Learn Haicheng and seek a breakthrough in the reform of the medical and health system. Further establish the concept of marketization, and truly take medical care as a company, project to grasp, industry to do, and accelerate the pace of restructuring. First, the intensity is big. We must conscientiously implement the spirit of the mobilization meeting for the reform of the medical unit system in the city. On the basis of summarizing the experience of the pilot projects of Yangzhuang and Tangtou Health Center, we will gradually push it forward and strive to bring out the reform plan for all town health centers in March. Before the completion of 8-10 non-town government government health centers and some towns where the government is located in the health care system. Other medical units must also fully implement the separation of management rights and ownership. The medical defense separation work will be completed in the first quarter. The second is that the form must live. Adhere to the local conditions, due to the hospital's policy, according to the actual hospital and the wishes of the hospital staff, the stocks should be rented, rented, and sold. The improvement of service level and the form of restructuring that is conducive to safeguarding the interests of employees can be boldly carried out and tested boldly. The third is to take measures. In the process of restructuring, we must first grasp the expansion work, grasp the optimization and supervision of the hospital's equity, and ensure the qualification of the dean and the import of medical technicians to ensure the standardization of hospital management. Fourth, the market is going to be released. On the basis of adhering to the “Jiangdu Medical Institution Reform Plan” and the entry requirements for employees and medical technology, encourage social forces to organize specialized hospitals such as oral, eye, facial features, acupuncture, medical beauty, acute and chronic diseases, rehabilitation, etc. A variety of ownership medical institutions compete fairly and develop together.
2. Learn from the river and seek breakthroughs in the reform of rural community health services. First, focus on the existing foundation to consolidate. Taking the primary health care work in rural areas as the leader, we will conscientiously implement the “Regulations on Primary Health Care in Rural Areas of Jiangsu Province”, and continuously improve the level of health and disease prevention, maternal and child health care, health education, water reform and toilet rehabilitation, and rural cooperative medical work. The foundation is more solid and firm. The second is to closely manage the key links. We must pay close attention to formulating regional health plans and scientifically building a rural health service network. The rural health room can be closely linked to the town health center, or it can be directly used as the extension point of the town health center to implement integrated management. It is necessary to strengthen training and improve quality. The health administrative department and relevant departments cooperated, made overall planning, unified arrangements, strengthened the education of rural doctors, and strived to complete the transformation of rural doctors to practicing assistant physicians in 5-8 years. Adopting the method of democratic evaluation of the peasant people and the assessment of the work objectives and tasks, the final elimination system will be implemented for the village clinic staff, and the elimination ratio should reach 5-10 per year. Support and encourage urban health technicians to work in rural areas. If the health technicians at the city or town level need to be promoted or intermediate titles, they must work in the town or village health institutions for more than one year. It is necessary to strengthen the management of drug supply and use. The purchase of medicines in the village clinics is concentrated by the town health center or the anti-insurance office, allowing the town hospital or the defense office to charge a certain fee, but the markup rate must not exceed 10 of the purchase price. It is necessary to increase investment in health services in rural communities. All towns and related departments must allocate a certain proportion of funds to the rural community health services. The town health centers and village clinics must produce gross income 7 per year as the rural community health service development fund, mainly for rural communities. Business training and equipment purchase for health service personnel. The municipal finance arranges a certain proportion of fixed subsidies each year within the budget to initiate and develop rural community health services. The third is to optimize the effectiveness of medical services. This year, 1-2 towns can be selected for community health service pilots. Establish rural residents' health records in the pilot towns, guide patients with chronic diseases, acute rehabilitation patients to perform functional rehabilitation exercises, and conduct regular follow-up, two-way referrals, etc., strive to win patients with high-quality services, win the market, win development opportunities and space.
I. Basic Overview Haicheng City is concerned with the reform of the property rights system of township hospitals. Haicheng is located in the southern part of Liaoning and the northern end of the Liaodong Peninsula. It is a pilot unit for comprehensive county system reform at the county level. The city has jurisdiction over 4 administrative districts and 1 economic and technological development. District, 27 towns, 576 administrative villages, with a total area of 2732 square kilometers and a total population of 1.11 million. Since the reform and opening up, Haicheng has given full play to its regional advantages and carried out all-round reforms with courage to practice and dare to be the first to be bold and discouraged, so that the economic and social undertakings will renew their vitality and vitality. Before the implementation of the comprehensive system reform, the entire medical and health sector was arranged by the government, the mechanism was rigid, the management was not good, the people were overstaffed, the efficiency was low, and some hospitals could not even guarantee wages. To this end, since 1996, the city has carried out the reform of the property rights system for 20 township hospitals in line with the principle of “improving the city level, invigorating the town level, and strengthening the village level”. The city’s approach is:
1. In-depth investigation and research, adhere to the hospital policy. Before the restructuring, the city first conducted in-depth investigation and research, and solicited opinions through the convening of employee symposiums and expert demonstration meetings, to find out the bottom, grasp the facts, formulate detailed implementation plans, and make them public. In the process of restructuring, the Municipal Asset Appraisal Office conducts a review of the production and verification of assets and assets of the health center, and conducts qualifications and ability reviews of the purchasers to ensure the smooth progress of the reform. In terms of restructuring, the city adhered to 20 medical units that were adapted to local conditions and implemented policies, and sold 12 bidding units, and sold 7 units and merged one.
2. Take a variety of methods to properly resettle personnel. The city mainly adopts three resettlement methods for employees who have retired before the reform: First, the town government continues to pay its retirement expenses with the original health care institution; second, the hospital and retired employees jointly insure and participate in social pension insurance; In the case of voluntary application by employees, a one-time resettlement fee will be paid. Two-way choices are made for the placement of working staff: first, continue to work in the hospital; second, open the clinic by themselves; third, self-employment. After the reform of the hospital, the after-care work and creditor's rights and debts will be handled uniformly by the town government. The proceeds from the sale of health centers are mainly used for staff placement, payment of pension insurance for employees, payment of retirement fees and reimbursement of debts owed by health centers.
3. Establish a management organization and implement medical protection. Before the reform of township hospitals, the city implemented the separation of medical defense. The town government set up a health management office to manage the preventive health care of the towns that were originally managed by medical units, and rationalized the management system of rural preventive health care.
4. Take practical measures to strengthen management services. In the leadership relationship, the city requires that the reformed health center must accept the leadership of the local party committee and government, and obey the supervision and management and business guidance of the municipal health administrative department; the president and vice president of the hospital must consult with the local government and the municipal health bureau. Appointed and reported to the Health Bureau for the record. In terms of service functions, the reformed health center is required to undertake tasks such as supporting the rural areas and guiding the primary health care work. In the event of major disasters, accidents, epidemics or other accidents, it must obey the dispatch of the health administrative department. In the use of personnel, non-health technicians are required to work in health technology, and external health technicians must have intermediate titles or above. In the basic medical guarantee of the hospital, it is required to set up departments and personnel according to the basic standards of the grade hospital. At the same time, the Municipal Health Bureau also set up a health law enforcement brigade to centrally manage the city's medical market, find problems and investigate and deal with them in a timely manner, and severely revoke business licenses, and truly change from "medical management" to "administrative medicine."
After the restructuring, the city's health industry has achieved considerable development and achieved remarkable results, which are embodied in the following five aspects:
First, the socialization of health care has increased significantly. According to statistics, in the first three years of the reform, the special investment of 20 health centers was less than 1 million yuan. After only one year of reform, the operators invested 9.235 million yuan, more than 9 times that of the previous three years. By the end of 2000, the total fixed assets of 20 health centers was 27.39 million yuan, an increase of 21.17 million yuan over the 6.21 million yuan before the restructuring, an increase of 340.
Second, the quality of health technicians has been significantly enhanced. At the end of 2000, there were 87 people in 20 health centers with intermediate and senior technical titles, an increase of 60 people before the reform. The newly introduced high and middle-level talents are mainly from the large hospitals in Anshan and Shenyang. At the same time of introducing talents, in order to enhance the development potential of health centers, investors also pay attention to cultivating talents, some are sent to medical schools for further study, and some are sent to higher-level hospitals for further study.
Third, medical conditions have improved significantly. Before the reform, the 20 health centers were basically large internal medicine, and the surgery only handled, sutured, and did not perform surgery. Among them, 15 hospitals have no rescue rooms and no necessary rescue equipment. After the reform, the health centers have strengthened the departments of surgery, obstetrics and gynecology, pediatrics, Chinese medicine, and orthopedics, and the number of clinical departments has increased from 3 to 11. The reformed health center has generally set up a rescue room, equipped with the necessary equipment and medicines, equipped with X-ray machines, B-ultrasound machines, electrocardiographs, and some equipped with dynamic electrocardiographs, EEG machines and other equipment.
Fourth, the level of medical charges has been significantly reduced. In order to win the market and enhance competitiveness, the reformed hospitals have reduced the level of medical charges. Many hospitals have clearly priced or promised a total amount of fees when patients are admitted to hospital, which greatly reduces the medical expenses of patients. According to the survey, before the reform, the cost of hospitalization for appendicitis surgery was about 1,500 yuan. After the reform, the charge level of most hospitals was between 700-900 yuan.
Fifth, the quality of health care operations has improved significantly. The average utilization rate of hospital beds in 20 hospitals increased from 9.6 before the reform to 40.7, and the number of outpatient clinics increased from 441 to 644 before the reform; in 2000, the total income reached 18.8 million, doubled before the reform. The first Fan Wen § network to organize the article...
About the promotion of rural community health service reform in Luohe City Luohe City is located in the eastern part of Jilin Province and belongs to the Mid-levels. The city governs 20 townships and 258 administrative villages with a total population of 470,000, of which the rural population is 299,000. In 2001, the fiscal revenue was 117 million yuan, and the per capita net income of farmers was 3,180 yuan, slightly higher than the provincial average. In recent years, the city has a loose relationship with the rural three-level health service network, low level of rural doctor service, farmers' expensive medical care, difficult medical treatment, etc., and actively promoted the reform of rural community health services, and achieved good results. Fully affirmed that Vice Premier Li Lanqing made important instructions: "The Party Committee and the government of Luohe City actively carried out the reform of rural community health services and explored a feasible way to develop rural health services suitable for local conditions." The main practices of the city are:
1. Adjust the layout of rural health institutions. Breaking the traditional pattern of "one village, one room", re-provisioning the original township and village health resources, and adjusting 265 village clinics and individual clinics to 218 village-level community health service stations, balanced in rural population relatives In concentrated areas, each station covers a population of 1,000-3,000 people. The service station is led by the township health center and undertakes the treatment and rehabilitation of farmers' health education, disease control, maternal and child health care, common diseases and injuries.
2. Reform the employment system. The hospital will select and hire the personnel who enter the service station, and implement the full-time appointment system and the last-serving system. A total of 26 health clinic doctors in the city have enriched their work at the service station, and 17 rural doctors with unqualified quality have been dismissed.
3. Strengthen vertical cooperation between health institutions at the city, township and village levels. The township and village health institutions shall implement integrated management of health services, and the health centers shall be fully responsible for the business training, supervision and management of the service stations, and implement counterpart assistance, strong and weak, strong and weak. The hospital also took out some funds to uniformly purchase medicines and disposable syringes for the service stations, and provided financial support to the service stations. Under the government's organization, the service station collects funds of gross income of 7 per month, and the township health centers provide corresponding funds as the rural community health service development fund, which is mainly used for equipment purchase of service stations and supervision, management and personnel of rural community health services. Training, etc.
4. Transform service concepts and service models. Become a home-based service, and become a simple medical treatment for the combination of preventive health care and medical care. According to the basic requirements of community-based, service farmers, meeting needs, and strengthening management, the service station conducts household surveys, establishes health records for 123,000 farmers, implements a family visit system, and regularly visits the elderly and chronically ill patients. Patients who are transferred back to the two-way referral and dying patients are visited at any time, and all-day waiting, telephone consultation and round-the-clock consultation are carried out, and patients are diagnosed and treated in time; two-way referral service is carried out, and the service station can not diagnose it in time. The treated patients were transferred to the hospital. After the patient's condition improved, they were transferred back to the service station to continue treatment. The hospital gave a certain percentage of the service fee to the service station from the medical income, and truly benefited the people.
Since the implementation of rural community health services in Luohe City, it has achieved good results, mainly in:
1. Through the rational allocation of rural health resources, a rural health service network covering the whole city with reasonable functions and facilitating the people and the people has been formed, which has strengthened the technical guidance and management capabilities of the hospitals and expanded the service functions of the township and village health institutions. It has enhanced the sense of competition, stimulated the vitality of business, realized the organic combination of rural community health services and primary health care, and ensured the implementation of preventive health care.
2. By strengthening the basic construction of service stations, enriching technical personnel and waiting for treatment 24 hours, the service quality has been improved and farmers have been facilitated. Since the reform, the number of patients in the city's health centers and service stations has increased by an average of nearly 10 percentage points. The income of health centers has increased year by year. The service stations have directly increased their income by 160,000 yuan. The average annual income of each village doctor has increased by nearly 400 yuan. It not only improved social benefits, but also increased economic benefits and stabilized the health care teams at the township and village levels.
3. Through the implementation of household visits, two-way referrals, health experience and other measures, not only can farmers enjoy convenient medical and health care services at home, but also greatly reduce the burden of farmers' medical expenses. According to incomplete statistics, since the two-way referral and the reduction of drug prices have been carried out, the per capita illness and surgical expenses of farmers have been reduced by about 150 yuan per person, and the cost of medicines has been reduced by about 20. At the same time, because the drugs at the service station are uniformly purchased by the hospital, the quality of the drugs is better guaranteed.
Second, revelation and suggestions Drawing on the experience of the two places, combined with the actual situation of Jiangdu, we suggest that in the next period, we must focus on the following two aspects of work.
1. Learn Haicheng and seek a breakthrough in the reform of the medical and health system. Further establish the concept of marketization, and truly take medical care as a company, project to grasp, industry to do, and accelerate the pace of restructuring. First, the intensity is big. We must conscientiously implement the spirit of the mobilization meeting for the reform of the medical unit system in the city. On the basis of summarizing the experience of the pilot projects of Yangzhuang and Tangtou Health Center, we will gradually push it forward and strive to bring out the reform plan for all town health centers in March. Before the completion of 8-10 non-town government government health centers and some towns where the government is located in the health care system. Other medical units must also fully implement the separation of management rights and ownership. The medical defense separation work will be completed in the first quarter. The second is that the form must live. Adhere to the local conditions, due to the hospital's policy, according to the actual hospital and the wishes of the hospital staff, the stocks should be rented, rented, and sold. The improvement of service level and the form of restructuring that is conducive to safeguarding the interests of employees can be boldly carried out and tested boldly. The third is to take measures. In the process of restructuring, we must first grasp the expansion work, grasp the optimization and supervision of the hospital's equity, and ensure the qualification of the dean and the import of medical technicians to ensure the standardization of hospital management. Fourth, the market is going to be released. On the basis of adhering to the “Jiangdu Medical Institution Reform Plan” and the entry requirements for employees and medical technology, encourage social forces to organize specialized hospitals such as oral, eye, facial features, acupuncture, medical beauty, acute and chronic diseases, rehabilitation, etc. A variety of ownership medical institutions compete fairly and develop together.
2. Learn from the river and seek breakthroughs in the reform of rural community health services. First, focus on the existing foundation to consolidate. Taking the primary health care work in rural areas as the leader, we will conscientiously implement the “Regulations on Primary Health Care in Rural Areas of Jiangsu Province”, and continuously improve the level of health and disease prevention, maternal and child health care, health education, water reform and toilet rehabilitation, and rural cooperative medical work. The foundation is more solid and firm. The second is to closely manage the key links. We must pay close attention to formulating regional health plans and scientifically building a rural health service network. The rural health room can be closely linked to the town health center, or it can be directly used as the extension point of the town health center to implement integrated management. It is necessary to strengthen training and improve quality. The health administrative department and relevant departments cooperated, made overall planning, unified arrangements, strengthened the education of rural doctors, and strived to complete the transformation of rural doctors to practicing assistant physicians in 5-8 years. Adopting the method of democratic evaluation of the peasant people and the assessment of the work objectives and tasks, the final elimination system will be implemented for the village clinic staff, and the elimination ratio should reach 5-10 per year. Support and encourage urban health technicians to work in rural areas. If the health technicians at the city or town level need to be promoted or intermediate titles, they must work in the town or village health institutions for more than one year. It is necessary to strengthen the management of drug supply and use. The purchase of medicines in the village clinics is concentrated by the town health center or the anti-insurance office, allowing the town hospital or the defense office to charge a certain fee, but the markup rate must not exceed 10 of the purchase price. It is necessary to increase investment in health services in rural communities. All towns and related departments must allocate a certain proportion of funds to the rural community health services. The town health centers and village clinics must produce gross income 7 per year as the rural community health service development fund, mainly for rural communities. Business training and equipment purchase for health service personnel. The municipal finance arranges a certain proportion of fixed subsidies each year within the budget to initiate and develop rural community health services. The third is to optimize the effectiveness of medical services. This year, 1-2 towns can be selected for community health service pilots. Establish rural residents' health records in the pilot towns, guide patients with chronic diseases, acute rehabilitation patients to perform functional rehabilitation exercises, and conduct regular follow-up, two-way referrals, etc., strive to win patients with high-quality services, win the market, win development opportunities and space.
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