County implementation of the national essential medicine system work program
In order to steadily advance the implementation of the national essential medicine system, according to the Ministry of Health, the National Development and Reform Commission and other nine ministries and commissions, "Implementation Opinions on Establishing a National Essential Drug System", the Shandong Provincial Party Committee, and the Shandong Provincial People's Government "On the Implementation of Zhongfa [] No. 6 The spirit of the archives further deepens the implementation opinions of the province's medical and health system reform and the spirit of the Notice of the General Office of the People's Government of Shandong Province on Printing and Distributing the Implementation Opinions on the Implementation of the National Essential Drug System in Shandong Province. In accordance with the requirements of the Municipal Party Committee and the Municipal Government, The actual situation of the county is to develop this plan.
I. Implementation scope and start-up time The county township hospitals and community medical and health service centers implement the basic drug system, and the village clinics that implement integrated management are not included in the scope of implementation.
All grassroots medical and health institutions officially launched the implementation of the national essential medicine system at 0:00 on December 30.
Second, the main tasks are equipped with essential drugs in accordance with regulations. The country's 307 basic drugs and 216 kinds of supplementary drugs in Shandong Province are the basic drugs used in our county at this stage. All primary health care institutions must implement the relevant policies and regulations of the national essential medicine system, all of which are equipped with essential drugs. In principle, non-essential drugs should not be purchased. Other types of medical institutions must also use essential drugs as required. It is necessary to strictly implement the guidelines for the basic drug clinical drug use and the basic drug formula, standardize the behavior of primary medical institutions and medical personnel, and guide the people to form good drug habits to ensure the rational use of essential drugs.
Implement a unified bidding procurement and distribution system for essential drugs. Before the introduction of the provincial-level centralized online public bidding procurement method, the basic drugs required by the grassroots medical and health institutions are still purchased and distributed according to the original route within the maximum purchase limit determined by the province. After the provincial bidding procurement method was officially promulgated, the provincial-level unified bidding procurement and distribution shall be implemented in accordance with the regulations.
Implement the basic drug medical insurance reimbursement supporting policy. The essential drugs were all included in the basic medical insurance drug reimbursement catalogue, and the reimbursement rate was significantly higher than that of non-essential drugs. The essential drugs belonging to the Category A of the Urban Basic Medical Insurance are all included in the scope of payment for urban basic medical insurance; the basic drugs belonging to the Category B of the Urban Basic Medical Insurance are not included in the payment range of not less than 90%. The basic medical insurance for cities and towns shall increase the proportion of reimbursement in accordance with the provincial and municipal policies. The essential drugs were all included in the reimbursement list of the new rural cooperative medicines, and the proportion of reimbursement for hospitalized medical expenses was 10% higher than that of non-essential drugs.
We will continue to establish and improve a multi-channel compensation mechanism based on government investment to ensure the normal operation of grassroots medical and health institutions. Based on the principle of “scientific, fair, economical, efficient, and standardized”, in accordance with the requirements of the central and provincial and municipal “comprehensive reforms, approved tasks, approved revenues and expenditures, performance appraisal, overall arrangement, and multi-channel compensation”, establish and improve funds. The compensation mechanism implements the responsibility of the government's investment entities to ensure the normal operation of the primary health care institutions. And through the government to purchase services, comprehensively promote grassroots medical and health institutions to carry out public health services, and increase the income of public health services of grassroots medical and health institutions. At the same time, grassroots medical and health institutions should strengthen management, broaden service channels, improve service quality, increase medical service income, and minimize the negative impact of reduced drug revenue. The subsidies for grassroots medical and health institutions in all levels of finance in 2019 shall be prepaid according to the county's financial budget plan and settled at the end of the year.
III. Possible problems and countermeasures in the process of implementing the basic drug system Simultaneously promote the reform of the primary health care institutions. The reform of the personnel and distribution system within the primary health care institutions is not only an important part of strengthening the construction of the primary health care system, but also one of the basic conditions for ensuring the smooth implementation of the basic drug system. Personnel, health, social security and other departments should closely cooperate, verify the staffing of grassroots medical and health institutions, set up jobs in a scientific and rational manner, and formulate personnel and distribution system reform plans with performance-based wages as the core content in accordance with the requirements of higher-level policies and the actual conditions of our county. And actively organize implementation, achieve practical results, ensure the smooth implementation of the basic drug system and the consolidation of reform results.
Village doctor management issues. After the implementation of the basic drug system, the rural health clinics still implement integrated management, and the drugs used are all supplied by township health centers, and the drug addition rate must not exceed 15%. The patient was seen in the village clinic, and the reimbursement rate for drug expenses was 5% higher than that of non-essential drugs. The village clinic no longer pays profits to the hospital. Public health services for rural doctors are subsidized according to regulations.
The problem of non-essential medicines required for the operation of primary health care institutions. After the implementation of the essential medicine system, if non-essential medicines are required, they will be applied according to the procedures and will be increased after approval by the higher authorities. Approved increased drugs are sold at zero mark.
Before the start of the basic drug system, the drug stores of the primary health care institutions must be counted. Taking the 24 o'clock on December 29 as the benchmark time, before 24 o'clock, the drugstores of all primary health care institutions are counted accurately. The existing drugs belong to the basic drugs. From 0:00 on December 30, they will be sold at zero rate; they are not basic. The drug is either sold as a zero-plus or transferred to a health room.
The debt management of primary health care institutions. The historical debt formed before the implementation of the national essential medicine system was 48.92 million yuan, which was used for accounting purposes. The health centers or community health service centers with surplus each year can use the profits to repay debts year after year.
Fourth, work requirements unified thinking and understanding. The implementation of the national essential medicine system is the key and difficult point in promoting the reform of the medical and health system. It is of great significance to reform the medical institutions to "medicate medicines", effectively reduce the burden of people's medication costs, and ensure the safety of people's medication. All departments at all levels must attach great importance to, carefully organize, and carefully arrange the implementation of the national essential medicine system as a major event.
Do a good job in departmental collaboration. All relevant departments shall, according to the unified arrangements of the county party committee and the county government, perform their duties and jointly promote the implementation of the basic drug system. The Finance Bureau is responsible for formulating the fiscal compensation policies and plans for implementing the national essential medicine system, and implementing government investment; the Personnel Bureau is responsible for the preparation of the basic medical and health institutions, the reform of the personnel distribution system, and the implementation of performance pay by the health bureaus. The main distribution system and the personnel system reform; the Labor and Social Security Bureau is responsible for formulating the basic drug reimbursement methods for urban workers and urban residents, and supervising the implementation; the Health Bureau is responsible for the allocation of basic drugs and the organization of procurement and distribution information for primary health care institutions. To supervise and inspect the procurement, distribution and use of essential drugs in primary health care institutions, to timely grasp the operation status of primary health care institutions, to guide the rational use of drugs by grassroots medical and health institutions, to formulate new rural cooperative medical essential medicine reimbursement systems and supervise their implementation; The Supervisory Bureau is responsible for the supervision and inspection of drug quality, accepting complaints about relevant drug quality, reporting and organizing investigations, formulating and implementing supervision of the implementation of basic drug drugs for retail pharmacies; Supervision and inspection; the supervision bureau is responsible for the supervision and investigation of various violations of discipline and discipline; the medical reform office is responsible for comprehensive, coordination, service, and guidance work, and other relevant departments must conscientiously implement their duties, actively carry out work connections, and ensure the smooth implementation of the basic drug system. .
Strengthen financial security. The county government raises funds through multiple channels. After coordinating the special subsidies of the higher-level finances, the funds will be included in the budget to ensure the normal operation of the primary health care institutions. The County Health Bureau set up a health system accounting center to scientifically verify the income and expenditure base of grassroots medical and health institutions, standardize income and expenditure items and standards, standardize income and expenditure behaviors, and uniformly allocate funds for unified funding. The income of primary health care institutions is all counted by county health. Bureau financial account management.
Strengthen the management of primary health care institutions. The county health bureau should strengthen management, support and guide grassroots medical and health institutions to further strengthen internal management, standardize service behavior, and enhance development potential. After the implementation of the basic drug system in primary health care institutions, no new debts may be added. Continue to implement integrated management of the village clinics, namely, unified staffing, unified payment of wages, unified distribution of drugs, and unified management of accounts. Continuously improve the conditions of diagnosis and treatment of village clinics, improve the treatment of village doctors, and mobilize the enthusiasm of village doctors.
I. Implementation scope and start-up time The county township hospitals and community medical and health service centers implement the basic drug system, and the village clinics that implement integrated management are not included in the scope of implementation.
All grassroots medical and health institutions officially launched the implementation of the national essential medicine system at 0:00 on December 30.
Second, the main tasks are equipped with essential drugs in accordance with regulations. The country's 307 basic drugs and 216 kinds of supplementary drugs in Shandong Province are the basic drugs used in our county at this stage. All primary health care institutions must implement the relevant policies and regulations of the national essential medicine system, all of which are equipped with essential drugs. In principle, non-essential drugs should not be purchased. Other types of medical institutions must also use essential drugs as required. It is necessary to strictly implement the guidelines for the basic drug clinical drug use and the basic drug formula, standardize the behavior of primary medical institutions and medical personnel, and guide the people to form good drug habits to ensure the rational use of essential drugs.
Implement a unified bidding procurement and distribution system for essential drugs. Before the introduction of the provincial-level centralized online public bidding procurement method, the basic drugs required by the grassroots medical and health institutions are still purchased and distributed according to the original route within the maximum purchase limit determined by the province. After the provincial bidding procurement method was officially promulgated, the provincial-level unified bidding procurement and distribution shall be implemented in accordance with the regulations.
Implement the basic drug medical insurance reimbursement supporting policy. The essential drugs were all included in the basic medical insurance drug reimbursement catalogue, and the reimbursement rate was significantly higher than that of non-essential drugs. The essential drugs belonging to the Category A of the Urban Basic Medical Insurance are all included in the scope of payment for urban basic medical insurance; the basic drugs belonging to the Category B of the Urban Basic Medical Insurance are not included in the payment range of not less than 90%. The basic medical insurance for cities and towns shall increase the proportion of reimbursement in accordance with the provincial and municipal policies. The essential drugs were all included in the reimbursement list of the new rural cooperative medicines, and the proportion of reimbursement for hospitalized medical expenses was 10% higher than that of non-essential drugs.
We will continue to establish and improve a multi-channel compensation mechanism based on government investment to ensure the normal operation of grassroots medical and health institutions. Based on the principle of “scientific, fair, economical, efficient, and standardized”, in accordance with the requirements of the central and provincial and municipal “comprehensive reforms, approved tasks, approved revenues and expenditures, performance appraisal, overall arrangement, and multi-channel compensation”, establish and improve funds. The compensation mechanism implements the responsibility of the government's investment entities to ensure the normal operation of the primary health care institutions. And through the government to purchase services, comprehensively promote grassroots medical and health institutions to carry out public health services, and increase the income of public health services of grassroots medical and health institutions. At the same time, grassroots medical and health institutions should strengthen management, broaden service channels, improve service quality, increase medical service income, and minimize the negative impact of reduced drug revenue. The subsidies for grassroots medical and health institutions in all levels of finance in 2019 shall be prepaid according to the county's financial budget plan and settled at the end of the year.
III. Possible problems and countermeasures in the process of implementing the basic drug system Simultaneously promote the reform of the primary health care institutions. The reform of the personnel and distribution system within the primary health care institutions is not only an important part of strengthening the construction of the primary health care system, but also one of the basic conditions for ensuring the smooth implementation of the basic drug system. Personnel, health, social security and other departments should closely cooperate, verify the staffing of grassroots medical and health institutions, set up jobs in a scientific and rational manner, and formulate personnel and distribution system reform plans with performance-based wages as the core content in accordance with the requirements of higher-level policies and the actual conditions of our county. And actively organize implementation, achieve practical results, ensure the smooth implementation of the basic drug system and the consolidation of reform results.
Village doctor management issues. After the implementation of the basic drug system, the rural health clinics still implement integrated management, and the drugs used are all supplied by township health centers, and the drug addition rate must not exceed 15%. The patient was seen in the village clinic, and the reimbursement rate for drug expenses was 5% higher than that of non-essential drugs. The village clinic no longer pays profits to the hospital. Public health services for rural doctors are subsidized according to regulations.
The problem of non-essential medicines required for the operation of primary health care institutions. After the implementation of the essential medicine system, if non-essential medicines are required, they will be applied according to the procedures and will be increased after approval by the higher authorities. Approved increased drugs are sold at zero mark.
Before the start of the basic drug system, the drug stores of the primary health care institutions must be counted. Taking the 24 o'clock on December 29 as the benchmark time, before 24 o'clock, the drugstores of all primary health care institutions are counted accurately. The existing drugs belong to the basic drugs. From 0:00 on December 30, they will be sold at zero rate; they are not basic. The drug is either sold as a zero-plus or transferred to a health room.
The debt management of primary health care institutions. The historical debt formed before the implementation of the national essential medicine system was 48.92 million yuan, which was used for accounting purposes. The health centers or community health service centers with surplus each year can use the profits to repay debts year after year.
Fourth, work requirements unified thinking and understanding. The implementation of the national essential medicine system is the key and difficult point in promoting the reform of the medical and health system. It is of great significance to reform the medical institutions to "medicate medicines", effectively reduce the burden of people's medication costs, and ensure the safety of people's medication. All departments at all levels must attach great importance to, carefully organize, and carefully arrange the implementation of the national essential medicine system as a major event.
Do a good job in departmental collaboration. All relevant departments shall, according to the unified arrangements of the county party committee and the county government, perform their duties and jointly promote the implementation of the basic drug system. The Finance Bureau is responsible for formulating the fiscal compensation policies and plans for implementing the national essential medicine system, and implementing government investment; the Personnel Bureau is responsible for the preparation of the basic medical and health institutions, the reform of the personnel distribution system, and the implementation of performance pay by the health bureaus. The main distribution system and the personnel system reform; the Labor and Social Security Bureau is responsible for formulating the basic drug reimbursement methods for urban workers and urban residents, and supervising the implementation; the Health Bureau is responsible for the allocation of basic drugs and the organization of procurement and distribution information for primary health care institutions. To supervise and inspect the procurement, distribution and use of essential drugs in primary health care institutions, to timely grasp the operation status of primary health care institutions, to guide the rational use of drugs by grassroots medical and health institutions, to formulate new rural cooperative medical essential medicine reimbursement systems and supervise their implementation; The Supervisory Bureau is responsible for the supervision and inspection of drug quality, accepting complaints about relevant drug quality, reporting and organizing investigations, formulating and implementing supervision of the implementation of basic drug drugs for retail pharmacies; Supervision and inspection; the supervision bureau is responsible for the supervision and investigation of various violations of discipline and discipline; the medical reform office is responsible for comprehensive, coordination, service, and guidance work, and other relevant departments must conscientiously implement their duties, actively carry out work connections, and ensure the smooth implementation of the basic drug system. .
Strengthen financial security. The county government raises funds through multiple channels. After coordinating the special subsidies of the higher-level finances, the funds will be included in the budget to ensure the normal operation of the primary health care institutions. The County Health Bureau set up a health system accounting center to scientifically verify the income and expenditure base of grassroots medical and health institutions, standardize income and expenditure items and standards, standardize income and expenditure behaviors, and uniformly allocate funds for unified funding. The income of primary health care institutions is all counted by county health. Bureau financial account management.
Strengthen the management of primary health care institutions. The county health bureau should strengthen management, support and guide grassroots medical and health institutions to further strengthen internal management, standardize service behavior, and enhance development potential. After the implementation of the basic drug system in primary health care institutions, no new debts may be added. Continue to implement integrated management of the village clinics, namely, unified staffing, unified payment of wages, unified distribution of drugs, and unified management of accounts. Continuously improve the conditions of diagnosis and treatment of village clinics, improve the treatment of village doctors, and mobilize the enthusiasm of village doctors.
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