Xiamen for grading diagnosis "repair"

The 2016-04-22

Source: health

Chief journalists - Korea moves -

Slow disease first, "three" (3 armour hospital specialist, grass-roots hospital physicians and health management division) condominium, xiamen city in fujian province is to explore the classification characteristics of diagnosis and order. "With the relevant departments to form a complete set of policy streamlined, xiamen grading diagnosis and treatment work has been normalized." Xiamen Sun Wei deputy director of the health and family planning commission said.

S for the design of incentive mechanism

"There are 3 armour hospital specialist, grass-roots hospital physicians have the bottom spirit; by the health management services extend from hospital to home residents, created the last mile of doctor-patient communication." Xiamen shu-yu Yang, director of the health and family planning commission said that started from diabetes, high blood pressure, guided by flexible way in the city, to realize the high quality resources and patients "double down" at the grass-roots level, gradually build "big hospitals to put down, basic stand, patients willing to" situation.

After a period of time, how to let willing to meet at the grassroots level is in front of a new topic. Sun Wei said after practice the "three t" condominium, grass-roots doctor workload increase a lot, but it is very limited subsidies. Some grassroots organization workers produce the wait-and-see mood that hierarchical diagnosis was only an unsustainable "movement", the lack of participation.

"To play a role in grading diagnosis and treatment system at the grass-roots level, must establish the incentive mechanism of form a complete set." February 3, set by the xiamen municipal bureau of finance lead "about further perfecting the incentive mechanism of grassroots health institutions examination notice and xiamen city health and family planning commission, making the specific assessment of incentive measures for basic medical and health institution issued simultaneously. File is clear, basic medical and health institutions to complete the national basic public health services and meet performance requirements, basic public health funds balance part can be used for staff motivation; Met the requirement of the assessment of basic medical services, medical income balance can also be used for staff incentives.

According to the regulation, grassroots health institutions examination score above 80 points out of 100, according to the actual scoring percentage of further extract incentive funds from the balance; Comprehensive score of less than 80 points, can not extract incentive funds. National basic public health services project individual assessment points below 85 points, not to motivate your health budget balance. The appraisal result is located in the top three units, municipal finance, respectively for 1000 yuan, 800 yuan and 500 yuan per person per year of one-off reward.

Xiamen university first hospital affiliated hospital of gulangyu Zhang Xiaoliang told reporters that in 2015, 38 community health service institutions in the hospital in the city ranked first in the performance appraisal, scored 95.26 points. The hospital income 23.67 million yuan, the balance of more than 2.32 million yuan, which means that the hospital can be extracted from the balance 95.26% for staff incentives. In 2015, its per capita performance year-on-year growth of 52.6%. Zhang Xiaoliang said, hierarchical diagnosis and treatment, as long as you can manage the health of the residents, the grassroots agencies can bypass patients from a large hospital, from the reform of "beer".

Nowadays, xiamen 6 area 38 grassroots medical and health institutions of jurisdiction slow patients to carry out the "three" condominium service. According to the statistical analysis of 25000 patients attendance tracking, diabetes patients in primary JiuZhenLv increased from 40.7% to 78.1%, high blood pressure patients increased from 72.6% to 95.7%, and drive the other related diseases and complications of patients in clinic at the local level. Up 43.67% in 2015, the city basic medical services and basic medical and health institutions in the city, increasing per capita income 15000 yuan.

S tube fine mind can go far

"To really playing well, winning slow the disease prevention and control at the grass-roots level to be completed, the key depends on accurate management." Zhang Xiaoliang said.

Service time: 5 + 2, white + black, round-the-clock care for your health." This is written in the book of gulangyu hospital health management teacher Yang's business card. Yang told reporters that in the first step is the hardest for services, namely walked around 4965 households, from door to door parts, and acquisition cases based on of the classified management of the disease. At the same time, the community will also install wearable device for remote monitoring for focus groups, which makes the efficiency of slow disease management is greatly increased.

Yang contracted management of the residents are more than 400 households, including 120 hypertension patients, 27 patients with diabetes. "At first, I also regularly to residents' home, or let the residents to hospital measuring blood pressure and blood sugar. With the remote monitoring equipment, after residents as long as the click of a button, you can transmit the blood pressure and blood sugar to my mobile phone. It reduce the workload of household, we can make more energy to keep high-risk patients."

In order to let the doctor have momentum continues to manage patients, gulangyu hospital has also moved the nerves in performance appraisal. Hospital dean assistant Chen Linghui said, for the staff involved in the "three t" condominium, performance rewards consisting of workload and tournament awards, workload award is calculated based on quantity and patient control effect management, issued by the month, the bonus account for about two-thirds of the total amount of performance. Integrated service championship award points "quantity" and "quality" two dimensions for assessment, including assessment of workload accounted for 60%, 40% satisfaction appraisal, only the inspection results in the top three personnel can obtain "tournament prize", the champion was 50%, the runner-up to 30%, at 20%, comparison once every two months.

"From the point of work, each gp and health management division of the difference is not large, if you want to get good grades, the spell is slow disease management effect and the relationship with people." Chen Linghui said, service satisfaction assessment commissioned and neighborhood residents' committees, do a questionnaire about signing the crowd. Urge doctors to use the more time to communicate with residents, become acquaintances of patients.

Shu-yu Yang said, according to the precise management service mode, with the aid of "Internet +" means, grassroots doctors can not only ensure the "two disease", and ability to pipe up the more slowly. In the future, the city into "three t" condominium range of slow disease will continue to increase, related documents are issued.

To slow disease and all residents in the city of health management, by the mere force of 38 community health service institutions is not enough. Xiamen municipal development and reform commission (NDRC) commissioner of social development, WengXiaoLan says, this year the city for 441 new formulation of basic medical and health institutions, community health service institutions can take advantage of the new establishment continue to add the site, let more people find their own at home gp and health management division. Shu-yu Yang said that this year the city will also plan by conducting credit rating, from more than 1000 social capital at the selected in the outpatient department of the good faith service agencies involved in hierarchical diagnosis and treatment, alleviate the situation of insufficient primary care network.