Please input to the content of the translation or url in qinghai: hierarchical diagnosis and treatment for \"difficult\" to break the ice

Time: 2016-04-25

Source: China's traditional Chinese medicine

The author: butyl

Altitude sickness is in the majority large poverty area, apparent return rate, poverty, backward medical conditions, the economy is not developed... Despite the difficulties, bold in qinghai province will deepen the reform go deep into the grassroots, push forward the classification system of diagnosis and treatment, guarantee rural basic medical security, let the characteristics of medicine at the grassroots level, let the medical institutions at all levels take on different disease, strengths and gradually realize the specialization, the people see a doctor difficult henceforth no longer.

First option selected in the grassroots Tibetan characteristics

Zhao family lived in hainan Tibetan autonomous prefecture, southwest of xinghai county, 248 kilometers from the provincial capital, xining, in order to take father treating stroke sequela, often sit four hours of car, a big hospital in xining, the provincial capital hospital experts, high level, to see the doctor at ease.\" Zhao said.

But now \"the classification diagnosis and treatment\" policy implemented, zhao family have a little confused: \"which is used to want to go to go see a doctor, but now how can't literally go to large hospital see a doctor?\"

\"At the beginning of the hierarchical diagnosis and carry out, most people are zhao such concerns.\" Hides in qinghai province pharmaceutical administration on memories, most economic less-developed areas in qinghai, at the beginning of the policy implementation, the people do not understand, big hospital MenZhenLiang plummeted, basic-level hospitals grow slowly, policy implementation difficulties, doubts.

In addition, the state county in qinghai population distribution loose, if go to provincial hospital, sick patients not only cost more, have more delay the risk of illness. To see a doctor for economic conditions behind the nomads of the burden.

\"We introduce hierarchical diagnosis and treatment, not to let the people live in big hospitals, but people change habits of freedom, and standardize the order of medical treatment.\" Hides pharmaceutical waters that qinghai will \"Jane, then, check, inexpensive\" the characteristics of grass-roots level, focus on improving the capacity of basic-level hospital medical service, let the basic-level hospitals carry the responsibility of \"serious illness not county\".

Kumbum monastery traditional Tibetan hospital nearby inhabited by many tibetans, they have the deep feelings, of essential factors influencing in the treatment of cold area prone to rheumatism, arthritis, cardiovascular, digestive and other diseases have special effect. The hospital to develop the appropriate technology for Tibetan, add hidden dipping beds, gradually attracted more and more villagers came to the treatment. \"Now, Tibetan medicine bath in the home, and go to provincial capital than big hospital, effect is the same, we keep the long journey to provincial capital.\" Feel the change in the traditional Tibetan hospital door, zhuoma the old man said with a smile.

Nearly two years, depending on the state administration of traditional Chinese medicine in qinghai province public health benefits capital projects, the implementation of grassroots hides the medical services, engineering, improve the capacity to strengthen the construction of Tibetan pavilion in grassroots medical and health service agencies, in towns and townships and community health service center set up in 145 Tibetan pavilion, hides medicine 148, appropriate technology to promote grassroots health institutions obliged medical service coverage gradually increase, hides the overall level of medical services.

100% by the end of 2015, the province's community health service center can provide hides the medical services, 84.8% of community health service stations, 90.1% of towns and townships and 75.2% of the village clinic hides medical services, to provide basic medical and health institutions obliged medical services accounts for 40% of total medical services.

Referral \"alive\" pressure shunt

Timely find problems and solve the problem quickly, the road to reform especially flexible in qinghai.

With hierarchical diagnosis gradually introduced, problems appeared in each link also gradually: similar disease again admitted to hospital formalities trival, 3 armour hospital, while \"native\" county hospital, loosely connected... In view of the problems, improve the system of grading diagnosis and treatment of related policies in qinghai province, make provide human nature to adjust, to simplify the patient referral, specification different living such as ginseng protect the referral program at the same time, also improve the referral rate, inspection results, mutual recognition and related policies.

Old tibetans tashi is fresh from qinghai province traditional Tibetan hospital discharge, he take a physician referral list, pick up the clothes ready to go home to continue treatment. A grazing, the old man of coronary heart disease, just was immediately sent to the door county traditional Tibetan hospital treatment, only to find the old man appeared unexpected complications, hospital immediately referred to the provincial traditional Tibetan hospital treatment, the hospital opened the green channel, the old man finally through the crisis. Today, got better in the old man back to just was made in the county's traditional Tibetan hospital, continue to accept rehabilitation.

In order to implement the two-way referral, in 2015, the province has chosen the 9 kinds of diseases such as hypertension, diabetes, tuberculosis develop two-way referral indications, in the province within the scope of the pilot. At the grassroots medical institutions to carry out on chronic diseases of the elderly over the age of 60 offers free medicine diagnosis and treatment mode, at the provincial level hospital form chronic diseases diagnosis and treatment center, secri area branch established, provide technical support for medical institutions at all levels of diagnosis and treatment of chronic diseases, and head is carried out for chronic illness gradually pay package.

Traditional Tibetan hospital in qinghai province, deputy director of the youth to Dan said, at present, has formed the county of qinghai province state three factors influencing the medical network, covering the entire province, in order to ensure the province and around the Tibetan people's health, let the two-way referral in influencing medical network \"alive\".

Patients in hospital in qinghai province, Chinese medicine dermatology is always crowded, the doctors working pressure. After the implementation of hierarchical diagnosis, through two-way referral, part of the state of patients in a timely manner back to late undergoes treatment at the local level. \"Hierarchical diagnosis and treatment for the doctors to reduce a lot of burden and pressure after decomposition, doctors have more energy to study difficult problems encountered in clinical, it is a good beginning for strengthening the construction of key specialty.\" The hospital director said.

How did people begin from question to opt to classification, diagnosis and treatment? Originally, the province from the early stages of reform has been clear about the function orientation of medical institutions, grassroots medical institutions to provide basic medical and public health and maternal and child health, family planning services; Major medical institutions at the county level to carry out the common disease, frequently-occurring disease diagnosis and treatment of county residents, rescuing critical patients and venereology referral, etc; Tertiary medical institutions gradually reduce common disease, frequently-occurring disease assessment and diagnosis of focus in a stable condition of common chronic diseases of outpatient service. At the same time, also actively guide the diagnosis clear a stable patients with chronic patient, rehabilitation period from tertiary hospital referral to primary care health institutions in a timely manner.

Medical institutions at all levels do their expertise, the realization of medical resource distribution, not only reduce the pressure on health care, more ease the burden of medical expenses.

A serious illness can submit an expense account The burden of small

Ms zhang in xining, for fractures at the provincial hospital hospitalization, treatment for spent a total of more than 30000 yuan. After the basic medical insurance reimbursement and serious illness insurance reimbursement, their only took less than 10000 yuan.

In 2015, we will continue to improve the reimbursement policy of qinghai province to further promote the grading system. Actively promote the reform of medical insurance payment, now, the province's urban and rural residents health is higher than the national level, urban and rural residents health care financing standard from 510 yuan to 510 yuan. The province worker health, urban residents medical insurance, new farming rate were over 99.6%, within the scope of medical insurance policy in urban and rural residents in the hospital fee payment proportion reached 78%.

In addition, the full implementation of a serious illness medical insurance system in the province, the province's urban and rural residents per capita 50 yuan standard as a whole to establish a serious illness medical insurance funds. Key object in the hospital rescue not pay line, set up the policy within the scope of hospital medical relief ratio reached 80% ~ 100%, annual aid quota increased from 30000 yuan to 5 ~ 60000 yuan; Extremely poor support object according to 100% to give assistance and other assistance object according to 80% to help.

Also implemented a \"hospital before settlement\" in qinghai province medical service pattern. At present, the province more than 1 million patients with the \"settlement\" after hospital first medical service mode, no malice owe.

\"Grading diagnosis and treatment of complete cycle is long, we also need to constantly perfect the policy, through the classification system really solve the problem of the difficulty and high cost of the crowd to see a doctor, could not achieve a serious illness county, not out of the province, the critical and difficult and complicated benefit more people.\" Waters says.