About the implementation of health poverty alleviation project of guidance

The 2016-06-21 national health and population and family planning commission of the People's Republic of China

Hair [2016] 26 countries who finance

The provinces, autonomous regions and municipalities directly under the central government, all the services and arms, armed police troops political work department, logistics department, aftermath office ZhengGongZu, directs and commands all the military security groups:

Health poverty alleviation project implementation, to protect the rural poor will have access to basic medical and health services, and promote the health of China construction, prevent because of sickness poor, Chinese due to illness, let the rural poor out of poverty by 2020 target is of great significance. To be completed for the implementation of the CPC central committee and the state council about win out of poverty of important strategic deployment, agreed to by the state council, now on implementing health poverty alleviation project put forward the following opinions.

First, general requirements

(a) the guiding ideology. In-depth implementation of the party's 18 large and 18 class 3, 4, and fifth plenary session of the central poverty alleviation and development work conference spirit, around the "four" comprehensive strategic layout, and firmly establish and earnestly implement the innovation, the coordination, the development of green, open, sharing ideas, in accordance with the party central committee and the state council decision deployment, adhere to the accurate basic strategy for poverty alleviation, precise out of poverty, closely integrated with deepening the reform of medical health system, in view of the rural poor because of sickness poor, Chinese problem due to illness, highlight key areas, key crowd, major diseases, strengthen overall coordination and resource integration, take effective measures to enhance the level of rural poor health care and health service capacity in poverty-stricken areas and improve the health level of rural poor, for the rural poor population together with the people of the whole country into a well-off society in an all-round way to provide health care.

(2) the basic principles.

Adhere to the party committee leadership, government leading. Give full play to the role as the core leadership of party committees at all levels, strengthen the leading role of the government at all levels, strengthen organizational leadership, to carry out the department responsibility, giving full play to the advantages of political and institutional advantages, ensure health poverty alleviation project smooth implementation.

- stick to poverty reduction, classification ShiCe accurately. Approved in rural poor because of sickness poor, due to illness, on the basis of Chinese situation, take one to one policy, one of a family, one person one card down to the door, accurate to the people, the implementation of classified treatment, enhance the pertinence and effectiveness of health poverty alleviation.

Insist on resources integration and sharing. To improve the level of rural poor benefit as the focus, integrate the existing medical security, capital projects, technical personnel and other resources, market, society together, to mobilize the rural poor to actively participate in, take more fit actual poor areas and more effective policies and measures to enhance health poverty alleviation effect.

- problem oriented, deepen the reform. In view of the development of medical and health undertakings in poverty-stricken areas and rural poverty population to see the key difficult problem, increase the intensity of reform and innovation, we will accelerate the establishment of a perfect basic medical and health care system, ensure the rural poverty population will have access to basic medical and health services.

(3) the main goal. By 2020, everyone will have access to basic medical and health services in poverty-stricken areas and rural poor get timely and effective treatment of a serious illness, personal medical expenses burden dramatically reduce; In poor areas to effectively control the major infectious diseases and endemic diseases, the basic public health index is close to the national average, further improve life expectancy, maternal mortality, infant mortality rates, a significant reduction in the incidence of infectious diseases; Continuous destitute areas in the county and the national key poverty alleviation and development work on at least one hospital (including traditional Chinese, the same below) to achieve the secondary service levels of medical institutions, significantly improve service conditions, service ability and accessibility significantly increased; Regional health resources allocation and the people's health level gap narrowed, because of sickness poor, Chinese problems effectively because of illness.

Second, the key task

(a) improve the level of medical care, lightens the rural poor medical expenses burden. New type of rural cooperative medical care cover all rural poverty population and implement policy tilt, individual pay part by fiscal subsidies, according to the rules implemented in poor areas outpatient service as a whole, to improve policy within the scope of hospitalization expense proportion. In 2016, the new type of rural cooperative medical care of new financing is mainly used to improve the level of rural residents' basic medical insurance, and intensify the support of a serious illness insurance, reduce the starting line of a serious illness insurance, improve step by step is a serious illness insurance reimbursement ratio, etc., the implementation of more accurate payment policy, improve the level of the poor benefit. Increase the intensity of medical care, the rural poor covered all the major workplace disease medical treatment, temporarily unavailable for sudden major disease troubled patients, family support, basic life intensify temporary relief and charity relief support. Establish a basic medical insurance, serious illness insurance, disease, emergency rescue, medical rescue of cohesive devices, such as system play a role of complementary synergy, security force. Will be eligible medical rehabilitation program for the disabled included in the basic medical insurance by the regulation pay limits, improve the rural medical security level for the disabled. Advance payment reform, strengthen the fund budget management, perfecting according to disease, according to the man's head, according to the bed, the combination of a variety of ways, such as paying compound, effective control of costs. To solve the problem because of sickness poor, Chinese due to illness.

(2) to develop a serious illness and classify rural poor treatment of chronic diseases. Priority for each 1 set up dynamic management of the electronic health records, establish the poor health card, promoting grassroots medical and health institutions shall provide rural poor families with basic medical and public health and health management contract services. By county as the unit, the family planning service network, rely on the grass-roots health further approval because of sickness poor, rural poverty population in the number of Chinese families because of illness and disease, classifying need treatment of patients with serious illness and chronic diseases treatment. Can one-time cure, organization experts focus on implementation of treatment, choice since 2016 disease burden heavier, wide social influence and curative effect for centralized treatment of a serious illness, make diagnosis and treatment plan, clear clinical pathway, control the cost of treatment, alleviating poverty in patients with serious illness cost burden; Need maintenance treatment in hospital, the ability to the nearest medical institutions of the implementation of treatment; Need long-term treatment and rehabilitation, the grassroots health institutions in higher medical institutions under the guidance of the treatment and rehabilitation management. Light project implementation, for the rural poor cataract patients to provide treatment, treatment charge is solved through the current health care system and other channels, encourage charitable organizations to participate in. Strengthen rural poor health poverty alleviation work for the disabled, the poor areas at the grass-roots level medical institutions of medical personnel to carry out rehabilitation training, strengthening the construction of disabled persons rehabilitation services center at the county level, improving the capacity of grassroots rehabilitation services, medical institutions and professional rehabilitation institutions for disabled persons on the working mechanism of effective connection and coordination for the rural poor people with disabilities to provide accurate rehabilitation services.

(3) the implementation of the county in rural poverty population in the hospital diagnosis and treatment before they are paid. Poor patients in county hospital medical establishment that decide a dot to first pay after diagnosis, the medical establishment that decide a dot to establish a comprehensive service window, realize the basic medical insurance, serious illness insurance, disease, emergency rescue, medical rescue "one-stop" information exchange and instant settlement, poor patients simply conceit medical fee when discharged from hospital. Conditional place to study exploration in the district and provincial rural poverty population settlement mechanism of diagnosis and treatment before they are paid. Hierarchical diagnosis system construction in poor region, strengthen poverty county within the common disease, frequently-occurring disease related and relevant clinical subject construction, exploring the way through the county country integration medical association, enhance the service ability, in the county in 2020 to JiuZhenLv increased to 90%, basic implementation serious illness county.

(4) to strengthen the construction of poor area medical and health service system. The implementation of the general office of the state council concerning the national medical and health service system planning (2015-2020) notice do hair [2015] no. 14 (countries), in accordance with the "TianPingBuJi" principle, the implementation of poor areas county hospitals, township hospitals and village clinics standardized construction, make each key county of continuous destitute areas in the county and the national poverty alleviation and development work achieve "three ones", namely each county at least 1 at the county level public hospitals, 1 standardized in towns and townships, each township construction each administrative village have a clinic. To speed up the public health service network, improve the poor areas, with emphasis on the prevention and control of major infectious diseases, endemic diseases and chronic diseases, more in poor areas, maternal and child health care and other professional public health institutions for disease control and capacity building support. To strengthen the construction of ability of telemedicine in poverty-stricken areas, the realization of county-level hospitals and local medical and health service agencies at various levels and connectivity. Actively promote traditional Chinese medicine (including national medicine, similarly hereinafter) service level, fully developing the superiority of TCM characteristic medical preventive care. Priority in poor areas at the grass-roots level of Chinese medicine service project "much starker choices-and graver consequences-in" plan of action, improve the capacity of traditional Chinese medicine (TCM) in rural hospitals and community health service center set up museum, national physician hall, such as Chinese medicine comprehensive service, strengthen the equipment configuration and personnel of Chinese medicine.

(5) the implementation of the national tertiary hospital and continuous destitute areas in the county and the national key poverty alleviation and development work at the county level hospital one-on-one help. From the capability of the national selection of tertiary hospitals (including the army and armed police hospital), and continuous destitute areas in the county and the national poverty alleviation and development work key sign one-on-one support responsibility of county-level hospitals, clear support target tasks. Adopt the mode of "author" support, helping the hospital to be stationed 1 the dean or associate dean and related medical staff on casing support, we will focus on developing county outer rate nearly three years before 5 to 10 kinds of relevant clinical and auxiliary department construction and promotion of appropriate county-level hospitals in medical technology. Regularly sent medical teams, focus on diagnosis and service for the rural poor. Take technical support, personnel training, management guidance and a variety of ways, was help hospital to improve service ability, make its secondary medical institutions service levels by 2020 (more than 300000 people county was helping the hospital level 2 grade a level). Build support both telemedicine platforms, remote medical service. Poor areas and the relevant government departments and units to provide the necessary conditions and support.

(6) as a whole medical and health system reform in poor region. Deepening comprehensive reform of public hospitals in poverty-stricken areas and helping promote the reform of medical service price adjustment, medical insurance payment, medical institutions, public hospital compensation mechanism reform, strengthen the management of hospital costs. Deepening civil-military integration development, troops in poor areas of medical institution to grading medical service system in poor areas. Agency and staffing administration way of innovation of public hospitals at the county level, and gradually to prepare the records. In poor areas can be first exploration for public hospital performance salary amount for approval, reasonable medical and health institutions approved total performance salary, combined with the actual determine the ratio of awarding the performance salary, arouse the enthusiasm of the medical staff. To formulate conforms to practical recruitment introduced at the grassroots level to carry out the medical and health institutions in poverty-stricken areas of choose and employ persons autonomy. Strengthen the team construction of rural doctors, rural doctors in poor regions by training in rotation, 2017 years ago to complete the training. Want to combine the actual, by supporting and guiding rural doctors attend worker is basic endowment insurance by the regulation or urban and rural residents basic endowment insurance, and subsidy, and other forms, further improve the rural doctors pay of provide for the aged. Drug supply security mechanism, speed up and improve the poor areas as a whole do a good job in county hospitals with the drug supply and distribution management of grassroots medical institutions. According to the principle of distance, linkage between urban and rural areas, improve the purchasing, distribution, concentration, explore county country integration distribution, giving full play to the advantages of postal logistics services such as network, support in accordance with the provisions, to participate in drug distribution.

(7) increase the intensity of chronic diseases, infectious diseases, endemic disease prevention and control in poverty-stricken areas. To strengthen the monitoring tumor registration and the cause of death, expand coverage for cancer screening and early detection treated early. Strengthen the poverty-stricken areas with severe mental disorders screening registration, treatment and service management. Identified as complete fluorine, arsenic area of fluorine and arsenic reduction water project construction, the basic control of endemic fluorine, arsenic poisoning hazards. Take government subsidy distribution fees or subsidies, consumers make rural poverty population to eat, eat up qualified iodized salt, continue to maintain the state of eliminating idd. Comprehensive prevention and control of kaschin-beck disease and keshan disease endemic diseases. Intensify prevention and control of zoonoses, basic control echinococcosis popular western farmers and herdsmen, effectively curb brucella is popular. To strengthen the prevention and control work in poverty-stricken areas of the epidemic situation of tuberculosis (TB) is serious business guidance and technical support, to carry out the key crowd tuberculosis (TB) screening, standardize the medical service and management all the way, further reduce the incidence of TB in poverty-stricken areas. In serious AIDS epidemic of poor areas to establish prevention and control of contact, intensify prevention and control work.

Maternal and child health work (eight) strengthen the poor areas. Full implementation of free pregnancy eugenics health examination in poor areas, rural women supplement folic acid to prevent neural tube defects, rural women "two" cancer, breast cancer and cervical cancer screening, children's nutrition improving, newborn disease screening project, promote the comprehensive prevention and treatment of birth defects, do early detection, early treatment. Build system of rehabilitation aid for disabled children, gradually achieve 0 to 6 years old vision, hearing, speech, intelligence, physical disabilities children and children with autism for free operation, equipment configuration and rehabilitation training and other services. Strengthen maternal and newborn poverty areas critical patients treatment ability construction, strengthen the rural women's maternal care, to ensure the safety of maternal and infant. Strengthening the support of family planning work in poverty-stricken areas, we will adhere to and improve the family planning target management responsibility system, strengthening AIDS to the families of family planning special difficulties.

(9) engaged in poor areas of patriotic health campaign. Strengthening health town of activities, continue to carry out environmental sanitation clean action, as a whole the governance in poor areas of environmental health problems, the implementation of the rural residential environment of poor areas to improve action for poverty alleviation, effectively improving the quality of residential environment in poverty-stricken areas. Combining rural supplier and rural dangerous house renovation project, to speed up the rural sanitary toilet construction process. Strengthen rural drinking water and sanitation monitoring, investigation and assessment, the implementation of rural drinking water safety to consolidate advance engineering, and improve rural sewage treatment, and comprehensive control of atmospheric pollution, surface water environmental pollution and noise pollution. Strengthen health promotion and health education work, widely publicized residents' health literacy basic knowledge and skills, promote rural poor health consciousness, make them form good health habits and healthy lifestyle.

Three, safeguard measures

(a) to carry out the investment policy. The implementation of the central and provincial financial investment responsibility for poverty alleviation. The central government continues to make health poverty areas, family planning special funds transfer payments and promote health poverty alleviation project smooth implementation. National family planning construction project arrangement of public health in poor areas to cancel at the county level and shall destitute areas in western prefecture-level matching funds. Provinces and cities two levels of family planning project budget for health funds for further tilt to poor areas, continuous destitute areas in the county and the national key poverty alleviation and development work to integrate relevant fiscal funds by as a whole, increase investment in health poverty alleviation. Eastern provinces (cities) in poverty alleviation and cooperation within the framework of east and west, strengthening the support medical and health undertakings in poor areas.

(2) strengthen the comprehensive training. Support the development of higher medical education in poverty-stricken areas and the poor regions according to the demand, reasonable medical colleges in our region and medical professional enrollment plan. Mix, assistant general practitioner training resident standardization training, directional free order cultivation, general practitioner and a specialist AD hoc jobs plan, strengthen the construction of medical and health personnel in poverty-stricken areas. Explore and county-level integration management. According to the requirements of poor areas, the organization to carry out the appropriate technology project promotion, relying on existing institutions to establish demonstration bases, for classifying training, standardize the technology application. Receive poor areas, old revolutionary base areas, ethnic minority areas and border areas to the grassroots health workers studying army medical universities and medical institutions, training trainees. Targeted to strengthen traditional Chinese medicine appropriate technology promotion, the poor area in 2020 to each of the towns and townships have at least two doctors, each village clinic at least more than 1 rural doctors to master the five Chinese medicine appropriate technology, easy to check for common disease, frequently-occurring disease patients to inexpensive Chinese medicine services. Give full play to the national center for clinical medical research and collaborative research network, build promotion training services platform, improve the technical level of grassroots health workers. Around to formulate policies and measures to encourage outstanding talents of health services to the poor areas; Explore the grass-roots medical personnel incentive mechanism, to health technical personnel at the grass-roots level in poor areas for a long term in the title promotion, education training, salary, etc give appropriate tilt.

(3) fully mobilize social forces. Perfect encourage enterprises, social organizations and individual citizens to participate in the policies and measures of poverty alleviation project, health contribution outstanding, under the premise that respect their wish to project named and other incentives. Support all kinds of enterprises to set up a special fund to participate in the social donation and foundation health poverty alleviation project, in accordance with the provisions, the implementation of poverty alleviation donation pre-tax deduction, tax breaks and other preferential policies to encourage more social capital in poor areas, strengthen the supervision of donated funds to use. Give full play to the association, society and other social organizations, technology and other resources integration of social capital, talent, for the poor areas to send medicine, take medicine, warm. To build a government bailout resources, social aid project docking with the rural poor treatment demand information platform, guide support charitable organizations, enterprises and institutions and loving people with a serious illness such as poor charity relief.

Four, organize the implementation

(a) to strengthen organizational leadership and supervision. According to the plan as a whole, the provinces (autonomous regions and municipalities directly under the central government) overall responsibility, city (ground) county catch to carry out the work system, to combine actual poor areas around the formulate concrete implementation plan, a clear timetable and roadmap, layer upon layer to carry out the responsibility, carefully organize the implementation of health poverty alleviation project. County government should bear the main responsibility, will implement health poverty alleviation project as the important measures to fight poverty tough, make overall arrangements, policy, project to the ground, manpower allocation cohesion, proceed with the implementation, to ensure that the policy in place. Around health poverty alleviation project into poverty engines work led to the government responsibility system and poor area target evaluation management, as an important examination content and refining division of duties, a clear mission requirements, to the implementation of regular inspection.

(2) clear the responsibilities. National health and family planning commission, poverty relief office of the state council shall be responsible for overall coordination and supervise the implementation of health poverty alleviation project implementation work, formulate concrete scheme and assessment measures, organize regular assessment evaluation. National health and family planning commission, the state administration of traditional Chinese medicine, political work department of the central military commission, the central military commission of logistics security and shall coordinate the implementation of the national third-level hospital destitute areas county and the national poverty alleviation and development work key county hospitals counterpart support tasks, the counterpart support task to carry out the situation as an important part of the tertiary hospital performance evaluation. Poverty relief office of the state council, the ministry of civil affairs, China disabled persons' federation, in conjunction with the national health and family planning commission is responsible for conducting rural poor because of sickness poor, Chinese situation to verify the approval work because of illness. The national development and reform commission is responsible for the related to health poverty alleviation project content into the overall national economic and social development planning, strengthening health family planning infrastructure support poverty region. The ministry of education is responsible for supporting the development of higher medical education in poverty-stricken areas, guide the local administrative department of education to carry out the medical and health personnel training task. Responsible for the strengthening of national ministry of science and clinical medicine research center as the core into promotion system construction, promote the popularization and application of advanced suitable technology. The ministry of civil affairs to be responsible for the formulation to improve medical assistance, and overall shift disease medical relief work, improve the level of medical aid in poverty-stricken areas. The Treasury, according to the needs of work and money, the channels through the current health poverty alleviation project funding. National health and family planning commission jointly with the human resources and social security ministry responsible for Suggestions to consummate the poor areas, introduced in the medical and health personnel recruitment policy advice. Environmental protection department is responsible for the comprehensive improvement of the rural environment. Housing urban and rural construction ministry responsible for implementation of the rural residential environment of poor areas to improve action for poverty alleviation. Ministry of water resources to be responsible for guiding rural drinking water safety to consolidate promotion project implementation work. The auditor is responsible for the increase of health poverty alleviation project funding and usage of audit supervision dynamics, to monitor the health poverty related policies and measures to carry out the situation. The healthcare reform office of the state council shall be responsible for plan as a whole we will deepen reform of the medical and health system in poor region. The disabled persons' federation of China in conjunction with the state health and family planning commission, the ministry of civil affairs to carry out the basic rehabilitation services for the disabled, to strengthen the construction of ability of basic rehabilitation services for the disabled. Political work department of the central military commission, and push the troops involved in logistics security ministry of the central military commission is responsible for the overall health of poverty alleviation project related work, health service capacity building support poor areas.

(3) strengthen the propaganda guidance. Insist the right public opinion direction, carrying out health poverty alleviation series of promotional activities, through the news reports, deeds report, public welfare advertisement form, promote health poverty alleviation projects and various policy measures the progress and results, promote the general health workers into vivid deeds of poverty-stricken areas to relieve pain for the populace, and create a good atmosphere for public opinion.

(4) encourage adjust measures to local conditions around the innovative health form and way for poverty alleviation. Around to solve the problem of poverty due to illness, Chinese due to illness, combined with the actual actively explore, overall configuration and use of relevant funds, projects, improve efficiency, promote the poverty alleviation project implementation. By deepening the reform, the implementation of health poverty alleviation project of the power, through the health poverty alleviation and the related poverty of characteristic industries, labor service export, poverty measures such as cohesion, mix, improve the crucial effect poverty.

Attachment: the key tasks and schedule

The national health and family planning commission Poverty relief office of the state council The national development and reform commission

The ministry of education of science and technology ministry of civil affairs

The Treasury of human resources social security ministry of environmental protection

Ministry of housing urban and rural development of the state administration of traditional Chinese medicine

The political work of the central military commission Logistics security ministry of the central military commission

China disabled persons' federation

On June 20, 2016

The attachment

Key tasks and schedule

The serial number

Work task

Responsible for the department

schedule

1

To develop rural poverty population shift disease medical assistance policy measures

The ministry of civil affairs, poverty relief office of the state council, the ministry of finance, the state health and family planning commission, the China disabled persons' federation

Completed before the end of December 2016

2

To develop county in rural poverty population in the hospital after diagnosis and treatment measures for the implementation of paid first

The national health and family planning commission, human resources, social security, the ministry of civil affairs

Completed before the end of October 2016

3

To carry out the rural poor because of sickness poor, Chinese "due to illness" verify approval work

Poverty relief office of the state council, the ministry of civil affairs, China disabled persons' federation, the national health and family planning commission, human resources, social security

In 2016, completed before the end of July

4

For 2016 rural poverty population concentrated treatment of a serious illness

The national health and family planning commission, human resources, social security, the ministry of civil affairs

Completed by the end of August 2016

5

Establishing the national tertiary hospitals and continuous destitute areas in the county and the national key poverty alleviation and development work at the county level hospital one-to-one support relations

National health and family planning commission, the state administration of traditional Chinese medicine and political work of poverty relief office of the state council and the central military commission, the central military commission logistics security

Completed by the end of June 2016

6

Assessment method developing health poverty alleviation work

The national health and family planning commission, poverty relief office of the state council

Completed by the end of June 2016