The rural medical reform of Zhenan of Shaanxi is investigated: The location of comprehensive assessment ranks the top in the whole country

The rural medical reform of Zhenan of Shaanxi is investigated: The location of comprehensive assessment ranks the top in the whole country
The rural medical reform of Zhenan of Shaanxi is investigated: The location of comprehensive assessment ranks the top in the whole country
Reporter Wang Qun of " China's economic weekly magazine " In 2010, China's rural hygiene development projects will go to Zhenan of Shaanxi to carry on the assessment, speak highly of medical reform work of Zhenan county: 40 comprehensive assessment of project county of 8 provinces of the whole country, Zhenan ranks the first. Zhenan secretary of county Party committee Zhang YingAn says: Let masses diagnose the illness easy it sees the doctor expensive to be the intersection of Zhenan and original intention of medical reforming, let masses it falls ill to be final directions little. Medical reform first " Cure people " This year 36 year old, benevolence act as the intersection of Shaanxi Province and the intersection of Zhenan and the intersection of county and bronze, imprison the intersection of town and president of commune hospital through compete for at what it will be non- on the permanent staff doctor. "If not compete for publicly, as the president dare not desire in succession, present working pressure is very great, may step down from the stage carelessly. " 26 -year-old Li Ying is a nurse of the town commune hospital of the punch, according to her introduction, did to do few, easy to do difference to do more in the past, everybody's incomes are basically all the same. Press now " Pair of one hundred points " Examined, the more pay for more work, she took more than 2200 yuan last December, more than one time more than the past. Commune hospital doctor Li of town centre says in large level ground, " a pair of one hundred points " After making the performance to examine and implement, the doctor is no longer prevarication patient, there are more people seeing the doctor, the economic benefits of the hospital have gone up, the social benefit has gone up too. Shaanxi Shang Los Angeles Zhenan county is one " Nine mountains and half a water half point field " Soil stone mountain county,283,000 come loose people live in region of more than 3400 sq. km.s, in addition whether natural condition is bad, the economic base is weak, return to and cause the poor phenomenon to be comparatively serious poorly and due to illness due to illness. For a long time, the worker with unit health care at all levels of Zhenan county is used to holding " a secure job " Eat " mess " Life,fail the worker one service consciousness, efficiency consciousness, competition consciousness; The technical staff of the hygiene is insufficient seriously, counties, townships are medical 840 of Damien understaffed of health organ for two grades. Zhenan county Party committee, county government realize, should analyse and explain these persistent ailments, establish the real harmonious relationship between doctors and patients, must be settling well at first " People " Question upper and lower time. Zhang YingAn introduces: "We are reformed into the breach with the unit personnel distribution system of the hygiene in pilot medical reform, pursue president's recruiting, whole employing and system to assess of performance in the county, medical health organ of township, make president to be ready to accept a higher or a lower post, worker can engage, can retreat and salary can can be low. " The acting county magistrate of this county tells reporters Qu pool great wave: "The distribution system reform of the personnel, it is the redistribution of interests, some people are glad, some people are unhappy, this is very normal, so long as it is more difficult to accord with masses' interests we will insist on doing. " The ones that catch a hygiene president in medical organization in Zhenan county " The pivot " ,Break the identity demarcation line, has competed for 25 hygiene presidents, Vice President of villages and towns publicly, registered publicly, qualification is examined, written examination, interview, democracy is tested and assessed, procedure of organizing investigating etc., engaging the president, 37 Vice Presidents newly, in that 9 take the post as the president and fall and engage originally; Adopt many wheels to give a recommendation to the county director, recommend by general acclaim commonly and select. Implement probationary period of one year to the president, Vice President that engage newly. Meanwhile, implement whole system of appointment and work responsibility system to the workers of health clinics in towns and townships, employ 421 workers. Have set up examining, the rewards and punishments, engage continuously, discharge, the system of discharging an appointment. It is main fact to pursue working quantity, work quality " Pair of one hundred points " Make and examine. To leaving and engaging personnel the policy of laying off and distributing of retiring, leaving the post, resigning ahead of time etc., fall and engage and shunt 18 people. Invigorate and assign the mechanism, the funds of permanent staff of health clinics in towns and townships, by the Bureau of Finance of the county according to standard and unit budget making of the policy and supervising in accordance with the law and audit actively, the special management of health bureau, the Bureau of Finance includes the funds of personnel of health clinics in towns and townships in the commune hospital and unifies management to assign, have prevented effectively " Divide the light to eat to the limit " Phenomenon. In order to solve talent's bottleneck problem, Zhenan county will cooperate with western talents to revitalize and plan to recruit 12 people for the hygiene system in 2010, under the joint efforts of the cities and counties, work out for the newly-increased medical organization this year, the special fund of personnel training of the finance annual budget of 200,000 yuan hygiene of the county, every unit raises 100,000 yuan independently, the method adjusted through economy, guide and support the hygiene unit to strengthen personnel training. "Only this one, last year, 56 hygiene technical staff of villages and towns and medicine of 34 villages accepted that trained free in the whole county. " It is told reporters that the standing committees of the county Party committee of Zhenan, propaganda ministers are beautiful on yellow day. It is reasons why the final direction supplies the system to let the masses fall ill few because of the finance, all the time, the main expenditure of the hospital has depended on the medical income, the persons who become antithesis with immediate interest consciously between doctors and patients. The difficult problem of seeing the doctor in order to solve the masses, Zhenan county suits the remedy to the case: Pursue the basic medicine system, guarantee medical medicines are of high quality and at a reasonable price; Launch the pilot project of making a diagnosis regularly, set up the system of quality assurance, offer good service to masses, explore and set up medical quality actively and standardize the supervisory system; Set up the system of integration of urban and rural areas, equipoise health care in urban and rural areas to develop. The reporter knows, under coordinating in support in the department of public health of Shaanxi Province, technology and talent are in the fourth army Datang hospital where Western medicine in Shan defended the top level of the circle, the institute of traditional Chinese medicine of Shaanxi Province, woman in Shaanxi Province protect the institute and also guide hospital, institute of traditional Chinese medicine and woman of county of Zhenan county and protect the institute geared to the needs of the job separately, launch, make a diagnosis regular pilot project, make, improve 65 the intersection of form and number enter, leave hospital, judge standard and clinic diagnosis norm and popularize and implement already at present. Launch the national-level clinical route pilot project in the county hospital, according with chooses 20 pieces of number actually, make the clinical route and pursue strictly, ensure the quality of products, control the expenses. "We still try to launch ' the agreement is entrusted ' the fund-raising reform pilot project in some villages and towns, through the intersection of Huinong and card, voluntary to take peasant and agreement trust and way which the credit office transfer accounts raise for, join the intersection of joint-venture and King. " Deputy Bureau Director Hao of this county hospital introduces, from 2011, rural resident and urban residents can choose to participate in the rural cooperative medical service or urban residents medical insurance the whole county freely, implement the standard, unified management of paying the fees in unison, submit an expense account and subsidize in unison. In strengthening and helping geared to the needs of the job, the method of this county is: The health clinics in towns and townships of coordinated cooperation of medical organization at county level work, select to engage 6 hospital Vice Presidents at county level as 6 honorary presidents of health clinics in towns and townships by county hospital, select to send business backbone to the health clinics in towns and townships to diagnose in turn for a long time, guarantee to promote the comprehensive service ability of the health clinics in towns and townships effectively. Zhang YingAn says: "Zhenan is a poor county, the masses are more serious when causing and returning to the poor phenomenon poorly and due to illness due to illness, this is an important factor of restricting economic development of mountain area too, the input to the hygiene reform is to people's healthy input. " The burden of seeking medical advice in order to lighten the masses conscientiously, Zhenan county advances basic medical treatment to ensure covering completely. The ones that initiate in Zhenan are in hospital single number pays the mode by norm Have already popularized in the whole country. Strengthen the average daily expense limit of non- single number at the same time and control efforts, the proportion of medicines outside the strict catalogue and checking the positive rate, have? �� the intersection of Zhyuan and product prolong the intersection of rose and slow chivalrous ��, Chen of treadle-operated tilt hammer for hulling rice, Mou? "Last April, it is managed that we pursued medicines ' three in an all-round way unifiedly in 25 villages and towns of the whole county ', hold medicines to use 6 427 people of training class rationally, departments such as medicine supervising, hygiene, price, discipline inspection,etc. purchase, sell to the entering of medicines and execution that leads of a difference is supervised and inspected in the whole journey, in less than half a year, the rate of utilization of medicines is more than 95% in the health clinics in towns and townships and basic medicine catalogue of village clinic, spending with the expenses for medicine in the whole year reduces by 45%. " The person in charge of county Bureau of Drugs Supervision tells reporters in this way. Interview, imprison the intersection of town and the intersection of in the center and commune hospital, it gives one Feng that childs has an intravenous drip to be whether young mother tell reporter bronze: "Participate in now and shut newly and agriculturally, doctor said the country replenished the money for the hospital these two years, so medicines will not raise the price, the whole family spent more than 1000 yuan seeing the doctor altogether over the past two years, submit an expense account more than 700 yuan newly and agriculturally jointly, pay and is less than 300 yuan by oneself. " Introduces that beautiful on yellow day, last August, Department of Civil Affairs, health bureau, the intersection of people and the intersection of society and office, treat, do, make " Zhenan medical treatment, resident of county, ensure system and medical rescue system not to sew and connect the implementing scheme " jointly jointly, county of Zhenan, and already tried, has shut " through train " newly and agriculturally Wipe out mode. Medical rescue systems of urban and rural residents were implemented thoroughly, from last January to October, family planning, civil affairs department utilized the society to succour the fund effectively, pay, effect an insurance fund 14571 the intersection of people and 437,100 for family and pairs of woman family, only-child of the whole county, altogether, it is the whole county " household enjoying the 5 guarantees " Pay the intersection of medical insurance and the intersection of fund and 38502 the intersection of people and 810,000 with destitute household, all at school pupil effect an insurance expenses by medical the intersection of relief fund and commitments in full, subsidize 3,645,000 yuan for 1562 persons in hospital, subsidize 1,202,000 yuan for 1202 persons in clinic in rural poor medical rescue. "The method that difficult to see the doctor and see the doctor expensively only ' solve the problem ', in fact, if the masses fell ill few, do not then exist (see the doctor) Difficult with (see the doctor) Expensive problem. " Chief of Zhenan county hospital Wang ZhongYi who the town secretary comes from tells reporters, their concrete method is " It is linked that tertiary " ,Namely regard county, township, village health educational institution as the skeleton, regard peasant's health promotion association as carriers, with " rural health school " It is a new mode of health education of the platform. First, establish health education and health promotion association. Second, set up one burst of rooms of health education, make overall plans and coordinate the health care unit of the whole county and launch health education and health promotion and work. Third, set up " Manage the group oneself in health " . Fourth, launch " Five personal persons " Take action. Fifth, launch " The healthy tour " Take action. Sixth, launch the TV lecture of the health education. "Our method to set up peasant's health promotion association has already got abundant affirmation and favorable comment of Ministry of Public Health, centre, province and city expert. And it proves, this kind of attempt has made sure in fact ' let the masses fall ill few to practise, enable common people to be healthy '! " Wang ZhongYi says. The rural hygiene development projects Chinese Government of China utilizes The World Bank Loan and British government grant, international collaborative project that the rural hygiene reform launched explores. The project, with " suggetion on deepening the system reform of the medical and health of the State Council of Central Committee of the Communist Party of China " in order to guide, organize the comprehensive pilot project of development in fields such as rural health guarantee system, medical service system,etc.. The project has covered the areas of the west our country, middle, different economics and society development levels of east, including 40 counties of 8 provinces such as Shaanxi, Qinghai, Henan, Heilongjiang, Jiangsu, it accounts for 60% of the total number of project counties for the poor county to count.


|