Bed plans for the next five years are announced
Recently, the National Health Commission issued the Guiding Principles for the Establishment and Planning of Medical Institutions (2021-2025) (hereinafter referred to as the Guiding Principles).
The Guiding Principles guide health administrative departments at all levels to formulate the "Planning for the Establishment of Medical Institutions" (hereinafter referred to as the "Planning") in their respective administrative regions, give full play to the role of the government's macro-control and market allocation of resources, further promote the optimal allocation of medical and health resources, make up for shortcomings, change models, and increase efficiency, so as to achieve the coordinated development of urban and rural medical service systems, comprehensively enhance the capacity of medical services, and effectively improve the fairness and accessibility of medical services.
The establishment of medical institutions is macro-controlled by the main indicators such as medical service demand, medical service capacity, number of beds per thousand population (number of TCM beds per thousand population), number of physicians with a thousand population (number of Chinese medicine physicians in a thousand population), and number of nurses in a thousand population, and the specific indicator values are determined by each province, autonomous region and municipality directly under the Central Government according to actual conditions.
Improve graded diagnosis and treatment, focusing on strengthening specialized capacity building
Improve the urban medical and health service system based on community health service institutions, establish a division of labor and cooperation mechanism between urban hospitals and community health service institutions, and further improve the rural medical service network with county-level hospitals as the leader, township health centers and village clinics as the basis.
Accelerate the improvement of the hierarchical diagnosis and treatment system. In accordance with the urban grid layout management, the establishment is led by tertiary public hospitals or hospitals representing the medical level of the jurisdiction, and a number of hospitals, grass-roots medical and health institutions, and public health institutions constitute a close-knit urban medical group.
In accordance with the principle of county-township integration and rural integration, actively develop a close-knit county-level medical community, county-level hospitals focus on strengthening specialized capacity building, strengthen the counterpart assistance of urban tertiary hospitals to county-level hospitals, strengthen the division of labor and cooperation and business coordination between county-level hospitals and public health institutions, and strengthen technical guidance for township health centers and village clinics.
Integrate the existing medical resources in the region and promote the mutual recognition of the inspection and test results of medical institutions. Support the development of rehabilitation hospitals, nursing homes, and nursing stations (hereinafter collectively referred to as continuing medical institutions), encourage the transformation of some secondary hospitals in areas with abundant medical resources into continuous medical institutions, increase service coordination in the region, and expand the supply of continuous services such as rehabilitation, nursing, and palliative care.
With the goal of promoting the progress of national medicine, relying on existing resource planning, national medical centers, national and provincial regional medical centers, clinical medical research centers, and traditional Chinese medicine inheritance and innovation centers are set up, and private hospitals are encouraged to participate.
Strengthen the capacity building of clinical specialties during the "14th Five-Year Plan" period, build a high-quality talent team, and drive the overall level of national and regional medical services to a new level.
Focusing on diseases with high provincial mortality and high transfer rate, strengthen the technical and talent support of national-level high-level hospitals for provincial-level hospitals, improve provincial diagnosis and treatment capabilities, and reduce cross-provincial medical treatment.
Strengthen the supporting role of informatization, effectively implement the standards and norms for the informatization construction of hospitals and grass-roots medical and health institutions, promote the deep integration of emerging information technologies such as artificial intelligence, big data, cloud computing, 5G, and the Internet of Things with medical services, promote the construction of smart hospitals and the standardization of hospital information, and vigorously develop and standardize telemedicine and Internet medical care.
Establish and improve a major epidemic relief and treatment system with hierarchical and hierarchical triage
Relying on hospitals with strong comprehensive treatment capabilities, we will build a major epidemic medical treatment network in sub-areas across the country, led by national medical centers, national and provincial regional medical centers, and jointly composed of relevant medical institutions.
Adhere to the combination of medical and prevention coordination and peacetime and emergency, and form a major epidemic treatment system with a clear division of labor, complementary advantages, and coordinated linkage in accordance with the principles of grading, stratification, and diversion of treatment. Continue to strengthen the management of infection prevention and control in hospitals and improve the response capacity of major epidemics.
Strengthen the construction of a medical emergency service system. Build a three-level medical emergency service system covering urban and rural areas, with smooth connections and high-quality services. Cities at the prefectural and municipal levels and above and counties and county-level cities with conditions set up emergency centers (stations), and counties and county-level cities that do not yet have the conditions set up county-level emergency centers (stations) relying on medical institutions with a high comprehensive level in the region, and at the same time improve the emergency transport capacity of township health centers.
Large cities with conditions can set up emergency sub-centers or first aid stations under emergency centers. Promote the effective connection between the pre-hospital emergency network and in-hospital emergency, explore the establishment of a real-time interactive intelligent platform between pre-hospital medical emergency institutions and five major centers (chest pain center, stroke center, trauma center, critical maternal treatment center, critical child and newborn treatment center), and promote the integration of emergency emergency services.
Focus on the development of rehabilitation, nursing, traditional Chinese medicine fields
Strengthen the establishment of geriatric departments in general hospitals at the second and higher levels, encourage the establishment of geriatric departments in the second and higher traditional Chinese medicine hospitals with conditions, and guide the transformation of some first- and second-level public medical institutions into long-term care institutions.
Explore the construction of community (township) medical and nursing care service facilities in community health service institutions and township health centers, open geriatric departments in hospitals around pension institutions, carry out various forms of medical and nursing services, and do a good job in the diagnosis and treatment of geriatric diseases.
Expand the space for social medical services, and the total amount and space of social medical areas are not limited by planning. Encourage social forces to set up independent medical institutions such as non-profit medical institutions and medical laboratory laboratories, pathological diagnosis centers, medical imaging diagnosis centers, hemodialysis centers, and rehabilitation medical centers in the field of rehabilitation, nursing, and other shortage specialties, strengthen the standardized management and quality control of social medical services, and improve the level of homogenization.
Explore various forms of collaboration between social medical institutions and public hospitals. The setting of the clinic is not limited by the planning layout, and the filing system is implemented.
Promote the construction of the National Center of Traditional Chinese Medicine, the National Regional Medical Center of Traditional Chinese Medicine, the National Center of Integrative Medicine, and the National Regional Medical Center of Integrative Traditional Chinese and Western Medicine, set up at least 1 provincial-level regional medical center of traditional Chinese medicine in each province (autonomous region and city), vigorously develop key hospitals with traditional Chinese medicine characteristics, "flagship" hospitals of traditional Chinese and Western medicine, county-run traditional Chinese medicine hospitals, traditional Chinese medicine clinics and outpatient departments, and basically achieve full coverage of county-run traditional Chinese medicine medical institutions.
Relying on the construction of high-level TCM hospitals covering all provinces of the national TCM epidemic prevention and control base and the national TCM emergency medical rescue base, strengthen the construction of infrastructure conditions for infectious diseases, respiratory, emergency, critical care and other related departments of TCM hospitals, and improve the emergency and treatment capabilities of TCM hospitals.
Reasonably determine the size of public hospitals
In provincial-level areas, 1 provincial-level regional medical center is planned for every 10-15 million people, and at the same time, specialty hospitals and traditional Chinese medicine hospitals such as children's, tumors, psychiatry, and infectious diseases are planned and laid out according to needs, and the population size in sparsely populated areas can be appropriately relaxed, and occupational disease and stomatological hospitals can be set up according to the actual needs of medical services;
In prefecture-level and municipal areas, for every 1-2 million people, set up 1-2 prefecture-run tertiary general hospitals (including traditional Chinese medicine hospitals, and the population size in sparsely populated areas can be appropriately relaxed), and set up municipal specialized hospitals (including traditional Chinese medicine specialty hospitals) for children, spirituality, obstetrics and gynecology, tumors, infectious diseases, rehabilitation, etc. as needed. Orderly guide the transformation of some urban district-level hospitals into specialized medical institutions such as rehabilitation, nursing, spiritual and occupational diseases;
In county-level areas, according to the number of permanent residents, in principle, 1 county-run general hospital and 1 county-run traditional Chinese medicine hospital (including traditional Chinese medicine hospital, integrated traditional Chinese and Western medicine hospital, ethnic minority medical hospital, etc.) are set up, and ethnic minority medical hospitals are given priority in county-level areas of ethnic minority areas and ethnic autonomous areas. In principle, in areas with a permanent population of more than 1 million in the county, the number of county-run hospitals can be appropriately increased; the county-run hospitals should be integrated and set up with a permanent population of less than 100,000.
Counties and municipalities that serve a large population and are not covered by prefectural and municipal medical institutions may build psychiatric hospitals as needed or rely on county-run general hospitals to set up psychiatry specialties and wards. Achieve 1 standardized maternal and child health care institution organized by the government at the provincial, municipal and county levels.
Public hospitals should reasonably set the number of departments and wards according to their functional positioning and service capabilities. No more than 50 beds per ward. The number of beds in the newly established county-run general hospital (single practice point, the same below) is generally about 600-1000;
The number of beds in the newly established prefectural and municipal general hospitals is generally about 1000-1500; the number of beds in the newly set provincial general hospitals and above is generally about 1500-3000 beds.
When setting up and approving tertiary general hospitals, it is necessary to guide tertiary general hospitals to increase the scale and proportion of beds in critical care medicine, and rationally allocate clinical specialty resources. New tertiary general hospitals and their beds shall comprehensively consider factors such as bed occupancy rate, average hospital stay days, and difficulty in treating diseases, and in principle, the average hospital stay days are too long to be added.
In principle, we will support some public hospitals with strong comprehensive strength and build sub-hospitals on the basis of strictly controlling the scale of individual bodies.
In principle, by the end of 2025, there shall be no more than 3 sub-districts of eligible public hospitals; in new sub-districts, the number of beds in each sub-district shall not be less than the minimum requirements of the second-level hospital of the same category, and not higher than the maximum standard of beds in the general hospitals of the same level determined by these Guidelines, and the total number of beds in each sub-district shall not exceed 80% of the number of beds in the main campus at the end of 2020.