The market is ever-changing, has social medicine really entered the spring?
The author | to do so
Source| Zhu Ren on medical humanities
On April 7, 2022, Xinhua News Agency was authorized to issue the Decision of the State Council on Amending and Repealing Some Administrative Regulations, of which some provisions of the Regulations on the Administration of Medical Institutions have been amended and decided to take effect from May 1, 2022.
The article signed by Xu Yucai mentions:
The filing system was established according to law, giving the social doctor a reassuring pill.
The biggest highlight of this revision is that the filing system of medical institutions has been solidified in the form of regulations. In terms of the approval of the establishment of medical institutions, the original stipulation that "the establishment of all medical institutions must be approved and obtain a letter of approval for the establishment", and now the establishment of medical institutions is the coexistence of the approval system and the filing system.
Although before, the policy has made it clear that medical institutions at the second level and below no longer need to be approved, only "filing", but because the "law" has no basis, it always makes people feel uneasy and unsteady, and now in the new regulations, clear provisions have been made, which is obviously a reassuring pill for social medical treatment.
If you look at it this way, it is indeed a great encouragement to run a doctor for society, but the market is ever-changing, and social medical service has entered the spring? Let me tell you about a new system, the general hospital system, from Sanming City, Fujian Province.
In 2020, at the 4th China DRG Charging conference, Zhang Yuanming, vice mayor of Sanming City, introduced the Sanming General Hospital model to everyone. This system is a profound adjustment of the existing medical and health service model, medical concept, and medical order, and is a basic, long-term and systematic system design. Sanming's health "gatekeeper" system is a county-level health management organization system with the General Hospital as the main body.
"Administrative Reform" No. 12, 2021, Comrade Zhan Jifu published an article entitled "Promoting the Reform of Public Hospitals with the Concept of People First - Taking Sanming Medical Reform as an Example", which describes it as follows: Fundamentally solve the problem that the internal institutional mechanism of the health management organization is not perfect enough, the linkage between the upper and lower levels is not close enough, the three levels of people, finance, materials, events, performance, and management in the county and rural areas are highly centralized and unified, management, talents, and diseases are sinking, and the sharing of economic benefits is realized, and it truly becomes a family, a heart, and an account. Enhance the internal synergy of the health care organization, and the goal is to provide full-cycle and whole-process health care for the management and care objects.
The General Hospital immediately became a regional health management organization, implemented the package payment of medical insurance funds, stimulated the enthusiasm of medical staff to carry out health promotion work such as family doctor contract services and popularization of residents' health knowledge, and guided medical services from "curing existing diseases" to "treating existing diseases and treating pre-existing diseases", and finally changing to "people's health as the center".
At the 2019 China Health County Conference and County-level Hospital Development Summit, Yang Xiaodeng, Secretary of the Party Committee of Youxi County General Hospital, shared the practice and exploration of the hospital in the modern hospital management system. Yang Xiaodeng introduced that in Youxi, the people jokingly called youxi County General Hospital the "Second Health Bureau", because in order to strengthen the construction of the county medical community, the general hospital has set up a grass-roots health department, a grass-roots medical department, a grass-roots pharmaceutical department, a grass-roots finance department, a chronic disease department, a health education department, a distance training center, etc.
Synthesizing the above contents of the three leaders, we can see several characteristics of the general hospital system:
1. Compact medical association, six unifications
2, money follows people, regional medical insurance funds package payment
3. Performance (resident health) is linked to the income of medical staff
Some people will ask, what is the relationship between this and the regulations on the management of medical institutions?
For example, if you open a small restaurant, you may have competed with you in a large and small restaurant. One day, the restaurants that compete with you say they are going to merge into a restaurant group, how much pressure do you have.
Others will challenge to say:
1, the hotel has characteristics, not afraid of competition
Answer: Restaurants may differentiate themselves, but how much medical features does a clinic have?
2, the technology is not good, you can hire a chef
Answer: Not to mention the salary, why should a public hospital group with drought and flood protection come to your hospital?
3. Large-scale social medical institutions can be engaged
Answer: How big is it? How many social medical institutions can achieve large investment?
If the general hospital system is fully rolled out, the way out for social medical treatment may be:
1. Areas not covered by medical insurance, such as dentistry, aesthetic plastic surgery, reproduction, ancestral Chinese medicine, etc
2. High-end medical treatment, such as for-profit medical institutions, overseas medical services, etc
3. A group of doctors with strong professional fields, such as neurosurgery
Therefore, the so-called encouragement of social medical treatment is not to let you grab the job of public hospitals, but as a supplement to the medical industry. Then in the limited market, there are many competitors, don't be too optimistic. (Original title: When the Regulations on the Management of Medical Institutions Meet the General Hospital System)
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