Core Reading
In recent years, Jinshui District of Zhengzhou City has promoted the sinking of medical resources to the grassroots level to ensure the smooth operation of hierarchical diagnosis and treatment through the construction of a close-knit urban medical group, broken down barriers such as personnel relations and professional title evaluation, enriched the strength of primary medical care, and improved the ability of online diagnosis and treatment, promoted the construction of a healthy China, paid equal attention to prevention and treatment, built a three-level health management linkage system, integrated health management into grassroots social governance, and taken multiple measures to protect the health of the masses.
Not long ago, Uncle Wang, a retired citizen who needed long-term hospitalization, chose to transfer out of the provincial tertiary hospital and lived in the Renmin Road Street Community Health Service Center at his doorstep.
"Don't look at this as a community hospital, but it is connected to Jinshui District General Hospital, and the level is not low. He told reporters that he can be hospitalized at the door of his home, which is convenient for family visits and can often see old friends.
In recent years, Jinshui District, Zhengzhou City, Henan Province, has laid a solid foundation for the implementation of the hierarchical diagnosis and treatment system by building a close-knit urban medical group to promote medical resources to the grassroots level, and has effectively protected the health of the masses by building a three-level health management promotion linkage system, integrating health management into grassroots social governance, paying equal attention to prevention and treatment.
Construction of the City Medical Group
Hierarchical diagnosis and treatment are running smoothly
"Every day after the doctor's treatment, the old guys come to me to play cards and chat, and they live close to me, just a few steps away. It is also convenient for my son and daughter-in-law to deliver food, which is similar to living at home!" Uncle Wang sighed, "The community hospital at the door of the house is so good!"
"We have the deputy chief physician sent by Jinshui District General Hospital to meet Uncle Wang's treatment needs. Song Peipei, director of the Renmin Road Community Health Service Center, said, "After Jinshui District has established a close-knit urban medical group, the enthusiasm of doctors to work in the community has been greatly improved. ”
As the central urban area of the provincial capital, Jinshui District has 13 tertiary hospitals in an area of more than 100 square kilometers, with rich medical resources.
"There are so many big hospitals and good hospitals, which is providing conditions for us to carry out hierarchical diagnosis and treatment and weave a dense network of public health services at the grassroots level. Zhang Yanhua, head of Jinshui District, said that Jinshui District strives to promote hierarchical diagnosis and treatment and strengthen the construction of the grassroots public health service system, which is not only to help more than 1.6 million residents in the district, especially the needy people, to seek medical treatment nearby, high-quality and cheap medical treatment, but also to revitalize more high-quality medical resources for the people in Zhengzhou who come to Zhengzhou for medical treatment.
On the basis of years of medical reform, Jinshui District has established a close-knit urban medical group led by the Jinshui District General Hospital of the three-level comprehensive level, and implemented the "five unifications" of human resources, financial operation, material security, medical quality control and information management for 21 neighborhood community health service centers and 9 community health service stations.
Qu Yanming, President of Jinshui District General Hospital, used referral as an example to introduce the benefits of establishing a close-knit urban medical group, "As one of the upper and lower levels, the General Hospital will not only not compete with the community health service center for patients, but will also provide technical support. The cost of the community is low, the general hospital is well technological, and the patient can go wherever it suits him. ”
Qu Yanming continued to introduce that within the group, the transfer patients from the community to the general hospital are exempted from registration fees, and the process of medical treatment, examination and hospitalization is smooth, while the transfer patients are canceled from the starting line, and the special line is direct and the person is dedicated.
"In the past, it was often easy to go up and difficult to go down. However, since 2023, the number of downward referral patients in our group has reached 3,042, a year-on-year increase of 2 times. Qu Yanming said, "The volume of primary diagnosis and treatment accounts for 69% of the group. The problems of the inability to retain patients at the grassroots level and the overcrowding of large hospitals have been alleviated to a great extent in Jinshui District. ”
Strengthen the strength of primary medical care
Improve the ability of online diagnosis and treatment
Dr. Wang Qiang, who originally worked in the respiratory department of Jinshui District General Hospital and has a deputy senior title, took the initiative to ask to work at the Fenghuangtai Street Community Health Service Center near his home after passing the general practitioner examination. With a high level of medical care, Wang Qiang sees an average of 50 patients per day, and with the help of CT and other medical equipment, he helps 3 patients find early cancer, so that they can be treated early.
"From the general hospital to the community, the personnel relationship and treatment assessment are basically unchanged, and there is no ideological baggage. In the past two years, the children are still young, close to home, easy to take care of, and can also contribute to the community. Wang Qiang said that now the diagnosis and treatment environment and equipment of the community center are good, which can meet most of the medical needs.
"To promote hierarchical diagnosis and treatment, the difficulty lies in enriching the medical strength of the grassroots level. In recent years, Jinshui District has continuously increased investment and tilted resources to the grassroots. Li Huimin, Secretary of the Party Group and Director of the Jinshui District Health Commission, said that at present, 80% of the community health service centers in Jinshui District have installed CT and other medical equipment, and the average assets of the community health service centers have reached 11 million yuan.
"In terms of personnel management, we have smoothed the flow and deployment within the group, and realized that 100% of doctors with middle and senior professional titles regularly visit the grassroots for consultation, and 60% work at the grassroots level on a regular basis, which greatly enriches the grassroots strength. Li Huimin said.
"The bulge on the lateral leg bone of the patient's right calf, please pay attention to it. After sending the patient's medical images to the remote diagnosis center of the District General Hospital through the Internet diagnosis and treatment system, Wei Junli, a general practitioner at the Fenghuangtai Community Health Service Center, was still not at ease, and called again to explain some of her suggestions.
Li Huimin introduced that all community health service centers in Jinshui District are equipped with Internet diagnosis and treatment equipment, which is convenient for grassroots doctors to seek help online at any time, and more than 27,000 online consultations last year. "In 2023, the number of general practitioners in our jurisdiction increased by 118.96% compared to 2019 to 254. Medical staff are becoming more and more motivated to work at the grassroots level. ”
According to statistics, in the past three years, Jinshui District has adhered to the government-led and public welfare-oriented, integrated factors such as population distribution, infrastructure, and mass demand in the district, built 7 new neighborhood community health service centers, renovated and upgraded 14 neighborhood community health service centers, and all of them were incorporated into group management to achieve full coverage of grassroots public health service facilities in the district.
"According to the Service Capacity Standards for Community Health Service Centers (2022 Edition), all community health service centers in the district have met the basic national standards for capacity building, 60% of them have reached the national recommended standards for capacity building, and 9 have successfully established 'community hospitals', improving both the medical environment and service capacity. Li Huimin said.
Build a three-level linkage system
Social Governance of Health Management Integration
"Auntie, you are recovering well, you can go for a walk if you have nothing to do, but remember to walk slowly and be careful not to fall. At the home of the elderly Wang Lanying, Building 208 of Zhangzhuang Community, Fenghuangtai Street, Ma Yuling, a community doctor, told her after doing acupuncture and massage.
Zhao Haojia, a community health management promoter who came with her, left the latest health leaflets for the families of the elderly and registered information on treatment and recovery.
Wang Lanying, 75 years old this year, needs to be hospitalized for a long time after a cerebral hemorrhage, and her family has a heavy burden of care.
In October of the previous year, Jinshui District relied on the perfect family doctor service system to start a pilot family hospital bed, and Wang Lanying was the first to submit the application. "Living at home, enjoying hospitalization, most of the treatment costs are reimbursed, and the community doctor visits the hospital regularly. My children can take care of me at home, which saves me worry and effort. This policy is good!" Wang Lanying said.
While strengthening the capacity of medical services, Jinshui District focuses on promoting the construction of a healthy China, paying equal attention to prevention and treatment, building a three-level health management linkage system, and integrating health management into grassroots social governance.
Next to Ma Yuling's workstation at the "Community Doctor's Home" of the Fenghuangtai Community Health Service Center, there is a "List of Team Members of the Fenghuangtai Street Health Management Promotion Service", which is divided into 13 groups, each of which includes specific family doctors, community health management promoters, community nurses and experts from the district general hospital.
"Our health management system is comprehensive, multi-level, and linked. Li Huimin introduced, "There is not only a comprehensive community medical system, but also a three-level health promotion system that links districts, neighborhoods and communities. ”
According to Li Huimin, Jinshui District has innovated to create a "trinity" family doctor service position of family contracted doctors, street studios, community service stations, and building diagnosis and treatment points, providing 9 basic free services such as health education, health management, traditional Chinese medicine, and maternal and child health care for the masses, and based on this support, explore the opening of family beds for special patients, and promote the extension of health services to the people's doorsteps.
According to statistics, more than 1,219,000 people in Jinshui District have signed up with family doctors, established 1,433,900 residents' health records, and managed 141,400 patients with chronic diseases.
At the same time, the three-level health management promotion linkage system of districts, streets and communities has been innovatively constructed, and a health management promotion committee has been established at the district level, and health management promotion centers and health management promotion offices have been set up in streets and communities respectively, so as to incorporate residents' health services into the grid-based grassroots governance system led by party building, and each grid will be equipped with at least one health management promoter.
"Our role is mainly to popularize health knowledge to residents, and at the same time pay close attention to the health status of residents, and report to the authorities at any time if there are emergencies in the health of residents. Zhao Haojia said.
In order to meet the diverse health needs of the public, Jinshui District has opened a number of convenient maternal and infant rooms for public places to provide diversified maternal and infant services in public places. At the same time, in order to improve residents' self-health service capabilities, we will also add a number of smart medicine kiosks for long-term prescription patients to achieve self-service medicine pick-up by scanning QR codes, and a number of smart health houses that can carry out self-service health testing and physical fitness assessment for community residents. Li Huimin said, "Relying on science and technology to save costs and increase efficiency, and provide high-quality health services is an important development direction for us." ”
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