Jiangxi Explore the characteristic way of the rural hygiene reform

Jiangxi Explore the characteristic way of the rural hygiene reform
Jiangxi Explore the characteristic way of the rural hygiene reform
The people's livelihood is a buzz word instantly. What is the people's livelihood of health? The health demand for meeting the masses is the people's livelihood of health. In recent years, Jiangxi Government builds as the temporary lodging with the service ability of the hygiene in improving the work of the people's livelihood, have gone out of the way with one's own characteristics in the exploration of the rural hygiene reform. Strong bank of Hao's bright red of staff reporter It is ill to think highly of 1: Lower one liter " Mend directly " Can let material benefit see that mention Jiangxi Province, what people thought of is the old revolutinary base area, mountain area and poverty. Really, because of the limitations of rural economy condition, the difficult problem has been the greatest obstacle of the people's livelihood of health all the time that the cousin saw the doctor. The difficult problem of seeing the doctor of solving the countryside has become task of top priority of hygiene work of Jiangxi Province too. Speaking of the rural hygiene, the first prosperous sentence of rural hygiene Xiao Yun, division chief of place of department of public health of Jiangxi Province is: "In Jiangxi, medical expenses, wipe out proportion, lower one with equal to while being agricultural while being new ' mend direct ', the embodiment of service ability construction of the rural hygiene. " Ji'an county is located under middle part of Jiangxi Province, Jinggang Mountain foot. This county is two lines of revenue and expenditure of Jiangxi Province, shuts newly and agriculturally " Mend directly " , the online medicines concentrate on bidding and purchasing etc. the pilot county of the system reform of multiple rural hygiene. In the ward of the commune hospital of honest township of the county of Ji'an, reporters have met aunt Cui looking after the patient. Aunt at the venerable age of 81 is holding genuine Jiangxi " The mandarin " ,The patient introducing to the reporter on the sick bed: "This is my lover, 85 years old this year. Because the heart is not good, there are trachea diseases, will be in hospital for two or three days each month. Can only in hospital to the hospital of the county in the past, all spent two 300 yuan each time. Reach commune hospital diagnose the illness now, one only more than 100 yuan. " Where were the expenses of this reducing lowered from? "It is mainly medicines. " Vice County Magistrate Wu QiaoE of Ji'an county who is in charge of the hygiene says, this county not merely purchases by fixed position to reduce and purchase prices medicines, have also set up medicines and entered to purchase price information and medical care information announcement system, let the patient know what's what to all prices. In recent years, Jiangxi Province takes government as the leading factor, regards province as unit medicines and purchases the work on the net, have realized " Three is unified " : Unify the online bid, online trade of unity, unity to supervise on the net, guarantee the quality of medicines, reduce the empty high medicine price. The statistics show, 332 non-profit-making medical organizations at county level and above county level held by the government in Jiangxi Province participate in online medicines and concentrate on bidding and purchasing in 2008, 12009 medicines product rules in all win a bid. Win a bid of the price of medicines to compare with national development and reform committee, medicines supreme retail price and enterprise's independent pricing which the development and reform committee of Jiangxi Province makes newly, decreasing amplitude reaches 36.16%. Vice Chief of Jiangxi Province department of public health Guan YanMin says, though the statistical data in 2008 have not come out yet, estimate one of expenses for medicine can make concessions about 1,470 million of person one year alone. In order to further reduce masses' medical expense burden, not long ago, Jiangxi Province Provincial Party committee, provincial government also printed and distributed " opinion on insisting human-orientedly and further ensuring and improving the people's livelihood ". " suggestion " proposes clearly, will cancel the medicine price addition pilot project in the hospital directly under the provincial Party committee, health clinics in towns and townships in 2009, expand to the city, county in 2010 ' District) The hospital, realize the public hospital of the whole province cancels the price addition of medicine. After cancelling the steps addition of medicine, the finance will be offered the medical corresponding financial support of health organ. While the medical expenses are reduced, what Jiangxi Province shut newly and agriculturally submitted an expense account the proportion rose. Take Ji'an county as examples, the patient submitted an expense account in hospital in the health clinics in towns and townships the proportion has been up to 70% at present, when the patient leaves hospital, only need to pay and pay the part for itself, really let cousins receive the true advantage. Improving the fixed medical organizations of city, county, and township " Mend directly " On the foundation of the work, the hospital directly under the provincial Party committee of Jiangxi shut " mended newly and agriculturally directly " in an all-round way last year ,Realize that joins and shuts all fixed medical organizations in saving of peasant " It is in hospital that where, where to render an account " " leave hospital on the same day, render an account on the same day " in sum ,At one time the rendering an account rate is more than 90%, join and shut peasants and render an account more conveniently. The next step, Jiangxi Province will also explore and join and shut to peasants in the neighbouring county of the looks, compensation way in hospital of the medical organization of the township, realize " the locality joins and shuts, is in hospital in the strange land, the equal straight newspaper " . These Huimin policies have got cousins' warm support. In 2008, Jiangxi Province has already realized 96 counties with agricultural population are (municipal or district) Shut and cover newly and agriculturally completely, it reaches 29,294,700 people to join and shut peasants, it reaches 91.3% to join the shutting rate. In addition, a lot of places in Jiangxi Province have pulled open the compensation proportion that a patient seeks medical advice in different grade medical organizations. For example in 2008 township (town) many county To wipe out proportion, raise to 75% from 65% for 2007 grades of fixed medical organization, at county level fixed medical organization wipe out proportion, raise from 50% to 60%, lead peasants to go to the medical organization at the basic level to see the doctor. The clinic amount was 19,939,700 persons in 2006 of health clinics in towns and townships in the whole province, up to 25,526,400 persons in 2007, increased by 28%; The in hospitalling amount was 1,246,000 persons in 2006, up to 1,575,500 persons in 2007, increased by 26.4%. 2 can take a fancy to the disease: It means the hygiene service demand of the countryside will be further expanded to build and get home the commune hospital of the gate and think highly of the disease. How can make the supply ability served in conformity with demand? The method of Jiangxi Province is the function of strengthening health clinics in towns and townships and village clinic. In the honest township commune hospital in the county of Ji'an, aunt Cui points to the nearby own house outside the window to tell reporters for the reporter: "Now so long as a over road can be in hospital, the ward here is not worse than some of the county hospital. " Honest president of township commune hospital Liu LiMin talks the building of commune hospital is that a face is proud too. Really, compare with the slightly shabby house around, this white small building is extremely showy. He tells reporters, nearly 5 million yuan of apparatus total price in the new commune hospital building, among them more than 3 million yuan is at the cost of government, the health clinics in towns and townships have only raised more than 1 million yuan. The complete small building of facilities is relaxed " Hold " Ones that go to by commune hospital inside, outside, woman, child,etc. 8 piece business department. "Commune hospital offer in hospital sick bed also, there are 20 at present. If necessary, can also rise to 30. In just half a year, the number of people is up to more than 1000 persons in hospital. This but not dare to think in the old commune hospital. " The reporter has the same feeling in the interview of the county of Chongyi of Jiangxi Province too. The county town, villages and towns and village capital of Chongyi county " Hide " In the mountain, it is one of them that the long queue Zhen captures and assembles the village. Capture, assemble village to be very little, but and village committee share the intersection of hygiene and the intersection of service station and " although the sparrow little, the five internal organs are available " of the first floor ,Have realized and diagnosed the room , the therapeutic room, observation ward, dispensary, health education room, guards' room " Room six is separated " . The head of service station says, this clinic is transformed on the basis that the village committee work in the house, it pays 20,000 yuan to transform the expenses government among them. Through transforming, is the hygiene service station of this village complete now? Curtain �'s subcutaneous ulcer of moat of monthly ��'s muddleheaded Wu's vent in the sides of a garment of tip stirs the ticket =�� Cheng Ma =]Get escape from the intersection of �� and the intersection of page and 32 ��, macerate ] the intersection of enemy and � visit, flatter, dredge �� condemn the intersection of Wu and the intersection of vent in the sides of a garment and bridge Is neodymium not poisonous Huan �� male Yin of awake fraud strong in? Chief of Chongyi county hospital Guo YuanJun tells reporters, every rural community health station newly built or transformed, the standard built and transformed is authorized in unison from and the health bureau. Through by fixed position, declare, confirm, each service station can get the intersection of county and the intersection of finance and subsidy of 20,000 yuan. In 2007, this county finished construction and improvement project of 56 clinics, will finish 50 in 2008. Since 2007, Jiangxi Government implements the people's livelihood project, further strengthens the input power on service system construction of the rural hygiene. For 4 years in succession, the provincial finance has arranged the fund of 421 million yuan together, purchase the medical apparatus for the central commune hospital, 90 general hospitals at county level of 483 villages and towns of the whole province, and defend skill personnel and rural doctor and carry on professional training to the health clinics in towns and townships. In addition, Jiangxi Government also arranges the fund of 200 million yuan, reconstructs the clinic of 20,000 villages of the whole province within two years. The implementation of the people's livelihood project has brought along the local government and collective in the village by increasing the form of investing, offering the land etc. to support the infrastructure construction of the rural health organ too. 2007, only the intersection of village and the intersection of clinic and construction, Jiangxi Province form a complete set 177 million together, at city level the intersection of complete network and 6,010,000 among them, the complete network at county level costs 13,400,000 yuan, villages and towns invest 24,840,000 yuan collectively, rural doctor raises 130 million yuan independently. All parts offer 235,000 square meters of land or house free, reduce or remit the fee of 3,857,000 yuan of rule. In recent years, country and Jiangxi Government have also obviously increased the input into rural sanitary equipment one. From 2004 to 2007, provincial finance invest 166 million totally, according to practical and " filling up " Principle,last apparatus 28 kinds of 22828 set (piece)ses medicals basic . At the beginning of of 2008, the goal that Jiangxi Province puts forward is: Strive to let 60% of the central commune hospital, 50% of the general commune hospitals reach the construction criterion. By October of 2008, already there are clinics of 4257 villages () in the whole province , 336 commune hospitals of centres of villages and towns are up to standard, all overfulfil the task. 3 sees the disease well: " internal and external and concurrently repair " " should solve the health people's livelihood of the countryside, the hardware level that only improves the medical organization is certainly not all right to improve the medical level, talents are a key. " Wu QiaoE says. The reporter has met one and was once called the doctor whose discipline dared. He worked in the commune hospital of a piece of factories and mines originally, it was one of the 133 medical practitioners that the department of public health of Jiangxi Province admitted by examination towards the society in July of 2008. He has been assigned to the honest township commune hospital at present. These 133 medical practitioners including that once the discipline dared have been assigned to 127 health clinics in towns and townships. In these commune hospitals, a lot of are in not having medical practitioner's state for a long time. There are " professional players " Joining,these that place is medical level raise greatly. Accepting an appointment of a medical practitioner is included in the health clinics in towns and townships and manages while working out, the organizational affiliation is changed over to the health clinics in towns and townships recruiting, will have enjoyed 20,000 yuan, subsidy of 10,000 yuan for each person every year of provincial finance of Jiangxi for each person every year of state revenue for 5 years in succession. 5 years later, they will enjoy equal salary, welfare treatment with commune hospital personnel. If this group of doctors can be regarded as " Aid inside " ,Jiangxi Province has also made " The foreign aid " Policy: From 2006, each medical unit directly under the provincial Party committee is responsible for no less than 3 counties and medical unit and a piece of health clinics in towns and townships directly of coordinated cooperation; Each directly subordinated medical unit of setting up area is responsible for no less than 2 counties and medical unit and 4 health clinics in towns and townships directly of coordinated cooperation; The medical unit is responsible for no less than 5 health clinics in towns and townships of coordinated cooperation directly in each county. At all levels the intersection of city and medical unit to responsible for coordinated cooperation, want, launch the intersection of coordinated cooperation and job or activity 1 or more times half a year while being every, and through implementing measures such as the coordinated cooperation in urban and rural areas,etc., strive to make each county (municipal or district) No less than 1 higher authorities help the unit by fixed position, each of health clinics in towns and townships has no less than 1 higher authorities to help personnel by fixed position. The statistics show, the hygiene system of Jiangxi Province keeps nearly 600 experts of talent service group of hygiene reserving a post to serve in the basic unit throughout the year, have already formed and made sending, interdynamic helping the pattern from head to foot step by step. Meanwhile, the department of public health of Jiangxi Province also launched the rural hygiene talent " a thousand of pair " Project. Since 2008, make and send hygiene technical staff about 1000 persons to the county, township health care unit to launch the work of helping from the urban health care unit every year, select and appoint 1000 left and right health clinics in towns and townships and technical backbone of health organ of community and go to the health care unit at county level and above county level to receive a training and study. Vice Chief of Jiangxi Province department of public health Guan YanMin says, Jiangxi Province has also implemented the professional leader's construction project of rural hygiene technology, the goal is to train the rural hygiene professional technique leaders about 2000 persons by 2010, make the whole province each health clinics in towns and townships, can have from 1 to 2 technological leader. At present, altogether 987 rural hygiene professional technique leaders of two batches are chosen as training the target in the whole province, responsible for in grades by the tertiary health authorities of province and city, county, carry on the dynamic management and follows and train. Jiangxi Province set up president, commune hospital of town, choose, appoint system also, make presidents of health clinics in towns and townships public to compete for, the president requiring each county to compete for and choose publicly wants to be more than 50%. Newest statistic reveal, should save, have nearly 700 health clinics in towns and townships choose, happen the intersection of quality and fine, the intersection of ability and strong, the intersection of style and positive technician serve as a president through compete for. It is how to keep talents here that rural talents build and also want a problem solved. Guan YanMin says, the method to retain staff is to rise the salary, apt to promote and send the certificate of merit. Rise the salary: Within the range of the whole province, the professional and technical personnel working in the health clinics in towns and townships, can float first class salary upwards on the basis of prevailing wage; Work in the health clinics in towns and townships for full more than 8 years continuously, the first class salary going up is transferred to regular earnings; To the hygiene technical backbone working in the health clinics in towns and townships with arduous condition for a long time, every month is offered certain job subsidies again. It is apt to promote: Promote the standard, full more than 5 years, personnel who obtain the intermediate qualifications of professional technique to working in the health clinics in towns and townships after making the special professional title, engage preferably; Participate in the high title and do in the test While commenting and combining the examination, delimit the qualified thread alone; When participate in the evaluation of qualification of the advanced professional technique, relax the requirements for scientific research and thesis. Send the certificate of merit: From 2007, the department of public health of Jiangxi Province launches a " 30 honorable mention that engaged in rural hygiene " in the hygiene system of the whole province every two years Assert, cite, work, to award, reward certificate in the intersection of hygiene and professional and technical personnel that countryside work for a long time, at the same time on-the-job to claim of evaluating, engage, is have a holiday, recuperate etc. pay preferably, build and take root the good atmosphere of the countryside, service peasant actively. Practice has proved, these measures made the good result. 4 two lines of revenue and expenditure: The government " in charge of the money as well as administrates personnel " Ji'an county is one of the 6 pilot counties of the national two lines of revenue and expenditure. What is the core of two lines of revenue and expenditure? Wu QiaoE says: "It is government's responsibility! The government no longer turns a deaf ear to the health clinics in towns and townships, does not ignore to the rural hygiene again, regard two lines of revenue and expenditure as, stress hand, in charge of money administrate personnel also, bring rural health people's livelihood of cousin into the duty of the government to come. " Since the end of 2006, Jiangxi Province is also going to chestnut county and south Feng County to launch the provincial two lines of revenue and expenditure of health clinics in towns and townships to manage the pilot project at the same time. Pilot work begins from the county hospital establishes to the accountants of health clinics in towns and townships to check and calculate the administrative center, have finished the centralized management financial in health clinics in towns and townships to the whole county progressively and assigned to the family to check and calculate. According to the experiences of 3 pilot counties of two lines of revenue and expenditure, realize the policy is " in charge of the money " Function all right last 3 respect: First, work out the incomes of the health clinics in towns and townships and budget for expenditure rationally, factor of considering public health task, strength counting, service range, business that the health clinics in towns and townships undertake and developing synthetically etc., according to the principle of balance between revenue and expenditure, the health clinics in towns and townships organize incomes according to the annual budget sanctioned, arrange the expenditure, does not have budget expenditure to control strictly. Second, standardize the receipts and expenditures of the health clinics in towns and townships to manage, set up the accountants of health clinics in towns and townships to check and calculate the administrative center in the county hospital, base on the premise that the status of a legal person of health clinics in towns and townships does not change unify collection and allocation of funds by the state to the financial affairs of the health clinics in towns and townships, check and calculate separately, manage separately. The health clinics in towns and townships cancel to accountant and cashier, only have a person who renders an account, is responsible for the routine work about financial administration. Third, deal with the revenue and expenditure balance and difference of the health clinics in towns and townships rationally, regard revenue and expenditure balance fund of about 50% as the undertaking development fund of the health clinics in towns and townships, used in work such as the building of contingent of the specialized personnel of health clinics in towns and townships of the whole county by the pool of health authority at county level, other return commune hospitals, as the salary of performance, the part that revenue and expenditure lose is filled by the finance. The pilot work in two years proves, the financial centralized management of health clinics in towns and townships has been obtained" three is increased by one and lowered " Effect,not lasting number of people, the business incomes of health clinics in towns and townships to increase of namely government input against health clinics in towns and townships, health clinics in towns and townships, join and shut peasant's burden of hospitalization cost to reduce. 3 this grade of governments of pilot county subsidize every county of the health clinics in towns and townships equally, rose to 5,866,600 yuan in 2007 from 3,507,500 yuan in 2006, increasing degree was 67.26%; Allocate funds to rise to 1,846,700 yuan in 2007 by average 300,000 yuan of every county in 2006 in financial project, increasing degree is 515.57%. In 2008, already there will be 43 (municipal or district) counties in Jiangxi Province Manage the system reform after implementing the financial counties of health clinics in towns and townships. Policy of two lines of revenue and expenditure " Administrate personnel " The function is realized by system to assess of the performance. On one hand, the government asks the bottom to protects the doctor's basic income, remove the worry of the doctor at the basic level; On the other hand, through implementing the rational system to assess of performance, stop " mess " The phenomenon reappears. The performance examination allocative decision which the honest township commune hospital makes can be found out since 2008, examination index divide for working quantity type ' Accounts for 45% of the scores) , quality ( 30%) , medical ethics and atmosphere ( 25%) ,3 of what another ticket is rejected select: Medical liability accident, taking the covert payment and charging without permission. Liu LiMin has an intimate knowledge of change after scheme of two lines of revenue and expenditure is implemented: "In the past, the doctor of the hospital was in order to survive, had to regard it as the goal of the work to earn money. Different now, doctor's few worry, add the implementation of the examination allocative decision of the performance, think about the patient more in the course of practising medicine, is improving one's own service level and service consciousness constantly in routine duties. " Xiao YunChang annotates the working achievement of the pilot project of two lines of revenue and expenditure with one group of such data: 3 counties are in hospital expenses once dropped to 441.11 yuan in 2007 from 535.40 yuan in 2006, decreasing amplitude was 17.61%, the clinic drops to 26.87 yuan in 2007 at 30.62 yuan since 2006 of expenses once, decreasing amplitude is 12.25%, 3 counties leave hospital the number of people rises to 125821 persons in 2007 from 66811 persons in 2006, increase by 88.32%; Emergency call person rises to 765834 persons in 2007 from 756156 persons in 2006, increase by 1.28% on the door. The expert thinks, the economic development level of Jiangxi Province is not high, but in improving the work of the people's livelihood, the government does not regard objective difficulty as the reason, put forth effort to proceed from oneself, promote the service ability of the rural hygiene, let cousins think highly of the disease, take a fancy to the disease, see the good disease. While promoting, show government's responsibility to the limit.


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