The State Council Issued A Series Of Papers To Promote The High Quality Development Of Public Hospitals, And The Pay Reform Is The Key

"After 40 years of reform and opening up, the construction of medical service system, 20 years of hospital capacity building, and 10 years of deepening the reform of medical and health system, China's public hospitals have reached a critical period from" quantity accumulation "to" quality improvement ". We must focus on improving quality and efficiency." At a recent State Council policy briefing, Li Bin, deputy director of the national health and Health Commission, pointed out.

"The next step is to continuously improve the quality and efficiency of medical services and promote the high-quality development of public hospitals in accordance with the" opinions on promoting high-quality development of public hospitals "(hereinafter referred to as" opinions ") from the aspects of system construction, scientific and technological progress, and concept innovation At the 2021 kick-off meeting of the medical quality and safety improvement project in public hospitals, Guo Yanhong, the inspector general of the medical administration of the National Health Commission, said.

Less than half a month after the release of the opinions, the State Council issued the key tasks for deepening the reform of the medical and health system in 2021 (hereinafter referred to as the task), which clearly proposed to promote the high-quality development of public hospitals, further promote the comprehensive reform demonstration of public hospitals and establish and improve the pilot of modern hospital management system.

These two policy documents mentioned the construction of smart hospitals and hospital information standardization, deepening the reform of personnel compensation system and so on have become the key elements to promote the high-quality development of public hospitals, especially for the improvement of the development quality of grass-roots public hospitals.

Liu Xingming, director of CT room of imaging department of Xinghua people's Hospital of Jiangsu Province, pointed out in an interview with 21st century economic reporter that with the progress of science and technology and the development of the Internet, artificial intelligence has become a booster for the high-quality development of public hospitals The grassroots should retain talents.

In the process of high-quality development of public hospitals, it is necessary to promote the deep integration of artificial intelligence and medical industry. Visual China

The linkage between public hospitals and primary health institutions is limited

Public hospital is the main force and main position in the field of medical and health, and is an important guarantee for the rapid and orderly development of health care. High quality development of public hospitals is an important guarantee for the realization of the 14th five year plan and the long-term goal of 2035.

"With the deepening of health system reform and the deployment and implementation of the strategy of healthy China, China has carried out positive reforms in the aspects of universal medical insurance, modern management and drug supply, but there are still many imbalanced and inadequate contradictions in public hospitals A head of a medical group pointed out to the 21st century economic reporter.

Among them, it is worth noting that in the task, it is also mentioned that we should strengthen the construction of public medical and health institutions and optimize and support the development of medical institutions run by state-owned enterprises“ In order to better solve the above contradictions, the state should also include state-owned hospitals in the same policy as the high-quality development of public hospitals, so as to promote the development of the whole public medical institutions in China. " The person in charge pointed out.

On February 5, 2021, Ma Xiaowei, director of the national health and Health Commission, pointed out in his speech at the national health work conference that we should have a profound understanding of the new situation, new tasks and new requirements of health work during the "14th five year plan" period, and strive to promote the high-quality development of public hospitals.

Jiao Yahui, director of the medical administration bureau of the National Health Commission, said in the process of drafting the opinions on promoting the high-quality development of public hospitals, we always regard improving the people's sense of access to medical treatment as one of the important objectives of high-quality development of public hospitals, and proposed a series of work arrangements, including increasing the supply of high-quality medical resources, We should innovate the mode of medical service, build the hospital culture oriented by the needs of patients, and so on. Through these work, we can meet the people's multi-level and diversified medical needs.

Fu Wei, director of the health development research center of the National Health Commission, also pointed out that the high-quality development of public hospitals should be considered not only from the level of individual institutions, but also from the level of system architecture“ We should adapt to the level of social and economic development and meet the needs of the masses. "

With the continuous improvement of China's economic level, people's medical and health needs present a multi-level and diversified development trend, which also exposes the deficiencies in different levels of medical services. Fu Wei pointed out that at the regional level, there are structural contradictions in the distribution and allocation of medical resources between urban and rural areas, regions and populations, and the lack of linkage among institutions has not been fundamentally changed; At the institutional level, the collaborative linkage between public hospitals and between public hospitals and grass-roots medical and health institutions is limited, and there is still a gap between urban and rural areas, regional separation, upper and lower levels, rapid and slow separation; At the individual level, the masses have more urgent requirements for new technologies and high-quality medical services.

At present, there are some prominent problems in the rural health system in China, such as the overall supply of health resources is insufficient, the efficiency of medical services is low, the quality and level of medical services need to be improved, and the burden of patients seeking medical treatment is increasing.

AI assisted diagnosis reduces manpower burden effectively

In fact, in recent years, with the multi-directional efforts of national policy investment, project support and local improvement of medical and health service level, medical equipment in primary hospitals in China has been greatly updated, including modern X-ray machine, B-ultrasound, biochemical analyzer, electrocardiograph and even CT machine, gradually "entering" township health centers and community service centers, It has greatly improved the service level and ability of primary medical and health institutions.

The state has also proposed that "serious diseases do not go out of the county", and that the hierarchical diagnosis and treatment mode should be applied to grassroots medical and health institutions. However, the above-mentioned "hardware" has kept pace with it, and some "software" still has shortcomings.

At present, there are still short boards, which are mainly "human" short boards. For example, there is a serious lack of professional medical technicians at the grass-roots level, the professional knowledge and skills of existing medical staff and the ability of equipment management and protection, the level of diagnosis and treatment is not high, and there is a big gap with the needs of the people. Therefore, although there are advanced medical equipment, but "can not use, can not use" embarrassing situation.

Liu Xingming also pointed out to the reporter of the 21st century economic report that the requirements of patients for the quality of medical care are also constantly improving. They have some serious diseases. They do not believe in local hospitals, and they want to see a doctor in hospitals at or above the provincial level“ The focus of medical quality lies in the improvement of medical technology level of doctors, which is essentially different from the improvement of service in other industries, that is, the improvement of development quality

It is understood that part of the short board problem is trying to solve with technical means. Jiao Yahui also pointed out that in the high-quality development stage of public hospitals, it is necessary to build a "Trinity" smart hospital of intelligent medical treatment, intelligent service and intelligent management, and improve the efficiency of medical services by means of informatization.

Dongfang Securities believes that the "opinions" will promote the construction of smart hospital system to a new level, and gradually straighten out Internet medical policies and mechanisms. At the same time, increasing the number of new hospital districts of grade three hospitals and the construction of urban medical group and county medical community will also bring about the increase of information demand, which will accelerate the release of medical information demand.

Liu Xingming told the 21st century economic reporter that intelligent medical treatment is actually a means to improve the convenience of some medical treatment and reduce the workload of doctors“ At present, telemedicine and information-based artificial intelligence applications also provide convenience for doctors. For example, doctors in some township hospitals do not have the authority to issue reports, and technicians only have the right to film. Therefore, the relevant reports are sent directly to the medical imaging center of our hospital for interpretation of the reports and help with consultation, so that medical problems can be solved directly in the local area. "

The current situation of serious shortage of grass-roots medical and technical personnel is caused by many reasons: township health centers usually select existing personnel to operate medical equipment after short-term study, which is not professional and does not have the ability of generalist; Due to the limited establishment of community service centers, the service population is relatively small, the lack of technicians and the operation level is not high; Small and medium-sized private hospitals from the cost control, professional technicians are particularly in demand. In addition, the contradiction between supply and demand of basic medical technicians is obvious.

It is understood that a large number of county-level hospitals upload films to the imaging department of Xinghua people's hospital every month. For example, in May, there were more than 2000 films (including half of the general radiology department), and the hospital of Xinghua City People's Hospital of Jiangsu Province also has more than 300 films every day. The two together make up nearly 8000 films a month.

However, it is worth noting that there are only 19 staff in the CT room of imaging department of Xinghua people's Hospital of Jiangsu Province. Facing a large number of films, the workload is huge“ So we work overtime every day. Artificial intelligence can help us to do a part of screening and auxiliary diagnosis, mainly in the processing of coronary artery and head and neck CTA. For example, the artificial intelligence now used can automatically process the images of coronary artery, take pictures automatically, and write diagnostic reports Liu Xingming said that some artificial intelligence products, including Shukun technology, have been applied in hospitals.

Liu Xingming said that the use of artificial intelligence technology can greatly shorten the post-processing time of CTA“ The post-processing of CTA can be completed within three minutes. "

Wang Ximing, deputy director of the imaging department of the First Affiliated Hospital of Suzhou University, said that it takes more than ten minutes for a skilled doctor to process a CTA; CTP time is similar, artificial intelligence can speed up the processing, and more accurate“ The application of artificial intelligence in CT scan mainly includes two aspects: one is to detect cerebral hemorrhage and locate hematoma, and the key is to quantify the volume of hematoma; The other is to score the aspects of ischemic stroke. Young doctors have problems such as slow score and poor consistency. AI can improve scoring speed and be more accurate. The artificial intelligence post-processing software of one-stop CTA can also detect cerebral aneurysms and make accurate measurement

Qiao Jie, President of the Third Hospital of Peking University, also proposed that in the process of high-quality development of public hospitals, it is necessary to promote the deep integration of artificial intelligence and medical production, teaching, research and application. Through the research and development of medical and industrial projects such as intelligent surgical robots and wearable devices, we use information technology to promote the development of scientific and technological innovation and the transformation of achievements. New artificial intelligence technology is used to actively explore intelligent assisted diagnosis and treatment, and carry out multi scene intelligent speech recognition, auxiliary diagnosis and treatment, medical quality evaluation and other applications.

However, Liu Xingming also stressed that in order to improve the development quality of public hospitals, the most fundamental thing is to train doctors. At the same time, it is necessary to solve the contradiction of not going out of the county due to serious diseases. The core is to improve the treatment of doctors and keep talents at the grass-roots level.

It is also mentioned in the task to deepen the reform of the personnel compensation system. We should implement the requirements of "two permits", reasonably determine and dynamically adjust the salary level of public hospitals. We should strengthen supervision and guidance to local governments, and promote the implementation of the government's medical responsibility and public hospital investment policy. We should broaden the funding channels for the reform of salary system in public hospitals. Hospitals are allowed to set up salary items on their own, and the annual salary system is encouraged for the main responsible persons. We should reform and improve the evaluation mechanism of medical personnel title, highlight the performance orientation of practical ability, and encourage health professionals to take root in the front line of disease prevention and treatment.

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