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20 19 12 Dongzhengbanfa [ 20 19 ] No. 12

Sub-district offices, district committees, offices, bureaus, and district-affiliated agencies:

2019 5 31 日区委全面深化改革领导小组第 2 次会议审议通过,现印发给你们,请遵照实际,认真贯彻执行。 The "Implementation Plan for Comprehensive Reform of Medical and Consumption in Dongcheng District" has been reviewed and approved by the 2nd meeting of the Leading Group for Comprehensive Deepening Reform of the District Committee on May 31 , 2019 , and is now issued to you. Please implement it in accordance with actual conditions.

Dongcheng District People's Government Office

6 14 June 14 , 2019

(This is publicly available)

Implementation plan of comprehensive reform of medical and consumption linkage in Dongcheng District

In order to implement the spirit of the “Notice of the General Office of the Beijing Municipal People's Government on Printing and Distributing the Implementation Plan of the Comprehensive Reform of Beijing Medical Consumption and Consumption ” (Jingzhengbanfa [ 2018 ] No. 50 ), further promote the reform of the medical and health system in Dongcheng District, combining this district Actually, make this plan.

I. Scope of reform

According to the unified requirements of the city, the scope of the institutions participating in the comprehensive reform of the medical and consumption linkage is the same as the comprehensive reform of the separation of medicines. The public medical institutions and military medical institutions organized by the government, institutions and state-owned enterprises in the Dongcheng jurisdiction apply this plan.

The social medical institutions designated by the basic medical insurance can voluntarily apply to participate in this comprehensive reform of medical and consumption linkage and implement various reform policies.

A total of 242 institutions participated in the reform , including 223 public institutions and 19 social organizations . There are 117 designated medical insurance agencies, 125 non-medical insurance designated agencies , and 234 management agencies in Dongcheng District .

Reform goals

The comprehensive reform of medical and consumption linkage is in accordance with the overall requirements of adherence to reform and improvement, reform and supervision, and reform and guarantee synchronization. The main content is "one reduction, one promotion, one cancellation, one procurement, one improvement". Among them, "one reduction" refers to reducing the price of medical equipment inspection items; "one increase" refers to increasing the price of medical services such as traditional Chinese medicine, pathology, rehabilitation, mental, surgery; "one cancellation" refers to canceling the medical consumables bonus; "One purchase" refers to the centralized purchase of pharmaceutical consumables; "One improvement" refers to the further improvement of medical services and the public's sense of gain.

By canceling the medical consumables bonus, launching the national centralized procurement of pharmaceuticals, and implementing the joint procurement of medical consumables in Beijing, Tianjin, and Hebei, to make room for regulating the price of medical service items, so as to streamline the relationship between medical service prices and better reflect the technical and labor services of medical personnel Value, improve the quality of medical care and services, and better meet the needs of the people.

III. Key reform tasks

(I) Further promote the implementation of medical service price reform

In accordance with the unified requirements of the city, the relevant provisions of the "Notice on Regulating the Adjustment of Pricing Items of Medical Services such as Pathology" issued by the Beijing Medical Insurance Bureau and other 4 departments were fully implemented (Jing Yi Bao Fa [ 2018 ] No. 1 ). Technical service value items, that is, to raise the price of 5 types of medical service items such as traditional Chinese medicine, pathology, rehabilitation, mentality, surgery, etc. , reduce the price of medical equipment inspection items, regulate and adjust some medical service items and prices totaling 6621 items, which will be implemented from June 15 .

(2) Cancellation of medical consumables

On the basis of the comprehensive reform of the separation of medicines and the abolition of drug additions, the abolition of medical consumables has been abolished. That is to say, the medical institution charges the consumables to implement the purchase price plus difference rate charging policy for patients, and the 5% charge for consumables above 500 yuan is no longer charged, and the 10% bonus for less than 500 yuan is no longer charged. It is directly based on the purchase price. Charges to reduce the patient's cost burden on medical consumables.

(3) Implementing a pilot for centralized drug procurement and joint procurement of medical supplies for Beijing, Tianjin and Hebei

In accordance with the city's unified regulations, implement the national pharmaceutical centralized procurement policy and supporting measures for public medical institutions, and organize the implementation of six types of medical consumables such as intracardiac vascular stents and artificial joints within the scope of regional second-level and above public medical institutions. Joint procurement, gradually expanding the scope and scale of joint procurement of medical consumables; public medical institutions in the region participate in the national centralized procurement pilot for drugs, carry out joint procurement of 25 kinds of drugs, verify the commitment of selected drugs for the procurement of selected quantities, allocate and rationally use selected drugs, Further regulate the order of drug circulation, reduce drug prices, promote rational use of drugs, and ensure the safety of drug use by the masses.

(IV) Fully implement the three-year action plan of Dongcheng District for improving medical services

With solidification as the starting point for the construction of the hospital's working system, innovative medical service models will be created. Establish and improve the appointment consultation system, telemedicine system, clinical pathway management system, mutual recognition of inspection and test results system, medical social workers and volunteer system. Promote the appointment diagnosis and treatment system, and implement the requirement that regional tertiary hospitals reserve at least 30% of the number of sources for community health institutions . Scheduled appointments are implemented. The tertiary hospitals are scheduled to make appointments within 30 minutes, and the general hospitals are scheduled to make appointments within 20 minutes. Give full play to the role of clinical pathways as medical quality control and management tools, implement full-service management of medical services, and increase the proportion of clinical pathway management in regional public hospitals to more than 30% .

(5) Strengthen comprehensive supervision and performance evaluation

Strengthen supervision of medical services, procurement of medicines and consumables, and prices of medical services, and standardize medical service behavior; improve performance-based pay systems based on performance appraisals, improve incentives and restraint mechanisms for medical institutions, and motivate medical staff; revise district-owned public hospitals The performance evaluation index system of medical reform, improve the evaluation system of the core elements of quality, operation efficiency and development of public hospitals in the district, and continue to explore the financial investment mechanism linked to financial subsidies and performance evaluation. Deepen the construction of medical ethics and popular practices, seriously investigate and deal with industry malpractices and behaviors that infringe on the interests of the masses, and build a harmonious doctor-patient relationship.

(6) Strengthen the reform of medical security and payment methods

Implement the relevant policies of the Beijing Municipal Medical Security Department to improve medical insurance reimbursement and medical assistance, and include medical services that meet the requirements into the scope of basic medical insurance reimbursement. Intensify medical assistance to social assistance targets, and give full play to the role of protection. Further improve the implementation of the total budget management system for medical insurance funds, and develop a composite medical insurance payment method.

Fourth, safeguard measures

(I) Strengthen leadership

Give full play to the functions of the leading group for deepening the reform of the medical and health system in Dongcheng District, and coordinate and coordinate the comprehensive reform of medical and consumption linkage. Establish work organization and work mechanism to ensure that various reform measures are implemented.

(2) Refine the division of labor

The District Health and Health Committee will play the role of the District Medical Reform Office, take the lead in organizing and coordinating the comprehensive reform of medical and consumption linkage, implement the national centralized procurement of pharmaceuticals and the joint procurement of medical supplies for Beijing, Tianjin, and Hebei, and improve related medical services.

The district medical insurance bureau shall strengthen the training and interpretation of price policies for medical service items, and guide and supervise medical institutions to do a good job of price maintenance and upgrading of medical insurance information systems. It is necessary to implement the medical insurance reimbursement policy and composite medical insurance payment methods in accordance with the requirements of reform, and implement medical assistance policies and measures targeted at social assistance targets. We must pay close attention to the risks in the implementation of the reform and do a good job of emergency response.

The District Market Supervision Bureau shall strengthen the management of the quality of medicines and consumables of medical institutions and the price of medical services, guide and supervise medical institutions to update their price catalogs and publicize them, strictly investigate and punish price violations of medical service items in accordance with the law, and strengthen guidance and supervision of the implementation of reforms.

The District Human Resources and Social Security Bureau has researched and promoted the reform plan of public medical institutions' salary system, and scientifically approved the total performance salary of medical institutions.

The District Finance Bureau is responsible for ensuring funding for this reform.

The District Bureau of Science, Technology and Information Technology will do a good job in ensuring informationization during the reform.

The Propaganda Department of the District Party Committee and the District Network Information Office will do a good job of reform publicity and public opinion monitoring and guidance.

(3) Do a good job of propaganda and guidance

Adhere to the correct orientation of public opinion, give play to the role of central and municipal media, district media and Weibo and WeChat, and do a good job of media-wide news release and news propaganda and guidance. Strengthen public opinion monitoring, do a good job of collecting, guiding, researching and judging public opinion in a timely manner, and create a good atmosphere for the implementation of the comprehensive reform of medical and consumption linkage.

(D) do a good job in information system transformation

Implementation of a comprehensive upgrade of the information system, including the completion of the reform of the hospital's HIS system, the implementation of the joint reform of the information system involved in joint testing and emergency drills, etc., all the institutions involved in the reform have the information system requirements to support the reform.

(5) Strengthening monitoring and evaluation

The District Health and Health Committee, the District Medical Insurance Bureau, the District Market Supervision Bureau and other units shall, in accordance with their respective responsibilities, monitor the implementation of the comprehensive reform of medical and consumption linkage, regularly form monitoring reports, evaluate the progress and effectiveness of the reform, identify problems in time, and improve management. Measures to ensure that the expected reform goals are achieved.

Related Links : Interpretation of the Comprehensive Reform and Implementation Policies of the Medical and Consumption Linkage in Dongcheng District