A survey of health reform in Ningxia: A dollar for the nearest doctor

Zhou Zhizhong In recent years, Ningxia has carried out fruitful exploration and practice in reforming the basic medical and health system, making the people ill, establishing the primary medical and health service system, comprehensively implementing the "three unification" of drug recruitment and supporting the development of Chinese medicine. "The core of Ningxia health reform is the" three unity of drug recruitment "and the establishment of basic medical service system. The standard of inspection is that the masses are benefited.　　"The Ningxia Hui Autonomous Region Health Department director Liu Tianxi said. It is an important and difficult problem to solve the difficult problems of the people who have difficulty in seeing a doctor, the expensive disease and the serious illness, and the small province of Ningxia as well as the underdeveloped ethnic areas in the west. How does Ningxia develop health reform under existing conditions? What benefits does health reform bring to the masses?　　　　The reporter made an investigation. Urban and rural residents sharing the benefits of April, Guyuan Yuanzhou District opened a town 30 Li Pu Village villagers Longhaijen with 4-year-old son Hui to the village health room to see a doctor. Li Hui has a cold, sore throat. Village Ma Shuyi based on the condition of the first spore ammonia tablets, ribavirin granules prescription. After seeing the illness, Longhaijen only paid 1 yuan. Ma Shuyi Introduction: "Farmers have colds disease, to the village health room to see, medicine 3 Yuan below, a penny does not charge, the drug costs more than 3 yuan, 1 yuan." "One of the core modes of health reform in Ningxia is to establish a basic medical service system." "The Ningxia Hui Autonomous Region Health Department director Liu Tianxi said. "The people of Ningxia customarily refer to the basic Medical service system as a ' one dollar money nearest doctor '." "Guyuan and Yinchuan are the first pilot areas for a" one-yuan-dollar-nearest-doctor ". Urban and rural residents free to enjoy the program immunization, maternal and child health care, chronic disease management and other 10 categories of 49 basic public health services, the government to the village health room at the cost of 30 general disease diagnosis and treatment and 74 kinds of 0 differential basic drugs, the implementation of "one household one card, the nearest doctor, cheap medicine, one yuan each time."　　According to the cost price of the 30 diseases are screened by the investigation of common, frequently-occurring, 74 kinds of drugs provided at cost price is also commonly used drugs for medical treatment, basic to meet the needs of basic medical services. Health Department Rural Department Yang Sanzhong director told reporters, in order to solve the "one Yuan money doctor" requirements, Ningxia adjusted the policy of new agricultural and rural cooperative, from new agricultural and fund for the participating farmers each year allocated 30 yuan, for the provision of rural residents basic medical services.　　At the same time, Ningxia established the rural medical aid system in the vast countryside, and gradually formed multi-level rural medical security system. Low cost of medical treatment, Ningxia how to mobilize the enthusiasm of grass-roots health workers? Ningxia will be the township health Centers adjusted to the full public institutions, to solve the full salary, village subsidy from 25 yuan per month to 300 yuan. Ningxia also strengthened the training of grass-roots health teams to improve their medical standards.　　Using colleges and universities for the professional and technical personnel of township hospitals for a year of standardized training, at the same time in county-level medical institutions to establish village training base, every year for all village health room staff for one months of centralized rotation. Unified bidding and price reduction is regarded as the core model of Ningxia medical reform AnotherThe initiative is the "Three unification of drugs", which began in 2006. Ningxia takes the autonomous region as the unit, the medicine implements the unified tender, the unified price, the unified distribution. Autonomous Region party secretary Jianguo said Ningxia is a small province, more than 60,000 square kilometers of land area, more than 6.1 million people.　　This is a favorable condition for the implementation of the "three unification" of drug recruitment. Liu Tianxi introduced: "Ningxia basically set up a unified regional drug supply guarantee mechanism, drugs and medical supplies prices greatly reduced." 3 years to let the cumulative 387 million yuan. It can be said that the "three unified" implementation of medicine to pry the health reform in Ningxia. "The total decline of drug prices in Ningxia Township health centers, County hospitals and autonomous hospitals has reached 48.76%, 40.68% and 32.69%, respectively, by 40.71% per cent," he said.　　2008, Ningxia Public medical institutions, the main medical supplies into a unified bidding procurement, six categories of general medical supplies, 130 varieties of medical supplies, the total average decline of 48.83%; two kinds of special medical supplies, 545 varieties, the total average decline of 42.71%. Drug recruitment "Three unity" at the same time standardize the supply of medicine channels. Ningxia Medical institutions more than 90% of the drug has been incorporated into a unified distribution management system, the successful acceptance of drug use coverage reached 100%. Break the former drug supply mode, reduce the supply and circulation of drugs, stabilize the market drug prices, standardize the drug circulation order, effectively prevent the fake and inferior drugs into the medical institutions, to ensure the quality of drugs. Tongxin County Hexi Town Upper Bend Village Health Clinic Tian Hongyu told reporters: "Now make a phone call, distribution department put medicine to the delivery." In the past our own procurement, many channels, high prices do not say, but also easy to buy counterfeit, expired drugs, now these worries are gone. "Through in-depth investigation, full demonstration and extensive consultation, Ningxia formed the" drug "three unified" list of basic drugs and a series of ancillary management measures, set up a suitable for the local situation of the basic drug system.　　　The basic catalogue covers medical insurance for urban workers, medical insurance for urban residents, and common medicines for the catalogue of new agricultural drugs. Ningxia "Iron Fist" to carry out the reform of the New deal, establish a clear punishment mechanism.　　Two Health bureau director, two Ren Township Hospital director for the reform of the new Deal or the violation of drug recruitment "three unification" rules private out of the purchase of medicine, was exempted from duty. is the burden of public hospitals in the "Storm Center" heavy or light? According to the introduction, the drug-related situation in the past with drug recruitment "three unity" and the establishment of public health care system, such as the development of a series of reforms have been broken, and the reform of public hospitals has not been fully pushed aside, the hospital compensation mechanism is not perfect problems at all levels of government. At present, the price of medicine, supplies, inspection fees should be digested by the hospital itself, and the current hospital burden of 40% or three to become the government's financial allocations, the rest by the hospital to solve their own. Fiscal allocations are basically just enough to keep the expenses of retired medical institutions. The Government's financial allocation to public hospitals is far from addressing the needs of hospitals. So many questions to explore. Another measure to increase health finance into the new medical reform in Ningxia is to solve the problem of people having local medical treatment. Its main practice is to increase the financial input of the primary health service.　　Since 2006, after 3 years of continuous efforts, Ningxia has completed 30 county-level medical and health institutions in the region, 188 township hospitals, 2,774 Village health rooms to achieve standardized construction. Now, all over the Ningxia urban and rural medical institutions have a unified identity, and the county 10 million yuan, the center township hospitals 300,000 Yuan, township hospitals 100,000 yuan, village health room, 3000 yuan medical facilities equipped. Each township hospital also equipped with an ambulance, the rural level three health service network to achieve full coverage.　　At the same time, adjust the regional health planning, sink the urban health resources, set up 134 health institutions in the urban community, covering more than 90% urban residents, and basically form the Urban Community health Service system. In order to let the masses see the disease, Ningxia pay close attention to the new rural cooperative medical care to expand the face, raise the level of financing, increase reimbursement ratio, raise the cap line. The 2007-year fund-raising level of the whole district is 50 yuan per person per year, up to 100 yuan in 2009, and the top line for reimbursement of medical expenses increased from 10000 to 20000 yuan, and the reimbursement proportion of county medical institutions in Sichuan and mountainous areas was increased to 45% and 50% respectively, The capital utilization rate of the new agricultural combination is close to 80%, minus the starting line, the actual reimbursement ratio for the county level is 55%, Township is 60%, at the same time, the township hospitals reimbursed the line from 150 to 75 yuan. 2009, a total of 3.6 million farmers in Ningxia participated in the new farming, the rate of 94.6%.　　The benefit level of the rural residents is further improved and the common people get benefits. Enhance the service ability of Chinese medicine Ningxia in recent years, the introduction of the "building a famous hospital, a famous branch, the Tree" project, the implementation of the "Strengthening of Chinese medicine specialist (special disease)" and "construction standards and assessment rules" to enhance the service capacity of Chinese medicine.　　This is one of the other new measures of Ningxia health reform.　　The construction of Chinese Medicine specialty (special disease) as the breakthrough point of strengthening TCM characteristics and improving the discipline level of TCM, Ningxia has determined 10 autonomous regions of Chinese medicine and integrated Traditional Chinese and Western medicine key specialist (special disease) construction project, a group of Chinese medicine characteristics of the specialty (special disease) construction achieved significant results. 2008, Ningxia launched the "into the countryside, into the community, into the family" activities, grassroots Chinese medicine services gradually popularized. Through the promotion of basic Chinese medicine appropriate technical projects, acupuncture physiotherapy, massage massage, cupping, fumigation and other TCM diagnosis and treatment technology gradually into the community and rural health services.　　At present, 85% Township hospitals and community service centers in Ningxia have established TCM and Chinese pharmacy, more than 65% of the village health Room and 45% of the Community health service stations can provide "Jane, then, test, inexpensive" Chinese medicine diagnosis and treatment services. The study of Hui nationality medicine in Ningxia has achieved preliminary results. Ningxia organization related units and experts, successively published the "Chinese Hui Medicine", "A brief history of Hui Medicine, "Hui Materia medica", "Hui Zhi" 4 of the Hui Medical monographs, "back to the medical side", "back to the Doctor hair Micro" and "Great Arch North Medicine" has completed the first draft compilation, is under review. In the autonomous Region of Chinese Medicine Research Institute and Ningxia Medical College set up a return to medical research institutes, excavation, collation and study of the Hui medical work has also achieved preliminary results, in order to carry forward and inherit the Hui medical characteristics lay a good foundation.