Recently, the General Office of the Chongqing Municipal Government issued "Several Measures to Further Deepen Reforms and Promote the Healthy Development of the Rural Medical and Health System", which focuses on cultivating rural medical and health talents, performance evaluation of grassroots institutions, building a close-knit regional and county medical community, and improving service capabilities. In other aspects, a series of new mechanisms have been established, and it is proposed that the city will build at least 60 district and county medical and health sub-centers by 2025.
The "Measures" require that medical and health resources at the township (street) and village (community) levels should be reasonably allocated, and the proportion of Grade A township health centers in the city should not be less than 30%; each township health center should be equipped with at least one ambulance; Encourage medical and health institutions in districts and counties to improve the medical risk sharing mechanism of village clinics through overall participation in medical liability insurance; carry out free medical student training for rural orders to reduce the recruitment conditions for talent shortages in township health centers; implement the recruitment of medical college graduates The policy of exempting rural doctors from applying for practice registration and exploring the granting of prescribing rights to public health physicians in rural medical and health institutions; professional and technical personnel who have worked in township health centers for 15 consecutive years or have worked for 25 years in total and are still working in township health centers can Recruit to corresponding targeted positions through "targeted evaluation and targeted use"; by 2025, more than 80% of village clinics will be able to provide traditional Chinese medicine services.
The "Measures" clarify that the overall subsidy level of district and county finance for the funds required for the excess performance of township health centers shall not be less than 60%; if the "surplus distribution for the year" account of the township health center is positive and the performance assessment is qualified, the overall subsidy level will be no less than 60%. 60% of "this year's surplus distribution" will be used to increase the total excess performance in the next year; establish a subsidy for general practitioners, with the required funds fully guaranteed by district and county finances; encourage the implementation of personalized contracted paid services for family doctors, and residents will pay voluntarily Sign a contract to purchase; dynamically adjust the special subsidy standards for rural doctors in village clinics. Practicing physicians, practicing assistant physicians, rural general practice assistant physicians, and rural doctors will be paid by the district and county governments at a rate of not less than 1,000 yuan, 800 yuan, and 700 per person per month respectively. A special subsidy of 600 yuan or 600 yuan will be provided.
The "Measures" emphasize the need to deepen the construction of a compact district and county medical community, improve the system of "total payment, surplus retention, and reasonable over-expenditure sharing" of the medical insurance fund within the compact medical community; promote chronic diseases in township health centers and district and county-level hospitals The drug catalogs are unified and prescriptions flow freely. Resource sharing centers for medical examinations and medical imaging within districts and counties are established and improved. The "fund pool" system for grassroots medical and health development is improved. Development and construction expenditures such as infrastructure and equipment purchase of rural medical and health institutions are provided by The district and county governments will arrange in full, and operating costs such as personnel and business expenses will be compensated through service charges and government subsidies; dynamically adjust the general diagnosis and treatment fee standards for township health centers and village clinics to meet the district and county medical and health service capacity standards of district and county-level hospitals. The medical service charges of sub-centers (community hospitals) can be implemented according to the standards of second-level hospitals. The medical service charges of Class A and B township health centers that meet the service capacity standards of first-level hospitals can be implemented according to the standards of first-level hospitals; gradually increase the level in districts and counties. Increase the proportion of domestic medical insurance funds used in rural medical and health institutions, add appropriate service items for primary medical and health institutions in rural areas to the medical insurance reimbursement catalog, and increase the proportion of service income of rural medical and health institutions.
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