Dense weave rural primary health care network

On the one hand, large hospitals in large cities are overcrowded, and it is difficult for people to see a doctor. On the other hand, rural areas lack medicine and medicine, and people often have no way to seek treatment. How to effectively solve this problem, so that the city is not crowded, it is not difficult to see a doctor in rural areas? It is an important means to strengthen the construction of rural medical networks and realize the equalization of urban and rural medical care. Sanhe City, Hebei Province, through the strengthening of rural medical network construction, has facilitated the rural population and reduced the burden on urban hospitals.

In the health clinic of Huangqinzhuang, Liqi Town, Sanhe City, Hebei Province, the reporter encountered Cui Qiying, a villager who is currently seeing a doctor. She told reporters, "Previously doctors didn't run to the county town or run to the town. It would take more than half a day to go back and forth, and they would spend a few tens of yuan on travel expenses. Now that the village has a health room, it's much easier to see a doctor. Money is also Spend less."

In Sanhe City, like Cui Qiying, there are still many people who can easily see the doctor. This is attributed to the city’s comprehensive urban and rural integrated primary health network construction in the rural areas under its jurisdiction. Through the village's standardized health clinic construction, financially directly supported college students' village doctors, a fully-covered rural affordable medicine distribution system, and rural residents' full-fledged health education management system, the four basic projects have enabled Sanhe City's rural medical care to truly integrate with urban health care. It has made it difficult for the rural people to see the sick and see the expensive problem.

The village has a health room

Whether the people see the doctor is convenient or not, and it has a direct relationship with the distribution of medical resources. To solve the difficulty of seeing people in rural areas, we must first solve the problem of backward medical facilities in rural areas. To this end, Sanhe City spent three years investing 90 million yuan to build 298 standardized rural health clinics throughout the city. The construction of the entire health room follows the principles of village collective land expropriation, financial payment, property ownership in villages, and health center management. , Each health room infrastructure investment is 250,000 yuan, the total area is to reach 120 square meters, diagnosis, treatment, pharmacy, disposal, observation, health education are divided into 6 separate rooms, to achieve water, electricity, access, telephone, network Other conditions. At the same time, it invests 50,000 yuan for each village clinic and is equipped with electrocardiograph machines, physiotherapy machines for Chinese medicine, electro-acupuncture instruments and other medical equipment. In terms of operating funds, Sanhe City Finance has allocated RMB 8,200 per year as a high-standard village clinic officially put into use since January 2013, which has provided basic guarantees for the daily expenses of health clinics.

In Dawangzhuang Village Health Department of Huangzhuang Town, the reporter saw that there is a wide open area, bright and clean windows, and a variety of office equipment and medical equipment required for primary medical care are available, just like a high-standard hospital. Li Hongtao, deputy director of the Sanhe City Health Bureau, told reporters that with the improvement of living standards, chronic diseases such as hypertension and diabetes are increasing in rural areas. The village health room has a health education room. The rural doctors can comprehensively explain health knowledge and can effectively prevent the occurrence of chronic diseases. This not only protects people's health, but also reduces government expenditure.

Dr. Coban enters the grassroots

In addition to the lack of necessary hardware facilities, the lack of high-quality medical personnel is also a shortcoming in rural health care. To this end, the Sanhe City government has proposed to provide qualified medical practitioners for each rural medical point. The "College Village Medical Project" launched in 2011 proposed that 50 village students be provided with village doctors each year, and that each village should have a high-quality practicing doctor's development goal. For these university students village doctors, Sanhe City implements a fixed, fixed, and indeterminate management model. The funding required by college students for village doctors is entirely borne by the municipal finance.

“The former rural doctors were mostly “barefoot doctors” who had not received formal professional education. The problem of large knowledge gaps and the ageing of the team were widespread. Through the increase of government expenditures, village medical posts were solved, which on the one hand solved the lack of high-quality talents in rural medical posts. The problem has also solved the problem of 'taking medicine to raise medical care'.” Guo Wanda, director of the Sanhe City Health Bureau, said that at present, 150 village university doctors have been trained in Sanhe City, and they have gradually entered the rural health department.

In the Huangqinzhuang health room, the village doctor Pingzhi who graduated from Hebei Medical University told the reporter that his monthly salary is about 3,000 yuan. The government also provides “three insurances and one gold” social security, and treats one patient at a time in the village. The government health department can also give doctors 5 yuan for treatment and treatment subsidies. The drugs will be sold at a zero-to-medium price in accordance with the centralized procurement price, and all drug expenses will be included in the rural medical insurance expenditure. In this way, the problem of “taking medicine to support medicine” was effectively eliminated, which effectively reduced the expenditure of the peasant masses, and made the problem of over-standard excessive medical use medicines effectively controlled.

Systematic service Huiminzhong

“Farmers, now that our lives are good and nutritionally adequate, we must pay attention to preventing the excesses of rich diseases such as hypertension and hyperlipidemia. These diseases are mostly related to excess nutrients. If such diseases are not well controlled, it is very likely that It will bring about life-threatening illnesses..." In the Zhongmenzhuangcun Health Department in Puyang Town, 10 chronically ill patients in the village are sitting in the health education room and listening to the village doctor Xie Ming for spreading health knowledge.

The 75-year-old villager Ruan Chaowen told reporters that his heart disease and high blood pressure can be effectively controlled, thanks in large part to various lectures on health that he regularly listens to in the health department and regulates his daily life. Now, I'm always willing to go to the village clinic and have a chat with my doctor. The health lecture he received was part of the full chain system service.

According to the ideas of system engineering and system implementation, Sanhe will further develop the rural medical service system and implement all-chain system services while solving the problem of lack of rural medical sites and practitioners. This mainly involves three aspects of the network, one is the pharmaceutical distribution network to protect the safety of drugs and control the price of drugs; the second is the practice of doctors to train the network, the city and town center hospitals to deploy medical personnel to regularly train rural doctors, rural Medical practitioners regularly provide health knowledge to rural residents; third, they are public health files and rural chronic disease prevention and control networks.

Li Li, Director of the Public Health Management Office of Sanhe City Health Bureau, told reporters that in the procurement of essential drugs, Sanhe City implemented a strict government bidding and procurement system, and all health centers and village clinics use 307 kinds of basic drugs determined by the country and The 175 kinds of supplemental medicines that are filed for the record will be uniformly distributed and distributed for medicines, with zero sales, and the average price of essential drugs will be reduced by about 40% on average. At the same time, Sanhe City also stipulates that all health centers and integrated management village clinics will implement zero-difference sales of essential medicines, which will reduce the price of medicines by about 40%. After the zero sales of essential drugs were implemented, the average outpatient medical expenses and the average inpatient medical expenses in the hospitals dropped by 27.2% and 14.4% respectively year-on-year.

"The construction of residents' health records, tracking services for rural frequently-occurring diseases and chronic diseases is an important aspect of implementing the sharing of medical resources. It is important for facilitating patient visits and reducing medical insurance expenses." said Li Li, through the city-wide medical network. With the construction of the system, regardless of the hospital in which the patient is seen, the doctor can fully grasp the basic conditions of his body and is crucial for the timely determination of the condition. At present, a total of 556,778 residents' health records have been established in the city, with a profile rate of 83.8%. With these health records, 53957 hypertensive patients, 17818 diabetics, and 1857 patients with severe mental illnesses in Sanhe City have been effectively managed. For example, the general public has a physical examination once a year, common chronic disease patients visit once a month, and 4 physical examinations a year, which will solve many diseases in the prevention stage and budding. According to preliminary statistics, implementation of this measure will at least reduce the incidence of chronic diseases in rural areas by about 20%. "This, in turn, has greatly eased the problem of overcrowding in large hospitals," said Li Li.