On the 4th, the National Health and Health Commission issued the "Notice on Doing a Good Job of Basic Public Health Services in 2019" (hereinafter referred to as "Notice") on the official website, which is divided from the original basic public health services and the new basic public health services. The aspect clarifies the task objectives. Clearly continue to implement 12 types of projects such as the establishment of residents' health records, health education and vaccination, child health management, maternal health management, and 19 newly-introduced related work specifications in accordance with the "National Basic Public Health Service Specification (Third Edition)" . At the same time, the notice also pointed out that in 2019, the subsidy standard for basic public health services per capita is 69 yuan, and the additional 5 yuan will be used for villages and communities. It is necessary to benefit the grassroots.
Newly classified into 19 basic public health services
According to the "New Standards for Basic Public Health Services (2019 Edition)" released in the notice, 19 new basic public health services related tasks include: endemic disease prevention, occupational disease prevention, and monitoring of major diseases and health hazards Work, human bird flu, SARS prevention and control project management, plague prevention project management, national health emergency team operation and maintenance guarantee management, rural women "two cancers" inspection project management, basic contraceptive service project management, children in poor areas Nutrition improvement project management, neonatal disease screening project management in poverty-stricken areas, folic acid supplementation to prevent neural tube defects project management, national free pre-pregnancy eugenics health inspection project management, thalassemia prevention and control project management, food safety standards follow-up evaluation Project work, health literacy promotion project management work, national random supervision and random inspection project management work, elderly health and medical care service management work, population monitoring project work, health and health project supervision and management work.
Among them, endemic disease prevention, occupational disease prevention, and monitoring of major diseases and hazardous factors are the tasks that are guaranteed to be completed every year. The remaining 16 tasks are implemented by the provinces in combination with local reality. Related work is not limited to grassroots medical and health institutions. These 19 basic public health services are provided by the National Health and Health Commission with work specifications and performance evaluation indicators, which are implemented by the provinces in combination with local actual conditions. In the implementation, the projects must be well connected to ensure the continuity of related work.
Subsidy per capita service funding increased by 5 yuan
The notice shows that the subsidy standard for basic public health services per capita in 2019 is 69 yuan, and the additional 5 yuan will be used for villages and communities. It is necessary to benefit the grassroots. All localities should proactively implement local fiscal authority and expenditure responsibilities in accordance with the requirements of the “Notice of the General Office of the State Council on Printing and Distributing the Reform Plan for the Division of Financial Responsibilities and Expenditure Responsibilities between the Central and Local Governments in the Medical and Health Field,” and strictly follow the “Ministry of Finance? National Health and Health Commission? State The Notice of the Medical Security Bureau and the State Administration of Traditional Chinese Medicine on Printing and Distributing Five Subsidy Funds and Other Administrative Measures for Basic Public Health Services (Caishe  No. 113) requires that the project funds be in full and on time, and that the project funds shall not be seized or misappropriated . On the premise of ensuring that the national basic standards are in place, the content of security or the standard of security can be increased reasonably. The increase in expenditure is borne by the local government, and it cannot be used to squeeze out national project funds.
Strengthen the management of vaccination units in grassroots institutions
The notice proposes that grassroots health administrative departments at all levels should cooperate with relevant departments to strengthen the informatization construction of vaccination and promote the traceability management of vaccine production, circulation and use. It is necessary to guide the daily management of vaccination units established in community health service centers and township health centers and the prevention and emergency treatment of vaccination risks. Strengthen the main responsibility, strictly implement the "Vaccine Circulation and Vaccination Management Regulations" and other laws and regulations and work specifications. Optimize and refine the vaccination process, on the basis of the implementation of "three checks and seven pairs", add a "one verification" link, and before the vaccination, ask the vaccinator or guardian to verify the type and validity of the vaccination to ensure that the vaccination is correct. Strengthen the training of medical personnel, and improve the skills and level of standardizing vaccination.
Promote the opening of electronic health records to individuals
The notice shows that the channels and interaction forms of electronic health records open to individuals are optimized, and the principles of safety and convenience are adhered to, creating conditions for the public to use electronic health records. To further clarify the contents of electronic health records open to individuals, the basic personal information, health examination information, key population health management records and other medical and health service records in the files should be opened to individuals in accordance with the law and regulations based on the informed consent of the person or his guardian .
Take advantage of “Internet +”, integrate appointment registration, online health assessment, online query of test results, medication guidance and other functions to improve the utilization rate of electronic health records by the public. Reasonably quantify the workload of primary-level medical and health institutions and medical personnel to provide online services based on electronic health records, and play an incentive role in performance evaluation. In their promotion work, all localities must implement the "National Standardization and Standardization of Informatization Construction of Primary-level Medical and Health Institutions" (Guo Wei Planning Letter  No. 87) and the requirements of national cybersecurity laws, regulations and hierarchical protection systems, and implement safety management responsibilities. Properly handle the relationship between opening electronic health records to individuals and ensuring the safety of citizens ’personal information.
Promote the integration of medical and prevention with the breakthrough of chronic diseases such as hypertension and diabetes
The notice proposes that in 2019, we will continue to explore the basic medical and defense integration service model with the management of chronic diseases such as hypertension and diabetes as the breakthrough point, and promote "separation from top to bottom". Seven provinces, including Shanxi, Liaoning, Guangdong, Chongqing, Guizhou, Yunnan, and Shaanxi, should play the role of pilots for the integration of medical and prevention of hypertension at the grassroots level, transform the service delivery model, and take advantage of the team of family doctors. Leading role; promote the establishment of a two-way collaboration and referral mechanism between grassroots institutions and higher-level medical institutions, and actively play the technical guidance role of disease control institutions. Other provinces should refer to the pilot requirements of these 7 provinces to continue to explore the integration of medical and prevention of hypertension at the grassroots level.
In 2019, grassroots diabetes medical prevention and integration management work will be launched. All localities will use the "National Primary Diabetes Prevention and Treatment Management Guideline (2018)" issued by the Chinese Medical Association as a technical guide for the development of grassroots diabetes medical prevention and integration, and organize the training of teachers and grassroots medical personnel . The National Health Commission will select some prefectures and cities with better information bases and strong primary medical service capabilities to carry out the pilot, and invite provinces who wish to submit the application materials by the end of September 2019. The National Health Commission commissioned the National Cardiovascular Disease Center and the Chinese Medical Association to establish hypertension and diabetes quality control monitoring systems respectively. All localities should do a good job of linking the regional health and health information system with hypertension and diabetes quality control monitoring systems to promote hypertension. 3. Data sharing of integrated management of diabetes medical prevention.
Innovative performance evaluation methods
The notice emphasizes the implementation of the "Opinions of the Central Committee of the Communist Party of China and the State Council on the Comprehensive Implementation of Budget Performance Management", strengthening project performance evaluation, giving full play to the role of information technology in performance evaluation, reducing on-site evaluation, and improving the efficiency and quality of performance evaluation. If necessary, organize personnel to verify on site. Counties (cities, districts) should implement the main responsibility for project performance evaluation, formulate scientific and reasonable performance indicators, and conduct at least one comprehensive performance evaluation every year for all medical and health institutions in the jurisdiction. Strengthen the effectiveness evaluation and cost-benefit analysis of the project, highlighting the residents' feelings and sense of gain. Make good use of the performance evaluation results, and link the evaluation results with the allocation. Clarify the division of labor between the two levels of the village and the basic public health service tasks undertaken by the village level. After the performance evaluation, the timely payment should be made according to the results. The subsidy funds should be effectively implemented to protect the legitimate rights and interests of the rural doctors. Subsidies.
All localities should actively organize and carry out ten-year evaluation of the project, make full use of daily data and information, focus on continuous and dynamic health management information mining, make full use of charts, data, typical cases and other forms, and focus on the promotion of basic public health services in the jurisdiction since the implementation of the project Equalization effectiveness, objective analysis of existing problems, and targeted policy recommendations. The provincial project evaluation report should be submitted to the National Health and Health Commission before the end of September.
Really reduce the burden on the grassroots
The notice clearly stated that the requirements of the “Notice on Resolving Outstanding Problems of Formalism as the Burden Reduction at the Grassroots Level” of the General Office of the Communist Party of China were implemented, innovative working methods and methods were strengthened, and the construction of basic public health service information systems was strengthened. Business collaboration. In accordance with the principle of one source, one source and multiple uses, we cleaned up the grass-roots organizations' strong reports of multiple reports, multi-head reporting, and excessive reporting frequency, and strived to achieve "only once" for similar information. Where the electronic health files are complete and open to individuals, the corresponding paper files can be cancelled after being evaluated by the provincial health and administrative department. In 2019, the project progress data submitted to the National Basic Public Health Service Project Management Information System (http://glpt.nbphsp.org.cn) by quarters will be changed to semi-annual reports. Strengthen the centralized management of the reports of grass-roots organizations. New reports must be issued after being reviewed by the higher-level grass-roots health management department, eliminating repeated issuance and repeated filling, improving work efficiency and quality, and effectively reducing the burden on the grass-roots level.
In addition, the notice also proposes to give full play to the role of disease prevention and other professional public health institutions, strengthen county-level professional public health institutions' technical guidance on basic public health services, and improve the standardization of services related to the work of grassroots medical and health institutions. At the same time, all provinces are required to submit the basic information (including institutional information, address, contact number, content of the project, etc.) that provides basic public health service institutions to the national basic public health service project management information system. Open to the public, convenient for the masses to inquire. Counties (cities, districts) and grass-roots medical and health institutions should post a publicity poster uniformly produced by the National Health and Health Commission or the provincial health and health administrative department in a prominent position; those who use basic public health services funds to carry out work should be in a prominent position in the promotional materials Express “Basic Public Health Service Projects” in bold font; public welfare advertisements of basic public health service projects produced by the National Health and Health Commission are widely broadcast. Encourage grass-roots medical and health institutions to classify and refine service content, carry out personalized publicity, and, if conditions permit, regularly push health education information to residents of the jurisdiction.
Source: People's Network