National Health Grass Roots (2019) No. 52
Provinces, autonomous regions, municipalities directly under the Central Government, and the Xinjiang Production and Construction Corps Health and Health Commission, Department of Finance (Bureau), Administration of Traditional Chinese Medicine:
In order to implement the "Notice of the General Office of the State Council on Printing and Distributing the Reform Plan for the Division of Central and Local Financial Responsibilities and Expenditure Responsibilities in the Field of Medical and Health" (Guobanfa  No. 67, hereinafter referred to as the "Plan"), do a good job in basic public health in 2019 Service work, the relevant matters are now notified as follows:
1. Clear the task objectives
(1) The content of the original basic public health services. All localities should continue to implement the establishment of resident health records, health education, and prevention in accordance with the overall performance goals and regional performance goals of the 2019 central transfer local special transfer payment basic public health service project, and in accordance with the "National Basic Public Health Service Specification (Third Edition)" Vaccinations, child health management, maternal health management, elderly health management, hypertension and type 2 diabetes and other chronic disease health management, severe mental disorder patient management, tuberculosis patient health management, Chinese medicine health management, infectious diseases and public emergency 12 types of projects such as reporting and handling of health incidents and co-management of health supervision. In the process of carrying out child health management, implement the Notice of the General Office of the National Health and Health Commission on Doing a Good Job in Eye Care and Vision Examination for Children Aged 0-6 (Guoweiban Fuyoufa  No. 9) —Eye health care and vision inspection work for 6-year-old children; strengthen childhood obesity screening and health guidance, and actively carry out prevention and control of childhood obesity. We will provide basic public health services to the poor and promote equalization of basic public health services.
(2) Newly classified as basic public health services. According to the requirements of the "Plan", the contents of maternal and child health, elderly health services, medical and nursing integration, health emergency, pre-pregnancy inspection, etc. in the original major public health services and family planning projects will be included in basic public health services from 2019. For the content newly included in the basic public health services, the three key tasks of endemic disease prevention, occupational disease prevention, and monitoring of major diseases and hazardous factors are listed separately by project, with clear funding and tasks; other disease prevention and control, maternal and child health services, elderly health and The National Health and Health Commission provides work specifications and performance evaluation indicators for integrated medical and nursing services, food safety assurance, health supervision and management, health emergency team building, population monitoring and family planning services, and health literacy promotion. All provinces, in conjunction with local actual implementation, should make good project connections during implementation to ensure the continuity of related work.
Second, raise the subsidy standard
The subsidy standard for basic public health services per capita in 2019 is 69 yuan, and the newly added 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 "Plan", strictly in accordance with the "Ministry of Finance National Health and Health Commission National Medical Security Bureau State Administration of Traditional Chinese Medicine on the issuance of five subsidy funds management methods such as basic public health services The Notice (Caishe  No. 113) requires that the project funds be ensured in full and on time, and that the project funds cannot be overrun 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.
3. Strengthen the management of vaccination units in grassroots institutions
The grass-roots 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 throughout the process. 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.
Fourth, actively and steadily promote the opening of electronic health records to individuals
Optimize the channels and interaction forms of electronic health files for individuals to open services, adhere to the principles of safety and convenience, and create conditions for the public to use electronic health files. 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 . Give full play to the advantages of "Internet +", integrate functions such as appointment registration, online health assessment, online query of test results, medication guidance, etc., to improve the utilization rate of electronic health files 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.
Five, take hypertension, diabetes and other chronic diseases as a breakthrough to promote the integration of medical and prevention
In 2019, we will continue to explore the basic medical and defense integration service model with the management of hypertension, diabetes and other chronic diseases as a breakthrough, and promote the “separation of upper and lower levels”. 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.
Six, innovative performance evaluation methods
It is necessary to implement the "Opinions of the Central Committee of the Communist Party of China and the State Council on the Comprehensive Implementation of Budget Performance Management", strengthen project performance evaluation, give full play to the role of information technology in performance evaluation, reduce on-site evaluation, and improve the efficiency and quality of performance evaluation. 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.
7. Effectively reduce the burden on the grassroots
Implement the requirements of the Notice of the General Office of the Central Committee of the Communist Party of China on Resolving the Outstanding Problems of Formalism to Reduce the Burden at the Grassroots Level, innovate working methods and methods, strengthen the construction of basic public health service information systems, and focus on data sharing and business collaboration with medical and health institutions and maternal and child health information systems. 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.
8. Give full play to the role of disease control and other professional public health institutions
Strengthen the technical guidance of county-level professional public health institutions on basic public health services, and improve the standardization of services related to the work of primary medical and health institutions All localities can combine the actual situation and rely on disease control agencies to establish a technical expert team for basic public health service projects in their jurisdictions and formulate annual basic public health service project guidance plans, including skills training, technical guidance, etc., to ensure and enhance the quality of services and Efficiency, increase residents' sense of gain, and benefit the grassroots.
Nine, increase publicity
Persist in carrying out project publicity, focusing on improving project awareness and public perception. In 2019, all provinces will submit the basic information (including agency information, address, contact phone number, project content, etc.) that provide 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.
National Health Commission Ministry of Finance
State Administration of Traditional Chinese Medicine
August 30, 2019