Under the great attention and correct leadership of the District Party Committee and District Government, under the strong supervision and strong support of the District People’s Congress and the District CPPCC, and under the effective professional guidance of the Municipal Health Bureau, the District Health Bureau and its All medical and health units under the district's jurisdiction seize the opportunity and work hard to deepen the reform of the medical and health system as the main line, improve the level of medical services as the starting point, and take the benefit of the masses as the goal, and implement various tasks in accordance with the requirements of the superior departments. Health work has made great progress.
1. Completion of health work in the district
(1) Remarkable results in competing for funds
In accordance with the national policy on encouraging social capital to enter the medical market, After many contacts, negotiations, demonstrations and on-site inspections, the District Health Bureau successfully introduced Hengyang Rende Otolaryngology Hospital, Hengyang Zhongde Orthopedic Hospital, Hengyang Huakang Hospital, and Hengyang Jingcheng Dermatology Hospital to our district’s medical market. The above four private hospitals Each investment exceeds tens of millions, with a total investment of 42.6 million yuan. It is expected to be put into use next year. The new site of Chuanshan Hospital in XX City was moved to next to Lixin Avenue, with an investment of 8 million yuan and a renovated medical business area of ??5,000 square meters. The new site of the hospital is currently being renovated. Our district’s health system ranks among the top in the city in terms of competition for funding and projects.
(2) Project construction is advancing steadily
The bidding for the construction projects of three township health centers and district health supervision offices has been completed, and construction has been fully launched, with central investment and provincial supporting facilities** *4.15 million yuan has been received. At present, the main body of Daiyingling Town Central Health Center has been completed and the decoration is nearing completion; the main body of the civil construction part of Yumushan Township Health Center has been capped; the joint construction project of Changhu Township Health Center and the District Health Supervision Office has started. It is expected to invest more than 10 million yuan this year.
(3) Key tasks are progressing smoothly and policies to benefit the people are being implemented.
1. Equalization of public health services. The first is to strengthen the basic work of residents' health records. At present, the standard creation rate of electronic health records for urban and rural residents in our district has reached more than 91%, and the health record usage and update rate has reached more than 82% respectively, exceeding the indicator requirements of superior departments. The second is to strengthen the screening and management of mental patients and chronic diseases such as hypertension and diabetes, and establish a "one disease, one card, one report" system to carry out family follow-up according to the disease type and relevant regulations. The third is to strengthen the management of children and maternal health care. From October last year to October this year, the mortality rate of children under 5 years old in our district was controlled at around 7.4‰. We have established and improved the system management of children and pregnant women, which has provided scientific and efficient maternal and child health care work. Standardized and orderly development has laid a good foundation. Fourth, the number of beds per 1,000 people has greatly increased. Since this year, our district’s health system has tapped into potential and improved service levels, resulting in a significant increase in the number of beds per 1,000 people in our district. The District Health Bureau has connected with the Municipal Health Bureau. According to data provided by the Municipal Health Bureau, the population served by medical and health institutions in our district is 237,162 (including the population of Huaxin Development Zone of 51,188), and the number of beds in medical and health institutions in our district is 4,878 (including the number of people in the area where it is located). The number of beds in health units in Huaxin Development Zone), the number of beds per 1,000 people is 20.6.
2. Hospital delivery subsidies for rural pregnant women. From January to November 2013, more than 576 rural pregnant women have received subsidies in accordance with the "one-stop" subsidy method, with the subsidy amount reaching more than 500,000 yuan (including rural cooperative medical subsidies). Rural pregnant women have benefited from it, and hospitalized delivery has been successful Basically free.
3. Carry out pre-marital medical examinations efficiently. In order to increase the awareness rate of premarital health care, more than 4,000 premarital health care notification cards have been issued and distributed to households by village maternal and child health workers and family planning officers. Through vigorous publicity and active coordination with civil affairs and family planning departments, those who participated in premarital medical examinations from January to November ***1436 pairs, 97 of whom were found to be sick, all have received further examination and health guidance, and specialist treatment was recommended.
4. The essential medicine system is implemented smoothly. The implementation of the national essential medicine system in 3 township health centers and 5 community health service centers continued to be consolidated, and it was promoted to cover 34 village clinics on August 1 last year.
On August 6, 2012, the government executive meeting determined that the district-level finance should invest no less than 541,000 yuan per year for the implementation of the essential medicine system in village clinics in our district. As of the end of August 2013, special financial subsidies at all levels had totaled 70.3 million yuan. Ten thousand yuan, of which the district-level finance allocates a special subsidy of 550,000 yuan; the district finance subsidizes 3 township health centers and 5 community health service centers with an annual subsidy of 3 million yuan. As of the end of November this year, 3 township health centers and 5 community health service centers in the district have purchased a total of 8.796 million yuan of medicines and sold 8.735 million yuan of essential medicines, which has greatly alleviated the people's problem of "difficult and expensive medical treatment". The effectiveness of the implementation of the national essential medicine system in our district is among the best among the four urban districts.
(4) Leading by example and building a brand
Since the Zhengxiang Street Community Health Service Center won the honorary titles of “National Demonstration Community Health Service Center” and China Community Health Association Training Base last year , is now committed to building a provincial model brand for the training base of the China Community Health Association, and constantly strengthening the connotation construction and hardware facilities. At present, the Zhengxiang Street Community Health Service Center has been designated as the district's general practitioner transfer training and internship base. It is now fully organizing and carrying out public health service training at the Chinese Health Association training base; the three health centers of Lianhe, Hongxiang and Henggang The service center focuses on strengthening the connotation construction, improving the service level, and striving to have the conditions to create a provincial or municipal demonstration unit next year to improve the overall service level of the community center in our district and receive unanimous praise from the general public.
(5) Strengthen daily supervision of health supervision
The District Health Bureau focuses on daily supervision of public places and medical institutions under the jurisdiction of the district. Regular health supervision and inspections have been carried out in public places under the jurisdiction of the district, so that the physical examination rate of employees in public places is 100%, and the employment rate with certificates is 100%. In the first half of the year, a comprehensive inspection of medical institutions in the city was conducted. Most medical and health institutions are practicing in accordance with the diagnosis and treatment subjects approved by the "Medical Institution Practice License". Currently, 21 penalty documents have been issued, and 21 fines have been paid, with a total amount of 29,500 yuan. 21 companies have made rectifications. No "black clinics" without a "Medical Institution Practice License" have been found in our district.
(6) Tighten the string of production safety
Carry out medical safety work closely around the policy of "safety first, prevention first", improve various rules and regulations, and establish Improve technical specifications, operating procedures, and work quality standards so that medical care activities can be followed and rules can be followed to strictly prevent the occurrence of medical errors and accidents. Regularly conduct safety inspections of each medical unit to find weak links in safety work. Conduct spot checks on the quality of medical care from time to time, and adhere to important medical safety governance systems such as the medical quality publicity system and the medical care hierarchical management system. Use antibiotics rationally and standardize the disposal of medical waste. We always insist on taking production safety as the top priority of our work, seeking benefits from safety, and adhere to the regular inspection system for production safety to ensure that medical personnel do not practice illegally or violate operating procedures. Since the beginning of this year, no safety accidents have occurred in health units in the region, and the safety production situation is generally stable.
(7) Solid progress in comprehensive family planning management
First, the implementation of a hospitalization identity registration system and a monthly reporting system. Guide hospitals to comprehensively establish and improve a "real-time reporting" system, and implement real-time reporting of information on prenatal checkups and delivery objects over 14 weeks of pregnancy. Second, the District Health Bureau and the Family Planning Bureau have jointly investigated and dealt with a typical case of "two illegalities". The third is to strictly implement the "eight and one strict" content of the health department's family planning work. And comprehensive family planning management work has been included in the overall year-end target management assessment of the health system. This year's provincial and municipal family planning work assessment results were remarkable and were highly recognized and praised by superior authorities.
(8) The "Three Major Activities" work has achieved results
Participating in the "Big Visits, Big Research, Big Service" activities has produced real results.
This year, we visited more than 1,000 households and 2 enterprises and eliminated one fire safety hazard; together with the Dayuantou Community Neighborhood Committee, we invested more than 2,000 yuan to reinstall new sewer pipes outside the family area of ??Feilong Company; we invested more than 3,000 yuan to purchase new sewer pipes. A batch of noodles, quilts, cotton-padded clothes and other supplies were sent to the community charity supermarket; a free clinic activity of "big visits, big research, big services" was held in Xinmin Village, and medicines worth more than 40,000 yuan were distributed to villagers for free; In view of the high incidence of stones, the working group collected free water samples from 7 wells in the village for testing, and collected water samples at 7 points in total, which provided scientific basis for villagers to prevent and treat diseases; in order to protect the health of villagers, farmers with high-risk groups for influenza were tested Free flu vaccination***, 30 in total. Visited 30 households in need in communities and Zhudian villages, and sent 12,000 yuan in condolence money; issued 10 free medical cards from the Zhengxiang Street Community Health Service Center to households in need in Dayuantou Community; Three brand-new wheelchairs were given to three needy and disabled households in Yuantou Community for free; Luo Qiong, the deputy district chief, and Deng Hongjun, director of the Zhengxiang Street Community Health Service Center, each took out 500 yuan from their wallets and handed them to the two elders. The disabled households in the community were highly praised by the surrounding people.
(9) Effective prevention and control of infectious diseases.
First, carry out infectious disease supervision work. From January to November 2013, *** wrote 56 supervision records, 11 monthly analyzes of infectious disease epidemics, and 48 weekly analyses; standardized fever and intestinal clinics Construction, comprehensive hospitals and health centers within the jurisdiction strictly follow the "four specialties and two specialties" standard, standardize the construction of fever and intestinal clinics; do a good job in registration and screening of patients with fever and diarrhea, and strictly ensure that "everything with diarrhea must be done" Check and report any doubts."
Second, in terms of emergency response to public health emergencies, 1. Strengthened the prevention and management of public health emergencies, and established prevention and control technical teams and epidemic control mobilization in accordance with the relevant spirit of superiors. The team is equipped with disinfection drugs, disinfection equipment and protective equipment, so that once a public health emergency occurs, it can be handled promptly and effectively. 2. Deal with the epidemic in a timely manner. This year, a mumps outbreak occurred at Xizhan Road Primary School in Lianhe Street, and a suspected foodborne disease incident occurred at the Yumu Campus of the University of South China on October 30. The emergency mobile team of the District Health Bureau rushed to the scene as soon as possible to carry out epidemic prevention and control. Through medical investigation and epidemic management, the epidemic has been effectively controlled, and no second-generation or severe cases have occurred. 3. Strengthen the construction of the emergency system. Since the beginning of this year, the emergency mobile team of the District Health Bureau has participated in three district-wide emergency drills to continuously improve the construction of the emergency system and related systems and improve emergency response capabilities.
The third is to strengthen epidemic reporting management. From January to November, medical institutions at all levels in the jurisdiction reported 2,112 cases of infectious diseases. Medical units in the jurisdiction can better implement the infectious disease reporting and registration system, with a reporting rate of 100%, and a timely rate of online card reporting of 100%, complete The rate is 100% and the reporting accuracy is 99.4%.
The fourth is to carry out planned immunization work. 1. From January to November ***, 11 cold chain operations were carried out, and the number of vaccination shots reached 48,836, and the vaccination rate met the standards required by superiors; 2. In January this year, a measles vaccine leakage check was carried out in XX District In the re-vaccination work, missed catch-up immunization work was carried out for school-age children and special groups in the district from 2008 to 2012. A total of 1,395 shots of re-vaccination were completed, and the re-vaccination task has been basically completed. 3. Carry out epidemic surveillance of diseases related to planned immunization. First, carry out measles epidemic surveillance, detect 286 suspected measles cases, including 10 cases of measles, and investigate and deal with the epidemic in a timely manner; second, in order to maintain the polio-free status, carry out acute flaccid Active surveillance of paralysis (afp) and active search for acute flaccid paralysis (afp) in sentinel hospitals. No cases of acute flaccid paralysis (afp) have been found so far. 4. Implement the supervision of the immunization program, formulate the "XX District Immunization Program Supervision Plan", and comprehensively carry out inspections of planned immunization rates, biological products management, children's card creation, and certificate creation. This year, our district represented XX City in welcoming the provincial immunization program inspection and ranked second in the province.
The fifth is tuberculosis prevention and control.
Up to now, *** has received 236 patients, and has fully supervised the medication management of the tuberculosis patients it received to ensure that the patients are treated in a standardized manner and send sputum for review on schedule. Judging from the treatment effect, after two months of initial treatment, the sputum was positive and the sputum was negative for bacteria. The conversion rate is 99%. After two months of re-treatment of smear positive, the sputum bacterial negative conversion rate is 95%. The sputum bacterial negative conversion rate of patients who have completed the course of treatment is 99%. The treatment effect is relatively satisfactory and has been highly praised by tuberculosis patients.
Sixth, carry out the AIDS comprehensive prevention and control demonstration area project. Strengthen leadership, hold coordination meetings, and implement various tasks. Since the launch of the AIDS Comprehensive Prevention and Control Demonstration Zone Project in 2009, all tasks have been carried out in an orderly manner, ensuring that leadership, investment, guarantees, and measures are in place, and it is down-to-earth. Carrying out AIDS prevention work has played a positive role in ensuring the health of the people. At the end of the year, we will welcome the inspection and acceptance of the AIDS prevention and control demonstration zone.
(10) Cooperate in carrying out the "Sanxiang Farmers' Healthy Walk" activity
According to the unified arrangements of the District People's Congress, cooperate with the district agricultural office and other departments to carry out the "Sanxiang Farmers' Healthy Walk" activities, Formulate an implementation plan based on the actual situation of the health system, and implement the "Hunan Provincial Patriotic Health Regulations"; combine the World No Tobacco Day activities with careful publicity of health knowledge and relevant laws and regulations, and all grassroots health units use World No Tobacco Day as a Taking this opportunity, *** produced 10 promotional banners, more than 100 no-smoking signs, updated 10 anti-smoking knowledge bulletin boards, and distributed more than 3,000 promotional materials.
(11) Solidly carry out the "Serving People's Health Action" large-scale free clinic activity week
In order to achieve effective results, the District Health Bureau requires all medical and health units to adopt various forms of Free clinic activities benefit the general public. First, on the morning of October 13, our district’s Health Bureau, Centers for Disease Control and Prevention, Health Supervision Institute, Maternal and Child Health Hospital, Zhengxiang Hospital, Nanhua Second Affiliated Hospital, Huaxin Hospital, XX City Red Cross Cancer Care Volunteers, etc. A large-scale free clinic event under the "Serving People's Health Action" was held. The *** plans to dispatch more than 30 specialists with medium and high professional titles and more than 10 volunteers to provide consultation, preliminary screening, diagnosis and general treatment of common and chronic diseases, popularize medical knowledge and health knowledge, and advocate healthy lifestyles , guide the masses to seek medical treatment scientifically. The event provided free clinics to more than 1,000 people, distributed free commonly used medicines, cooking oil, umbrellas, etc. worth tens of thousands of yuan, and distributed nearly 2,000 copies of common diseases, chronic diseases, AIDS prevention and maternal and child health promotion materials, and was well received by the general public. Leaders such as Zou Aimin of the Municipal Health Bureau and Luo Qiong, deputy head of the district government, were present to guide the work. All team members of the District Health Bureau and heads of relevant departments participated in this large-scale free clinic event. Second, the District People's Hospital and Yumushan Township Health Center carried out free clinic activities for local nursing homes. On the morning of October 15, 2013, XX District People's Hospital and Yumushan Township Health Center held a "Serving the People, Healthy Action" free clinic event at the local nursing home. A total of 15 medical workers participated to provide blood pressure for the elderly in the nursing home and villagers. Blood sugar measurement, chronic disease consultation and other services. During this free clinic, 196 people had their blood pressure measured, 196 had their blood sugar tested, 196 were treated, 156 prescriptions were issued, and more than 6,000 yuan in free medicines were distributed. This free clinic was unanimously recognized and welcomed by the local villagers. It not only relieves the villagers of hidden disease risks and reduces their economic burden, but also strengthens the villagers' health awareness. Third, the District Maternal and Child Health Hospital, township health centers, and community health service centers waived registration fees for patients, reduced related handling fees, and compiled specialist disease prevention and treatment promotional materials, which were welcomed by the majority of patients.
2. Main existing problems and suggestions
(1) Medical resources need to be integrated. Due to historical reasons, the distribution of resources among medical and health units in our district is unbalanced. Some units have heavy personnel burdens, and some units lack talents. It is difficult to introduce talents urgently needed by the entire health system. In the past ten years of zoning adjustment, there has only been one establishment and the introduction of 9 people. , resulting in aging personnel and structural imbalance in the health system. The District Center for Disease Control and Prevention and the District Health Supervision Office currently have only 15 people on staff. It is evident that they have to deal with the daily supervision of disease prevention and control and health law enforcement in the district. It is recommended that the government provide policy support.
(2) Policy investment needs to be increased.
Taking the implementation of the essential medicine system and performance-based pay as an example, the preliminary estimate shows that the district needs about 20 million yuan in funds, but the current policy investment from the central and provincial governments is only about 5 million yuan, accounting for only 25%; Changhu Health Center and the district The newly built project of the Health Supervision Office has a new area of ??5,000 square meters, and the total national debt funds are only 2.3 million yuan. The degree of difficulty can be imagined; currently, among the 34 village clinics in our district, only the Zhenxing Village Clinic is seeking 30,000 yuan in national debt funds in 2010. The construction of village clinics at the bottom of the network is seriously lagging behind due to renovation and expansion. It is recommended that the government's finances increase investment in health services.
(3) The issue of pension insurance for rural doctors needs to be clarified. At present, the age structure of rural doctors in village clinics in our district is relatively aging. How to solve their pension problem has become an urgent issue in the current work. It is recommended that higher-level departments follow the spirit of the Provincial Government's Xiangzhengbanfa [2011] No. 75 document and the actual situation of our region, include rural doctors in the scope of urban employee pension insurance, and provide certain policy and financial support.
(4) The medical insurance system is unbalanced. Currently, the five community health service centers in urban areas are designated medical insurance units that can only provide outpatient medical care, chronic disease recovery, hospice care and other medical insurance subsidy services. It is suggested that relevant functional departments at higher levels should favor primary medical units in their medical insurance policies.
3. Focus on the next step
1. Continue to implement the national essential drug system, ensure 100% coverage of the basic drug system in grassroots medical and health units, and allow the common people to share the medical reform Results.
2. Implement various measures to ensure that public health work such as free physical examinations for people over 65 years old, chronic disease management rate, and resident health file update rate are fully up to standard.
3. In accordance with the spirit of relevant documents from superiors, strive to provide district finance with matching funds for health construction projects.
4. Strive for the policy support of the district committee and the district government, initiate the reform of the personnel system and salary system of primary medical institutions, complete the approved establishment work, strengthen the training of on-the-job staff, and at the same time introduce urgently needed personnel within the approved establishment scope professional and technical personnel.
5. Coordinate with relevant departments. On November 15, the district government office and the district citizen blood donation committee will take the lead. The district health bureau and the district Red Cross will be specifically responsible for preparing and organizing various townships, streets, and medical and health systems. Nearly a thousand people from various units carried out the 2013 group voluntary blood donation activities.
4. Key work ideas
1. Focus on services and people’s livelihood. First, actively and steadily promote the reform of the medical and health care system, focusing on consolidating the implementation of the national essential drug system in 3 township health centers, 5 community health service centers and 34 village clinics, standardizing the rational use of drugs in all grassroots medical and health units, and conducting strict inspections. The behavior of purchasing medicines outside the Internet alleviates the hot issue of "expensive medical treatment" among the masses and allows ordinary people to share the results of medical reform. The second is to focus on strengthening public health work and implement various measures to achieve equalization of public health in urban and rural areas.
2. Focus on projects and increase strength. First, continue to strengthen the work of competing for funds and consolidate the construction of health infrastructure. The second is to complete the new project tasks of the Hongxiang Street Community Health Service Center as soon as possible.
3. Grasp the connotation and improve the level. Strive for policy support from the district committee and district government to introduce urgently needed professional and technical talents. Taking the demonstration establishment of the Zhengxiang Street Community Health Service Center as an example, we will create a demonstration brand of the training base of the China Community Health Association, and take this as an opportunity to comprehensively improve the service level of medical institutions in the district.
4. Respond to emergencies and improve the system. Establish and improve the emergency response system and emergency plans for public health emergencies, strengthen the monitoring, prevention, control and medical treatment of major infectious disease epidemics and public health emergencies, and strengthen the training of specialized emergency response teams at the district and township levels. Ensure the steady and healthy development of medical and health services.