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云浮市人民政府办公室关于印发云浮市医疗联合体建设工作实施方案的通知

发布时间  :2017-09-15 00:00:00.0 来源  :云浮市政府办公室 浏览次数  :1322次 字号:

 

云浮市人民政府办公室文件

云府办〔2017〕43号


 

云浮市人民政府办公室关于印发云浮市医疗

联合体建设工作实施方案的通知

 

各县(市、区)人民政府,市政府各部门、各直属机构:

《云浮市医疗联合体建设工作实施方案》已经市人民政府同意,现印发给你们,请认真组织实施。实施过程中遇到的问题,请径向市卫生计生局反映。

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2ZWAiUlgQa0fvNEgnYl8TJzEXZB8vSzYXVF0TUkMJbEgvNVkPcEYES2c1TVL3Yl02bVb4XyTvUkYJZ1n0c2j2QyUKLj8rYSkYLkMQOSz7K0MoY14gcGUxYUYgaGUkOfzJOEMoY14kYDwkalczZC3xLiHzOB8SZVctYVQLYV4mcFf9CPn7T1kmalEzcWIkS2IjYWH9LSvuT1kmalEzcWIkS2IjYWH9CPn7UlUxb1kuai4VNB3vKi=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0XzEEcWUsdDUBNSINVlP2MWo1ZlIOQUgPNEgRazULNGoWQDn1S0YFS2EuVFQGPUcTdFUwTygwTmEsUkc3cWYyQEIzUUoVdEbxJzomYCHvOV8UTTYxQVvxPi0sNGIQXWTxTlMRYTYpYD4ZQlLqQj0ZczUZZDTzdGgNQjYwaFcqYVoYYGcqayL0SS0qVl0BQCD3QjYWdkEFUUUpRyQZdjzqT2Y1USUkVUMVbTEgdi=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2YS0UUkUkamUFTikTNDg3M0YnM0glR1nxSEQoLWnwQyciQCk1UUoxcTTuM2Utc1IZYlgxTGoWOSEjdScOOR8oVGg3QEYodjULUVURS0gjYz8FTUQDZ0U2NV8CLSQFc2Q5J1MULEUGX0ACMTULPz05TToDRDUmKzkUX2X8Uj0iUWUpRUQQZkH1cTYYaS=1LWb0UWMNSFkQTT0pYln2blHqXRs2XTsSUTQIZyIqPlP4Umo2TjsEZjsKSzwsdGgTQjYDcz38YGj1RycWMzMSQlELYEcVXSciK2n4dj80QV4qLyURYy=zMT4BQ0UFYiIWVGEXdlIhUkcFakQzZzEUczYLM2nwNSIUQlcWamkUQV0TLCQKXTMsVmQFVBsqZEclSyYlR1ExZmoHYVk5T1sBTzYCOSgtdT8BTD8MTkMUSkkgcSX1QmgqUVMUR0YiXVoMQlcJYmQkPyX2ZjM5dlIFR2kSYEUFUTYGS2AvOB8IaVEmYTQCOfzJODYubl0gcFUeQlwgYy37KzYubl0gcFUeQlwgYy3MBiwAcF8sZWogcFkuak8FaFEmOi=7KzEza10odlEzZV8tWzYrXVb9CPn7TGIucFUicDQuX2UsYV4zOi=7K0Axa2QkX2QDa1M0aVUtcC3MBiwBXWICa1QkXV4jZUMoY14gcGUxYTYrXVb9LCvuPlExP18jYVEtYFkSZVctXWQ0blUFaFEmOfzJODYSYWI1ZVMkTz39LC=2LiDxLC=3LS=vMyb2MiXzOB8FT1UxclkiYUMNOfzJOEAxZV4zUlkyZVIrYS3wOB8PblktcEYob1khaFT9CPn7b0MoY14ScFEzYS34NSj4OB8yT1kmakMzXWQkOfzJOD0jMS4iYVDwX1P0XSD3M1LyYSEiMCchXyElMVQiNCUlLFEjLivuSVP0OfzJOEAxZV4zT1UzOi=7K0AxZV4zT1UzOfzJOEMkXVwSYWIoXVv9QlQ5ZkUiXUXxTmEqT1YGYUQEVmHqQGf4SST8SEcsMjoXMEEmbyAtRCguSmY4ZTM2S0A0XjEBLR8KaDj2cCMnVW=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

 

 

 

   云浮市人民政府办公室

   2017912

 

 

云浮市医疗联合体建设工作实施方案

 

为贯彻落实《广东省人民政府办公厅关于印发广东省推进医疗联合体建设和发展实施方案的通知》(粤府办〔201749号),推进我市医疗联合体(以下简称医联体)建设和发展,结合我市实际,制定本实施方案。

一、工作目标

——到2017年底,基本搭建医联体相关制度框架,全面启动多种形式的医联体建设试点,全市三级公立医院全部参与并发挥引领作用;选择云城区为试点,建成一个有明显成效的医疗集团;以市直医疗单位优势专科为龙头启动市域专科联盟建设。

——到2018年,在云安区建成一个有明显成效的医疗集团;在罗定市、新兴县、郁南县全面启动医疗共同体建设工作。

——到2020年,充分总结试点经验,全面推进医联体建设,形成较为完善的医联体政策体系。全市所有二级公立医院和政府办基层医疗卫生机构全部参与医联体,形成基层首诊、双向转诊、急慢分治、上下联动的分级诊疗模式。

二、工作措施

(一)明确医联体组织模式。根据我市实际情况,建设医联体的模式主要有以下几种:

——组建医疗集团。在云城区、云安区,由三级公立医院或者业务能力较强的医院牵头,联合镇卫生院、街道社区卫生服务中心等医疗机构,组建以人才共享、技术支持、检查互认、处方流动、服务衔接等为纽带进行合作的医疗集团。三级和二级医疗机构向基层医疗卫生机构和康复、护理等慢性病医疗机构转诊人数年增长10%以上。

——组建医疗共同体。在罗定市、新兴县、郁南县,以县级政府举办的综合医院、中医院、妇幼保健院为龙头,镇卫生院、街道社区卫生服务中心为枢纽,村卫生站为基础的县镇村一体化管理模式,形成县镇村医疗卫生机构分工协作机制,构建三级联动的县域医疗服务体系。

——组建专科联盟。由市直三级公立医院牵头,组建市域专科联盟。以市人民医院为龙头建成心血管内科、神经内科、呼吸内科、骨科、眼科等专科联盟;以市中医院为龙头建成中医骨伤科、中风病科、中医康复科、针灸科等专科联盟;以市妇幼保健计生服务中心为龙头建成新生儿科、产科等专科联盟,实现专科上下转诊,横向盘活现有医疗资源,形成补位发展模式。

——发展远程医疗协作网。鼓励二级、三级医疗机构向基层医疗卫生机构提供远程会诊、远程病理诊断、远程影像诊断、远程心电诊断、远程培训和手术示范、远程教学等服务。

——其他。在已建立的对口支援关系基础上,鼓励三级公立医院向县级医院派驻管理团队和专家团队,重点帮扶提升县级医院医疗服务能力和水平。鼓励社会办医疗机构参加医联体建设。

(二)完善组织管理和协作机制。牵头医院负责制定医联体章程,规定主体单位与其他成员单位的责任、权利和义务,完善医疗质量管理等制度。鼓励医联体探索在医院层面成立理事会。

(三)建立责任共担和利益共享机制。对医联体内部因双向转诊等互有参与业务产生的业务收入、医保基金的结余留用,探索实行按一定比例在牵头单位和成员单位之间进行分配。因管理不善等原因造成的医保基金超支等亏损,应由医联体牵头单位、成员单位和医保基金共同分担。

(四)进一步落实医疗机构功能定位。三级医疗机构要逐步减少常见病、多发病、病情稳定的慢性病患者比例,基层医疗卫生及专业康复、护理等机构为诊断明确、病情稳定的患者提供治疗、康复、护理等服务。通过签约服务,畅通医联体内部转诊机制,二级以上医疗机构要为医联体内上转的患者优先安排检查检验、设立住院绿色通道等服务,基层医疗机构要重点畅通诊断明确、病情稳定患者和术后康复期患者的下转通道。到2017年底,基层医疗卫生机构诊疗量占总诊疗量比例达到65%以上,居民两周患病首选基层医疗机构的比例达到70%以上,县域内就诊率提高到90%左右。扎实推进家庭医生签约服务,到2017年底,家庭医生签约服务覆盖率达到30%以上,重点人群签约服务覆盖率达到60%以上;到2020年,力争将签约服务扩大到全人群。

(五)促进人力资源有序流动。医联体内统一调配资源,统筹薪酬分配。鼓励医联体内二级以上医疗机构向基层医疗卫生机构派出专业技术和管理人才,主动为基层医疗卫生机构提供进修学习机会。在编制隶属关系不变的前提下,探索推进人才县管镇用、镇管村用,建立人才柔性流动机制。

(六)推动信息互通。加快建设全民健康信息综合管理平台和基层医疗卫生机构管理信息系统,推动医联体内实现电子健康档案和电子病历的连续记录和诊疗信息互联互通,便捷开展预约诊疗、双向转诊、健康管理、远程医疗等服务。力争到2017年底,分级诊疗管理信息系统基本覆盖全部二级三级医疗机构和80%以上的镇卫生院、街道社区卫生服务中心。探索实行远程医疗收费和支付政策。

(七)推动服务共享。依托医联体内牵头单位的影像、检验、病理、心电诊断等优势资源,建立区域医学影像中心、检查检验中心、消毒供应中心、后勤服务中心等,实现医联体内服务供给一体化、医疗质量质控同质化和检查检验结果互认。鼓励探索建立医联体内统一的药品招标采购、管理平台,形成医联体内处方流动、药品共享与配送机制。

(八)发挥医保经济杠杆作用。合理确定三级医院、二级医院、康复医院、护理院等不同级别、不同类别医疗机构的支付标准,在医联体内按规定转诊的病人按照连续的诊疗过程累计计算起付线,符合条件的日间手术和日间化疗按规定纳入医保支付范围。在总额控制下,探索对纵向合作的医联体等分工协作模式实行医保总额付费等多种付费方式,慢性病住院患者实行按床日付费,建立健全“结余留用、合理超支分担”等激励约束机制,激励医疗机构提高服务效率和质量。

(九)完善人员保障和激励机制。按照“允许医疗卫生机构突破现行事业单位工资调控水平,允许医疗服务收入扣除成本并按规定提取各项基金后主要用于人员奖励”的要求,完善与医联体相适应的绩效工资政策和分配激励机制。允许将收支结余的部分资金按规定用于奖励性分配。将基层工作经历作为医联体内医务人员职称职务晋升的条件之一。

三、工作要求

(一)加强组织领导。各县(市、区)人民政府要落实办医主体责任,落实公立医院投入政策,建立财政补助资金与绩效评价结果挂钩机制。卫生、人社、财政、发改、编办、食品药品监管等相关职能部门要认真履行职责,出台相关配套政策措施,密切配合,共同推进医联体的建设工作。医联体内各医疗机构的产权归属保持不变,继续按照原渠道拨付财政补助经费。201710月底前,各县(市、区)、市直三级公立医疗单位要出台推进医联体建设的工作方案,我市明确云城区为医联体建设试点地区。

(二)强化考核评估。市卫生计生局要抓紧在全市深化医药卫生体制改革工作检查考核框架下建立医联体考核指标体系,重点考核医联体技术辐射带动情况、医疗资源下沉情况等,不单纯考核业务量,要将二、三级医院医疗资源下沉情况、与基层医疗卫生机构协作情况以及基层诊疗量占比、双向转诊比例、居民健康改善等指标纳入考核体系,将考核评价结果作为人事任免、评优评先等的重要依据,并与医务人员绩效工资、进修、晋升等挂钩。医联体建设任务与分级诊疗制度建设一并纳入市深化医药卫生体制改革工作检查考核。

(三)营造良好氛围。充分利用各种传媒,广泛宣传医联体的就医政策和便利措施,引导群众就近到医联体内就医,扩大医联体的社会影响,形成有利于医联体加快发展的良好氛围,推动分级诊疗制度的建立。

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

公开方式:主动公开

 

抄送:市委各部委办,市人大办,市政协办,市纪委办,云浮军分区,市中级法院,市检察院,省驻云浮单位,各人民团体,各新闻单位。

云浮市人民政府办公室             2017年9月12印发