time:2023-11-28 10:25:35
2023 is the beginning year for implementing the spirit of the 20th National Congress of the Communist Party of China. Enhance the sense of gain, happiness, and security of the people through the new achievements of building a healthy China.
1、 Promote the expansion of high-quality medical resources and regional balanced layout
（1） Promote the establishment and construction of national medical centers and regional medical centers. According to the plan, establish a national medical center and a national regional medical center, and establish a mechanism for "unveiling and leading" and tracking effectiveness. Overall planning of national medical center construction projects for comprehensive, specialized, and traditional Chinese medicine categories, conducting evaluation of the effectiveness of national regional medical center construction, and promoting the establishment of management systems and operational mechanisms that are suitable for national regional medical centers. (The National Health Commission, the National Development and Reform Commission, the Ministry of Education, the Ministry of Finance, the Ministry of Human Resources and Social Security, the National Administration of Traditional Chinese Medicine, the National Bureau of Disease Control and Prevention, the Health Bureau of the Logistics Support Department of the Central Military Commission, and the people's governments of various provinces, autonomous regions, and municipalities directly under the central government shall be responsible according to their respective responsibilities. The following are all responsibilities of the people's governments of each province, autonomous region, and municipality directly under the central government and will not be listed anymore.)
（2） Continuously improve the medical level of cities and counties. Relying on existing resources, guide local governments to promote the construction of provincial-level regional medical centers. Promote the pilot construction of tight urban medical groups and strengthen the scientific and rational grid layout. Select several cities to pilot high-quality and efficient medical and health service systems. Continuously promote the work of matching tertiary hospitals to assist county-level hospitals. Encourage tertiary hospitals to explore cooperation mechanisms with county hospitals to achieve reasonable division of labor, complementary advantages, and shared benefits throughout the entire disease diagnosis and treatment chain. Organize the evaluation of medical service capabilities in county hospitals. Research and formulate guiding documents to promote the construction of a closely knit county-level medical community. Initiate the third batch of national hospice care pilot projects and implement a project to enhance hospice care service capabilities. (The National Health Commission, National Development and Reform Commission, Ministry of Finance, National Administration of Traditional Chinese Medicine, National Bureau of Disease Control and Prevention, and Health Bureau of Logistics Support Department of the Central Military Commission are responsible according to their respective responsibilities)
（3） Strengthen the capacity building of community and rural medical and health services. Expand the service functions of rehabilitation medical care, medical and elderly care integration, and hospice care in township health centers, and reasonably develop community hospitals. Promote the high-quality development of family doctor signing services, promote effective signing and standardized performance, and promote the participation of general medical departments in grassroots family doctor signing services in comprehensive hospitals. Improve the mechanism for county-level mobile medical services and on-site services to ensure full coverage of rural medical and health services. Implement actions to enhance the ability of community medical and elderly care integration and demonstration projects for medical and elderly care integration. Deepen the application of "Internet plus medical health" in urban and rural community disease prevention and treatment and health management. The National Health Commission, Ministry of Finance, Ministry of Civil Affairs, Ministry of Agriculture and Rural Affairs, National Administration of Traditional Chinese Medicine, etc. shall be responsible according to their respective responsibilities
（4） Improve the system and mechanism for promoting graded diagnosis and treatment. Explore the implementation of total medical insurance payment for close medical consortia, strengthen supervision and assessment, retain surplus, and reasonably share overspending. Encourage close medical consortia to establish a drug linkage management mechanism, and promote the connection of medication between upper and lower level medical institutions. In areas where conditions permit, medical and health institution personnel can be employed by counties and villages. Carry out performance evaluation of medical consortia. Promote the mutual recognition of examination and testing results in second level and above hospitals. (The National Health Commission, National Development and Reform Commission, Ministry of Finance, Ministry of Human Resources and Social Security, National Medical Insurance Administration, National Administration of Traditional Chinese Medicine, National Bureau of Disease Control and Prevention, and Health Bureau of Logistics Support Department of the Central Military Commission are responsible according to their respective responsibilities)
（5） Promote the inheritance, innovation, and development of traditional Chinese medicine. Accelerate the construction of the National Traditional Chinese Medicine Inheritance and Innovation Center, National Traditional Chinese Medicine Epidemic Prevention and Control Base, Key Hospital with Traditional Chinese Medicine Characteristics, and Flagship Hospital for the Coordination of Traditional Chinese and Western Medicine, and promote the construction of the National Demonstration Zone for Comprehensive Reform of Traditional Chinese Medicine. Strengthen the construction of rehabilitation and geriatric medicine departments in traditional Chinese medicine hospitals, and rely on existing resources to build a number of traditional Chinese medicine rehabilitation centers. Strengthen the cultivation of traditional Chinese medicine characteristic talents, and provide traditional Chinese medicine knowledge and skills training for physicians in grassroots medical and health institutions and rural doctors. Promote the research and development of ancient classic formula formulations, accelerate the release of key information research and approval of new drugs. (The State Administration of Traditional Chinese Medicine, the National Development and Reform Commission, the Ministry of Education, the Ministry of Finance, the National Health Commission, the National Medical Products Administration, and the Health Bureau of the Logistics Support Department of the Central Military Commission are responsible according to their respective responsibilities)
2、 Deepen the reform of public hospitals guided by public welfare
（6） Promote the reform and standardized management of medical service prices. Promote each province (autonomous region, municipality directly under the central government) to carry out the evaluation of medical service price adjustment in 2023, timely adjust prices within the total amount range that meet the conditions, and prioritize the inclusion of treatment, surgery, and some traditional Chinese medicine medical service projects with a focus on technical labor value in the adjustment scope. Continuously carry out the compilation of medical service price indices and related monitoring work. Evaluate the price reform situation of 5 pilot cities and launch provincial-level pilot projects for medical service price reform. (The National Medical Insurance Administration, National Health Commission, Ministry of Finance, National Administration of Traditional Chinese Medicine, National Bureau of Disease Control and Prevention, etc. are responsible according to their respective responsibilities)
（7） Deepen the reform of the salary system in public hospitals. Guide local authorities to implement the autonomy of internal distribution in public hospitals. Within the approved total salary, public hospitals can adopt various ways of autonomous distribution, and tilt towards majors that are urgently needed by the public and have a shortage of talents based on actual needs. Reasonably determine the internal salary structure, pay attention to the stable income and effective incentives of medical personnel, and further leverage the guarantee function of the salary system. It is strictly prohibited to issue revenue targets to departments and medical staff, and the salary of medical staff shall not be linked to business income such as drugs, sanitary materials, inspection, and laboratory testing. Explore the implementation of an annual salary system for the main responsible persons in public hospitals. (Ministry of Human Resources and Social Security, National Health Commission, Ministry of Finance, National Administration of Traditional Chinese Medicine, National Bureau of Disease Control and Prevention, etc. are responsible according to their respective responsibilities)
（8） Accelerate the high-quality development of public hospitals. Effectively implement the dean responsibility system under the Party Committee. Carry out quality evaluation of party building work in public hospitals. Strengthen the operation and management of public hospitals with the integration of business and finance as the core, and continue to carry out performance evaluation work for public hospitals and maternal and child health institutions. Carry out high-quality development evaluation and promotion actions for public hospitals. Play a leading role in the pilot demonstration of high-quality development in public hospitals, and strengthen the management of public hospital reform and high-quality development projects. We will carry out a three-year campaign to promote information exchange and sharing among medical and health institutions nationwide, promote the construction and grading evaluation of smart hospitals, and pilot projects for "5G+healthcare", medical artificial intelligence, and "blockchain+healthcare". Carry out theme activities to improve medical experience and enhance patient experience. Support the high-quality development of medical institutions run by state-owned enterprises. (The National Health Commission, Ministry of Education, Ministry of Finance, Ministry of Industry and Information Technology, State owned Assets Supervision and Administration Commission of the State Council, State Administration of Traditional Chinese Medicine, National Bureau of Disease Control and Prevention, and Health Bureau of Logistics Support Department of the Central Military Commission are responsible according to their respective responsibilities)
（9） Effectively strengthen comprehensive supervision in the pharmaceutical industry. Guide public hospital party organizations to strengthen their main responsibility for effectively and strictly governing the party, and prevent risks of integrity. Develop guiding documents on deepening institutional and mechanism reforms and strengthening clean governance in the field of medicine and health. Continuously strengthen the construction of professional ethics, promote the construction of a long-term mechanism for addressing corruption in the pharmaceutical industry nationwide, and further purify the industry atmosphere. Carry out a special campaign to crack down on fraud and insurance fraud, and manage dental implant fees. Strengthen anti-monopoly and anti unfair competition supervision in the pharmaceutical industry. Standardize the development of private hospitals. (National Health Commission, State Administration for Market Regulation, National Medical Insurance Administration, National Administration of Traditional Chinese Medicine, National Bureau of Disease Control and Prevention, National Medical Products Administration, etc. are responsible according to their respective responsibilities)
3、 Promote the orderly connection of multi-level medical security
（10） Consolidate and improve the basic medical insurance for all. Guide local authorities to establish and improve a mechanism for employee medical insurance outpatient mutual assistance, carry out overall planning of general outpatient services, strengthen positive publicity and policy interpretation. Dynamically adjust the list of medical insurance drugs. Expand the scope of cross provincial networked designated medical institutions and implement settlement for medical treatment in different regions. Promote all eligible designated medical institutions to support the application of electronic medical insurance vouchers. (The National Medical Insurance Administration, Ministry of Finance, National Health Commission, National Administration of Traditional Chinese Medicine, National Bureau of Disease Control and Prevention, etc. are responsible according to their respective responsibilities)
（11） Improve the multi-level medical security system. Improve the system of major illness insurance and medical assistance, and establish a long-term mechanism for preventing and resolving poverty caused by illness. Continuously deepen the pilot of the long-term care insurance system, summarize and evaluate the pilot situation, and study and improve policy measures. Develop commercial medical insurance, with a focus on covering expenses that are not covered by basic medical insurance. (The National Medical Insurance Administration, Ministry of Finance, National Health Commission, State Administration of Taxation, State Administration of Financial Supervision, State Administration of Traditional Chinese Medicine, etc. are responsible according to their respective responsibilities)
（12） Deepen the reform of diversified and composite medical insurance payment methods. Carry out payment based on disease diagnosis related grouping (DRG) or disease specific scoring (DIP) reform in no less than 70% of the overall planning areas. Promote the payment of long-term and chronic inpatient medical services based on bed days, and explore the implementation of payment based on disease types for advantageous diseases in traditional Chinese medicine. Guide various regions to establish and improve mechanisms for adjusting factors such as disease groups/types, weights/scores, coefficients, etc., and improve supporting mechanisms such as negotiation, surplus retention, special case negotiation, and fund supervision to improve the efficiency of medical insurance fund utilization. (The National Medical Insurance Administration, Ministry of Finance, National Health Commission, National Administration of Traditional Chinese Medicine, National Bureau of Disease Control and Prevention, etc. are responsible according to their respective responsibilities)
4、 Promoting reform and innovative development in the pharmaceutical industry
（13） Support drug research and development innovation. Clarify the shortcomings and support priorities of the pharmaceutical industry chain, guide and support enterprises to break through key technologies and achieve industrialization, and enhance the supporting level and supply guarantee capacity of the pharmaceutical industry chain. Continuously promote priority evaluation and approval work. Establish a sound mechanism for pricing new drugs. Continue to release a list of children's drugs that encourage research and development, as well as a catalog of generic drugs. (The National Medical Products Administration, the National Development and Reform Commission, the Ministry of Science and Technology, the Ministry of Industry and Information Technology, the Ministry of Finance, the National Health Commission, the National Medical Insurance Administration, and the Health Bureau of the Logistics Support Department of the Central Military Commission are responsible according to their respective responsibilities)
（14） Regularly carry out centralized and quantity based procurement of drugs and medical consumables. Carry out centralized and quantity based procurement of new batches of national organized drugs and medical consumables. Guide each province (autonomous region, municipality directly under the central government) to carry out at least one batch (including inter provincial alliances) of centralized procurement of drugs and medical consumables within the year, achieving a total of 450 national and provincial centralized procurement of drugs. Implement the policy of retaining surplus medical insurance funds for centralized procurement of drugs and medical consumables. Strengthen the rigid constraints on the quantity and implementation of centralized procurement and reporting in public medical institutions, improve the internal assessment methods and compensation mechanisms of medical institutions, and promote the rational and priority use of selected products. Improve the functions of the pharmaceutical centralized procurement platform and implement the pharmaceutical price monitoring project. (The National Medical Insurance Administration, Ministry of Finance, Ministry of Human Resources and Social Security, National Health Commission, National Administration of Traditional Chinese Medicine, etc. are responsible according to their respective responsibilities)
（15） Strengthen drug supply guarantee and quality supervision. Continuously promote the priority allocation and use of essential drugs. Strengthen collaborative monitoring, early warning, and graded response for shortage of drugs. Explore and improve new formats and models of drug distribution, and accelerate the innovative development of the drug distribution industry. Carry out comprehensive clinical evaluation of drugs, improve the monitoring mechanism for drug use, and promote standardized and rational drug use. Conduct full coverage spot checks on selected products in the centralized procurement of drugs and medical consumables organized by the state, conduct full coverage patrols on vaccine production enterprises, and conduct spot checks on blood product production enterprises. Reasonably import necessary drugs and medical devices. Research and improve the policy measures related to the "two vote system". (The National Medical Products Administration, the Ministry of Industry and Information Technology, the Ministry of Commerce, the National Health Commission, the State Administration of Taxation, the State Administration for Market Regulation, the State Medical Insurance Administration, etc. are responsible according to their respective responsibilities)
5、 Establish a sound public health system
（16） Promote collaboration and integration between medical and preventive measures. We strengthened the monitoring and analysis of COVID-19 and virus variation, compacted the "four responsibilities", and did a solid job in the normalization of prevention and control of COVID-19 "Class B and Class B". Strengthen the production and supply of emergency medical supplies, and enhance the ability of grassroots infectious disease prevention and treatment. Establish a public health responsibility list for all levels and types of public hospitals, clarify assessment and evaluation standards, promote the establishment of disease prevention and control or public health departments in secondary and above medical institutions, clarify work functions, and equip full-time personnel. Research and formulate management measures for disease prevention and control supervisors in medical institutions. Implement a sub domain expert system for public health. Strengthen the technical guidance and supervision assessment of disease prevention and control work in medical institutions by disease control institutions. Explore and promote the participation of professional personnel from disease control institutions in the work of medical consortia, and promote the coordinated development of county-level disease control institutions and county-level medical communities. (The National Bureau of Disease Control and Prevention, the National Health Commission, the Ministry of Industry and Information Technology, the Ministry of Commerce, the National Medical Products Administration, the National Administration of Traditional Chinese Medicine, etc. are responsible according to their respective responsibilities)
（17） Promote the reform of the disease prevention and control system. Establish and improve the system for monitoring, risk assessment, and early warning of infectious diseases, research and develop guiding documents for establishing a sound intelligent multi-point triggering infectious disease epidemic monitoring and early warning system, and promote the construction of infectious disease monitoring and early warning and emergency command information platforms. Develop guiding documents for the high-quality development of disease prevention and control systems. Promote the implementation of disease prevention and control system reform plans in local areas, and complete all reform tasks by the end of the year. (The National Bureau of Disease Control and Prevention, the National Development and Reform Commission, the Ministry of Finance, the National Health Commission, the National Administration of Traditional Chinese Medicine, and the Health Bureau of the Logistics Support Department of the Central Military Commission are responsible according to their respective responsibilities)
（18） Enhance the capacity of public health services. Adhere to prevention as the main focus, deepen the Healthy China Action and Patriotic Health Movement, and continuously improve the health literacy of the masses. Strengthen the management of major chronic diseases, enhance mental health and mental health work, and continuously promote occupational health protection actions. Strengthen the public health service capacity of grassroots medical and health institutions, improve national basic public health service projects and major infectious disease prevention and control projects. Strengthen food safety standards and risk monitoring and assessment. (The National Bureau of Disease Control and Prevention, National Health Commission, Ministry of Education, Ministry of Human Resources and Social Security, National Administration of Traditional Chinese Medicine, etc. are responsible according to their respective responsibilities)
6、 Developing and strengthening the medical and health workforce
（19） Strengthen the cultivation of scarce majors and high-level talents. Promote medical colleges to strengthen the construction of general medicine disciplines and establish universal teaching organizations for general medicine. Strengthen the standardization construction of geriatric medicine. Support vocational colleges to add majors related to elderly health services and elderly care services. Strengthen the training of professionals in mental health, critical care, geriatrics, pediatrics, anesthesia, public health, and the integration of prevention and treatment with composite talents. Implement the medical high-level talent plan. Strengthen the training of hospital management personnel on management professional knowledge. Guide various regions to strengthen the construction of professional nursing teams for the elderly, elderly care workers, and medical nurses, and organize professional training for nurses in grassroots medical and health institutions on common diseases, frequent illnesses, and psychological care for the elderly. (Ministry of Education, Ministry of Civil Affairs, National Health Commission, National Administration of Traditional Chinese Medicine, National Bureau of Disease Control and Prevention, etc. are responsible according to their respective responsibilities)
（20） Strengthen the construction of grassroots teams with a focus on general practitioners. Mainly focusing on "5-year college education+3-year standardized training", combined with various methods such as job transfer training and targeted undergraduate medical student training in rural areas, we aim to strengthen the team of general practitioners. Implement the registration or annotation of the scope of practice for general practitioners who have received training and passed the assessment according to regulations. Ensure the salary and benefits of general practitioners are in line with the salary level of clinical physicians in local county-level public hospitals under the same conditions. Optimize the structure of professional and technical positions in grassroots medical and health institutions, with a focus on general practitioners. Carry out training programs to enhance the capacity of rural health talents in counties. Implement the special plan for rural doctors among college students. Guide local authorities to ensure the participation of rural doctors in basic pension insurance. (The National Health Commission, Ministry of Education, Ministry of Human Resources and Social Security, Ministry of Agriculture and Rural Affairs, National Administration of Traditional Chinese Medicine, etc. are responsible according to their respective responsibilities)
All relevant departments in various regions should attach great importance to deepening medical reform work, effectively strengthen organization, strengthen publicity and guidance, respond to social concerns in a timely manner, and gather consensus on reform. Pilot provinces of comprehensive medical reform should further explore innovation and play a demonstrative and driving role. The National Health Commission should strengthen the overall coordination of medical reform work, work together with relevant departments to strengthen supervision, guidance, monitoring and evaluation, and ensure that all reform tasks are implemented and effective.
