Original title: Zhejiang guides hierarchical diagnosis and treatment of patients with “two chronic diseases”
(correspondent Li Ying Dai Wenyun special reporter Hu Ling) Recently, Zhejiang Provincial Health Commission and Finance Department , The Medical Insurance Bureau jointly issued the “Notice on Comprehensively Implementing Strengthening the Full-cycle Health Management of Hypertension and Diabetes and Promoting the Reform of Hierarchical Diagnosis and Treatment”, which clearly stated that through policy support such as medical insurance payment and financial compensation, the linkage between the upper and lower levels and the integration of medical prevention and control are the breakthrough points to guide the development of hypertension and diabetes. Patients are treated at the grassroots level and managed in a standardized manner to build a continuous, coordinated and orderly hierarchical diagnosis and treatment pattern. By the end of 2022, the contracting rate of “two chronic diseases” patients will reach more than 80%, and the grassroots medical treatment rate will reach more than 70%.
The province will start pilot projects in 22 counties (cities, districts) from July 2020, and comprehensively promote it on the basis of experience and results. The “Notice” clarifies that the county-level medical community will implement the total budget management of medical insurance, implement differentiated reimbursement policies for medical institutions at different levels, raise the ceiling for reimbursement of outpatient medical expenses for chronic diseases, and improve the guarantee level of outpatient medication for “two chronic diseases”. Continuous Prescribing System for Chronic Diseases. Deepen the reform of the compensation mechanism for grass-roots institutions, improve the standardization work value of “two chronic diseases” health management, refine the classification of chronic disease follow-up methods, continuous prescription of chronic diseases, integrated outpatient consultation and other equivalent projects, and implement the standardization of financial funds. Equivalent purchase. Encourage all localities to explore and promote the implementation of free medication for patients with “two chronic diseases” to improve patient compliance.
The province makes it clear that medical institutions at all levels and various types are positioned according to their functions to provide patients with hierarchical diagnosis and treatment services. Promote the integrated service model of medical treatment and prevention for chronic disease follow-up in grass-roots institutions, build an integrated chronic disease clinic, integrate and standardize the diagnosis and treatment paths and management paths of “two chronic diseases”, and clarify the process of pre-diagnosis service, in-diagnosis service, and post-diagnosis management To meet the requirements, realize the close integration of basic public health services and daily diagnosis and treatment services, so that patients with “two chronic diseases” can enjoy one-stop standardized services.
The province also requested to strengthen information exchange and performance assessment, including improving the provincial, municipal and county-level national health information platforms, promoting the interconnection of information systems centered on diagnosis and treatment and electronic health records, and strengthening two-way Referral, contract management, follow-up reminder, data introduction, information push and other functions; include the relevant indicators of the “two chronic diseases” reform into the assessment of cities and counties, and lead the hospital performance, medical insurance fund balance distribution, and grass-roots institutions performance assessment with the medical community , government purchase of services, etc.
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