Current situation of rural medical and health undertakings in China (please don't copy other answers from Baidu)

Present situation and development trend of health reform in China

China's health reform has made great achievements, but there are also some problems. We must "take its essence and discard its dross" to welcome the spring of China's health undertakings.

First, the achievements of health reform in China.

From the early days of the founding of the People's Republic of China to the present, profound changes have taken place in China's health undertakings and remarkable achievements have been made. This is mainly manifested in five aspects:

First, the people's health level has been continuously improved. According to the standards set by the World Health Organization, there are three main indicators to measure the health level of a country's people: one is life expectancy per capita, the other is infant mortality rate, and the third is maternal mortality rate. In the early days of the founding of New China, the average life expectancy in China was 35 years, and now it has increased to 7 1.8 years (77 years in the United States, 6l years in India and 49 years in Nigeria); At the beginning of the founding of New China, the infant mortality rate was 200%, but now it has dropped to 25.5%. (7%o, 30%o,112% o in the United States, India and Nigeria, respectively); The maternal mortality rate was 65,438+0,500/65,438+million in the early days of the People's Republic of China, and now it has dropped to 502/million (8/65,438+million in the United States and 465,438+00/million in Nigeria respectively). The changes of these three indicators show that the health level of China citizens has reached a higher level in developing countries.

Second, basically establish a medical and health service system covering urban and rural areas. After decades of efforts, there are nearly 300,000 medical and health institutions covering urban and rural areas, such as medical treatment, prevention, health care and supervision, which basically meet the medical and health needs of urban and rural residents. In 2006, the number of beds in various medical institutions reached 3.27 million, with an average of 3. 1 bed per employee;

The total number of health workers is 5.25 million.

On average, there are 1.5 doctors per worker. In addition, there are 880,000 rural doctors and health workers.

Third, the medical insurance system for urban workers was initially established, and the new rural cooperative medical system was launched. After 10 years' efforts, various forms of urban workers' medical security systems, such as basic medical insurance, supplementary medical insurance, free medical care and commercial medical insurance, which are suitable for China's national conditions, have been basically established, with 654.38+0.6 billion participants. Since 2003, China has carried out a pilot project of the new rural cooperative medical system in some counties (cities, districts), in which the central finance, local finance and farmers voluntarily participate in financing, with serious illness subsidies as the main part. By the end of September, 2006, 433 counties (cities, districts) had started the new rural cooperative medical system, accounting for 50. 1% of the total number of counties (cities, districts). 406 million farmers participated in the new rural cooperative medical system, accounting for 45.8% of the national agricultural population, and the participation rate reached 8 ii) .5ci/0; There are10.40 billion farmers in China who benefit from the new rural cooperative medical system. On the whole, the new rural cooperative medical system runs smoothly, is gradually standardized, and the health service level is improved.

Fourth, significant progress has been made in the prevention and treatment of major infectious diseases. In the history of China, infectious diseases used to be a serious threat to people's health and life safety. In 1950s, infectious diseases and parasitic diseases ranked first among the causes of death in China, but now they have dropped to the ninth place. Developing countries in China took the lead in eradicating major infectious diseases such as smallpox and polio. China is a country with frequent natural disasters, but for many years, it has successfully achieved no major epidemic after major disasters. In 2003, we defeated the SARS epidemic and successfully controlled the spread of avian influenza to human beings. The central government invested 26.9 billion yuan to establish and improve the prevention and treatment system and medical treatment system for AIDS, tuberculosis and hepatitis B.

Fifth, the level of maternal and child health care was further improved. Women and children are the focus of a country's health care, and their health level represents the overall health status of the population. China has always attached importance to and cared about the health problems of women and children. It has changed the traditional fertility model with high fertility rate and high mortality rate formed in the history of our country, and realized a virtuous circle of low fertility rate and low mortality rate.

Second, problems in development.

China's achievements in health care are universally acknowledged. The World Health Organization once praised China for protecting the health of the world's largest population at the lowest cost. However, if we use "people-oriented" and Scientific Outlook on Development to re-examine China's health undertakings, we will find that the development of health undertakings lags behind the development of economy and other social undertakings, the contradiction between the medical and health service system and the growing health needs of the people is still quite prominent, and the development of health undertakings is not comprehensive and coordinated. To sum up, there are the following aspects:

First, health resources are generally insufficient, and health development lags behind economic development. The population of China is1300 million, accounting for 22% of the world's total population, while the total health expenditure only accounts for 2% of the world's total health expenditure. In the past, we often said that China's health undertakings were low-input, high-output, low-cost and high-efficiency. But from the perspective of Scientific Outlook on Development, this is at the expense of affecting the interests of the masses and increasing the burden on medical and health personnel, especially excellent medical personnel.

Second, the allocation of medical and health resources is unreasonable, and the situation of lack of medicine in rural and urban communities has not completely changed. China's medical and health services should be low-cost and widely covered. The allocation of medical and health resources should be pyramid-shaped, but it is inverted pyramid at present. High-tech and excellent health talents are basically concentrated in big hospitals in big cities. It is difficult for people to seek medical treatment effectively in the local area. Going to other places and big hospitals for medical treatment not only increases the burden of big hospitals, but also increases the economic burden of patients.

Third, the medical security system is not perfect, and a considerable number of people rely on their own expenses to see a doctor. Although the medical security system for urban workers has been established, the coverage is too small. Laid-off workers, unemployed people and urban low-income people have no medical insurance. At present, the pilot project of the new rural cooperative medical system has benefited more than 400 million people, but the fund-raising efforts are small. Generally, each person only has 50 yuan every year, so the guarantee is not strong. Nearly half of the urban population and rural population have no medical insurance, and they have to pay for medical treatment at their own expense.

Fourth, the medical and health management system does not meet people's health needs. A sound medical and health system in a country should include medical and health service system, basic medical security system, drug and medical device supply system, medical expense price management system, financial fund guarantee system and health supervision and management system. According to the national conditions of China, these tasks cannot be managed by only one department, nor can they be managed well. Need to strengthen the coordination between departments, form a joint force, pay close attention to * * *.

Fifth, the production and circulation of drugs and medical devices are disorderly and the prices are too high. China's production and circulation enterprises are large in number, small in scale and difficult to supervise, so it is difficult to implement effective supervision for various reasons.

Sixth, it is difficult for social funds to enter the medical and health field, the corresponding laws, regulations and policies are not perfect, and the pattern of running hospitals through multiple channels has not been formed. The government, society and individuals raise funds through various channels to develop medical and health undertakings. However, after years of medical service system reform, the pattern of multi-channel medical service has not yet formed.

Some of the above problems have been unsolved for a long time, some are inevitable at this stage, and some are emerging in development. These problems have affected people's interests, social harmony and the development of health care, and should be solved step by step with the concerted efforts of Qi Xin.

Third, the future development trend of China's health undertakings.

To develop and promote China's health service, we must proceed from China's national conditions, learn from foreign beneficial experience, explore China's characteristic health development road, and strive to achieve the goal that everyone enjoys basic medical and health services in accordance with the Decision of the Central Committee on Several Major Issues in Building a Harmonious Socialist Society (hereinafter referred to as the Decision), and establish the following four basic systems.

(a) whether there are four basic systems.

The first is to build a basic medical security system covering urban and rural residents. China has a large population, and its per capita economic level and fiscal revenue are low. This basic national condition determines that China's health security system must start with the most basic medical and health care. It is a health security system organized by the government, which provides public health services to all residents free of charge and basic medical services at cost. This system aims at basic health care for everyone, with public health institutions, rural health institutions and urban community health institutions as the main service subjects, adopting appropriate medical technology and essential drugs, and the government bearing the personnel expenses and operating expenses. Adhere to prevention first, combine prevention with treatment, and pay attention to fairness and efficiency.

Second, build a multi-level medical security system to meet the medical needs of people at different levels. This requires social medical insurance system to resist risks. Due to the low level of urbanization in China, the large income gap among residents and the large number of agricultural population and informal employment, it is difficult to establish a unified social insurance system integrating urban and rural areas for a long time. Only according to the actual situation of urban and rural areas and the income of different groups of people can we establish different forms of mixed medical insurance system.

Third, establish a national system of essential drugs. Medicine is a special product and an important means to protect people's health. The special nature of drugs determines that the production and circulation of drugs have certain social welfare nature and cannot be completely regulated by the market. According to the experience of more than 90 countries in the world, the national essential drug system should be the core of the national drug policy. Its main contents are as follows: The state formulates the list of essential drugs according to the principles of safety, effectiveness, necessity and low price. The state organizes the production, procurement and distribution of national essential drugs through bidding, gradually standardizes the names and prices of the same kind of drugs, ensures the essential drugs, strictly manages and uses them, and reduces the cost of drugs.

Fourth, establish a scientific and standardized management system of public hospitals. In accordance with the requirements of separation of government affairs, management and administration, medicine and profit and non-profit, we will deepen the reform of the management system, operation mechanism and fund guarantee mechanism of medical institutions, promote the localization and industry-wide management of medical institutions, straighten out the medical and health administration system, strengthen the public service function of public hospitals, and correct the tendency of one-sided pursuit of economic benefits.

(II) Focus on in 2007

The following nine tasks

First, actively promote the construction of the basic medical and health system.

It will take several years to establish a basic health care system. This year's focus is to promote the construction of three systems, namely: strengthening the construction of public health system; Strengthen the construction of rural health service system; Accelerate the development of urban community health services. The above work is led by the government, increasing financial input.

Second, accelerate the new rural cooperative medical care.

The Central Economic Work Conference proposed that the new rural cooperative medical system should cover about 600 million farmers in 80% counties (cities, districts) of the country this year. This is the new requirement put forward by the central government to adapt to the construction of new socialist countryside and the new rural cooperative medical system, which is in line with the wishes of governments at all levels and farmers. During the "Eleventh Five-Year Plan" period, the central and western regions plan to invest 2168 million yuan, and with the arrangement of the eastern coastal government, the total investment in rural health construction will exceed 30 billion yuan.

Third, further strengthen hospital management. This year, we will continue to carry out the year of hospital management, focusing on the following work:

The first is to adjust urban medical service resources. Starting from the health needs of residents and the construction of basic medical and health system, some public hospitals will be transformed into community health institutions.

The second is to enrich the connotation of hospital management. Adhere to people-oriented, pay attention to people's all-round development, and strengthen the construction of loyal service spirit and humanized service culture.

The third is to increase the management responsibility of hospital presidents. To improve hospital management, the dean is the first responsible person. Hospital directors must have high political quality and management ability, adhere to Scientific Outlook on Development and correct political view, and improve comprehensive management ability.

Fourth, strict access to medical technology and personnel qualifications is required to ensure the safety of patients, and it is forbidden to practice medicine without a license and beyond the scope.

Fifth, strictly control the scope of medical services, adhere to rational examination, rational drug use and rational treatment, and improve the quality of medical services.

Sixth, standardize hospital income management and reform unreasonable economic incentive mechanism.

Seventh, reform the personnel system of public hospitals according to the general idea of the reform of public institutions.

Eighth, fully implement the system of making hospital affairs public, disclose relevant information to the society, accept supervision from the masses, and listen to their opinions.

The ninth is to optimize the medical practice environment and build a harmonious doctor-patient relationship.

Fourth, explore a long-term mechanism to control commercial bribery. Efforts will be made to strengthen ideological and moral education, ideal and belief education, improve the concept of obeying laws and regulations, and enhance the ability to resist corruption and change.

Fifth, do a good job in Chinese medicine. It is necessary to strengthen the inheritance and innovation of traditional Chinese medicine and give full play to the advantages and characteristics of traditional Chinese medicine and ethnic medicine in community health, rural health and treatment of major diseases.

Sixth, strengthen the construction of health legal system. Actively do a good job in the legislation of primary health care law, mental health law and traditional Chinese medicine law.

Seventh, strengthen the construction of health talents. According to the needs of rural and urban community health services, we should cultivate qualified personnel, strengthen the training of preventive medicine, family medicine, rehabilitation medicine and nursing staff, improve the knowledge structure, improve the quality of personnel and enhance the service ability.

Eighth, vigorously promote the openness of government affairs. This year, the hospital affairs publicity system was generally implemented in hospitals above the second level in China. Projects and contents closely related to the interests of the masses should be truthfully disclosed and subject to social supervision.

Ninth, study and formulate a reform plan for the medical and health system. The new medical reform plan that has attracted much attention is accelerating. In order to brainstorm and ensure the scientificity and rationality of the plan, the medical reform coordination group decided to entrust six independent and parallel research institutions at home and abroad to participate in the formulation of the medical reform plan. The six research institutions are: the State Council Development Research Center, Peking University and Fudan University; At the same time, it includes three overseas independent institutions, the World Bank, the World Health Organization and the international consulting firm McKinsey. The purpose of the medical reform coordination group is to improve the scientific and democratic decision-making scheme through this open working method. On the basis of comprehensive comparison of these six schemes, a new medical reform scheme with the widest knowledge and the strongest maneuverability is put forward.