中英对照2021国务院办公厅关于推动公立医院高质量发展的意见.docx

OpinionsoftheGeneralOfficeoftheStateCouncilonPromotingtheHigh-QualityDevelopmentofPublicHospitalsDocumentNumber：No.182021oftheGeneralOfficeoftheSlateCouncilAreaofLaw:GeneralProvisionsonHealthandSanitationOptimizationofDoingBusinessLevelofAuthority：RegulatoryDocumentsoftheStateCouncilIssuingAuthority：GeneralOfficeoftheStateCouncilDateIssued：05-14-2021EffectiveDate05-14-2021Status:EffectiveOpinionsoftheGeneralOfficeoftheStateCouncilonPromotingtheHigh-QualityDevelopmentofPublicHospitals(No.182021oftheGeneralOfficeoftheStateCouncil)Thepeople'sgovernmentsofallprovinces,autonomousregions,andmunicipalitiesdirectlyundertheCentralGovernment;andallministriesandcommissionsoftheStateCouncilandallinstitutionsdirectlyundertheStateCouncil:PublichospitalsarethemainpartofChina'smedicalSerViCesystem.Inrecentyears,especiallysincethe18lhCPCNationalCongress,thereformanddevelopmentofpublichospitalshasbecomeanimportantpartofdeepeningthereformofthemedicalandhealthsystemandhasachievedmajorphasedresults,whichhavemaximizedanimportantroleincontinuouslyimprovingthefairnessandaccessibilityofbasicmedicalandhealthservices,preventingandcontrollingmajorepidemics,suchasCOVID-19,andprotectingpeople'slivesandhealth.Forthepurposesofpromotingthehigh-quality国务院办公厅关于推动公立医院高质量发展的意见(国办发(2021)18号)各省、自治区、直辖市人民政府，国务院各部委、各直属机构：公立医院是我国医疗服务体系的主体，近年来特别是党的十八大以来，公立医院改革发展作为深化医药卫生体制改革的重要内容，取得重大阶段性成效，为持续改善基本医疗卫生服务公平性可及性、防控新冠肺炎等重大疫情、保障人民群众生命安全和身体健康发挥了重要作用。为推动公立医院高质量发展，更好满足人民日益增长的医疗卫生服务需求，经国务院同意，现提出以下意见。developmentofpublichospitalsandmoreeffectivelymeetingthepeople'sgrowingdemandformedicalandhealthservices,withtheconsentoftheStateCouncil,thefollowingopinionsareherebyputforward.I. GeneralrequirementsUndertheguidanceofXiJinpingThoughtonSocialismwithChineseCharacteristicsinaNewEra,thespiritofthe19thCPCNationalCongressandthesecond,third,fourthandfifthplenarysessionsofthe19thCPCCentralCommitteeshallbethoroughlyimplemented,thepublic'shealthshallbetakenasthecenter,theprimarypositionofpublichospitalsshallberaised,thegovernment-led,publicwelfare-led,andpublichospital-ledprinciplesshallbeinsistedon,theintegrationofmedicalcareandprevention,thecombinationofregularaffairsandemergency,andtheequalemphasisontraditionalChineseandWesternmedicineshallbeinsistedon,withthegoalofestablishingandimprovingamodemhospitalmanagementsystem,systeminnovation,technologicalinnovation,modelinnovation,andmanagementinnovationshallbestrengthened,expansionofhigh-qualitymedicalcareresourcesandregionalbalancedlayoutshallbeaccelerated,andeffortsshallbemadewithinfiveyearstoIumthedevelopmentmodeofpublichospitalsfromscaleexpansionintoqualityandefficiencyimprovement,turntheoperationmodefromextensivemanagementintorefinedmanagement,andturnresourceallocationfromfocusingonmaterialfactorsintolayingmoreemphasisontalentsandtechnicalfactors,tomoreeffectivelyprovidehigh-qualityandefficientmedicalandhealthservices,preventandresolvemajorepidemicsandrisksofpublichealth一、总体要求以习近平新时代中国特色社会主义思想为指导，全面贯彻党的十九大和十九届二中、三中、四中、五中全会精神，坚持以人民健康为中心，加强公立医院主体地位，坚持政府主导、公益性主导、公立医院主导，坚持医防融合、平急结合、中西医并重，以建立健全现代医院管理制度为目标，强化体系创新、技术创新、模式创新、管理创新，加快优质医疗资源扩容和区域均衡布局，力争通过5年努力，公立医院发展方式从规模扩张转向提质增效，运行模式从粗放管理转向精细化管理，资源配置从注重物质要素转向更加注重人才技术要素，为更好提供优质高效医疗卫生服务、防范化解重大疫情和突发公共卫生风险、建设健康中国提供有力支撑。emergencies,andprovidestrongsupportforbuildingofahealthyChina.II. Buildinganewsystemforhigh-qualitydevelopmentofpublichospitals1. Buildingnationalandprovincialhigh-levelhospitals.With(hegoalofpromotingnationalmedicalprogress,byrelyingonexistingresources,nationalmedicalcenters,clinicalmedicalresearchcenters,regionalmedicalcenters(includingtraditionalChinesemedicine),andtraditionalChinesemedicine(4tTCM,)inheritanceandinnovationcentersshallbeplannedforsetup,keyclinicalspecialtygroupsshallbeformed,andconcentratedeffortsshallbemadetotacklethekeyproblemsinthediagnosisandtreatmentofdifficultandcriticalillnesses,carryoutinnovativeresearchoncutting-edgemedicalscienceandtechnologyandthetransformationofachievements,andimplementthetrainingofhigh-levelmedicaltalentssoastodrivethenationalmedicalleveltoanewlevel.Byfocusingonthediseaseswithhighmortalityandhightransferratesintheprovince,thetechnicalandtalentsupportofhigh-levelnationalhospitalstoprovincialhospitalsshallbestrengthened,thefillingofshortcomingsinspecialtiesshallbeaccelerated,provincialdiagnosisandtreatmentcapabilitiesshallbeimproved,andcross-provincialmedicaltreatmentshallbereduced.2. Maximizingtheleadingroleofpublichospitalsinurbanmedicalgroups.Accordingtothegridlayoutmanagement,aclose-typeurbanmedicalgroupledbyGradeIIIpublichospitalsorhospitalsrepresentingthemedicallevelofthe二、构建公立医院高质量发展新体系（一）打造国家级和省级高水平医院。以推动国家医学进步为目标，依托现有资源规划设置国家医学中心、临床医学研究中心、区域医疗中心（均含中医，下同）和中医药传承创新中心，形成临床重点专科群，集中力量开展疑难危重症诊断治疗技术攻关，开展前沿医学科技创新研究和成果转化，实施高层次医学人才培养，带动全国医疗水平迈上新的大台阶。以省域死亡率高、外转率高的疾病为重点，强化国家级高水平医院对省级医院的技术和人才支持，加快补齐专业专科短板，提升省域诊疗能力，减少跨省就医。（二）发挥公立医院在城市医疗集团中的牵头作用。按照网格化布局管理，组建由三级公立医院或代表辖区医疗水平的医院（含社会办医院、中医医院）牵头，其他若干家jurisdiction(includingsocially-runhospitalsandTCMhospitals),withseveralotherhospitals,Primarymedicalandhealthinstitutions,andpublichealthinstitutionsasmembersshallbeformed,toberesponsiblefortheintegratedandcontinuousmedicalse,icesintermsofprevention,treatment,rehabilitation,andhealthpromotionforresidentsinthegridinanoverallmanner.Allhospitalsinthegroupshallstrengthencooperation,buildadvantageousspecialtiesinlightoftheactualcircumstances,andformadevelopmentpatternfeaturingdistinctivefeatures,complementaryspecialties,dislocationdevelopment,andorderlycompetitionsoastodrivegrass-rootsmedicalandhealthinstitutionstoimprovetheirservicecapabilitiesandmanagementlevels.Contractsigningforfamilydoctorswithgeneralpractitionersasthemainpart,featuringeffectiveinteractionofgeneralspecialists,andorganicintegrationofmedicalcareandpreventionshallbepromoted.Thestandardizedconstructionofpublichealthdepartmentsinpublichospitalsshallbestrengthenedandthepublichealthservicecapabilitiesshallbeimproved.3. Maximizingtheleadingroleofcounty-levelhospitalsinthecounty-levelmedicalcommunity.Undertheprinciplesofcounty-townshipintegrationandruralintegration,aclose-typecounty-levelmedicalcommunitywithcounty-levelhospitalsastheleadershallbeactivelydeveloped.Thecapacitybuildingofcounty-levelhospitals(includingTCMhospitals)shallbestrengthened,corespecialtiesshallbeimproved,specialtiesshallbeconsolidatedandsupported,advantageousspecialtiesshallbecreated,thecapabilitiesofpreventionandtreatmentoftumors,cardiovascularandcerebrovascular,respiratory,digestiveandinfectiousdiseasesshallbeimproved,andthe医院、基层医疗卫生机构、公共卫生机构等为成员的紧密型城市医疗集团，统筹负责网格内居民预防、治疗、康复、健康促进等一体化、连续性医疗服务。集团内各医院加强协作，结合实际建设优势专业专科，形成特色鲜明、专业互补、错位发展、有序竞争的发展格局，带动基层医疗卫生机构提升服务能力和管理水平。推进以全科医生为主体、全科专科有效联动、医防有机融合的家庭医生签约服务。加强公立医院公共卫生科室标准化建设，提升公共卫生服务能力。(三)发挥县级医院在县域医共体中的龙头作用。按照县乡一体化、乡村一体化原则，积极发展以县级医院为龙头的紧密型县域医共体。加强县级医院(含中医医院)能力建设，提升核心专科、夯实支撑专科、打造优势专科，提高肿瘤、心脑血管、呼吸、消化和感染性疾病等防治能力，提高县域就诊率。加强城市三级医院对县级医院的对口帮扶，逐步使县级公立医院达到二级甲等水平。加强县级医院与专业公共卫生机构的分工协作和业务融合，做实公共卫生服务。加强县级医院对乡镇卫生院、村卫生室的统筹管理，发挥县级医院医务人员对家庭医生团队的技术county-levelmedicaltreatmentrateshallbeincreased.ThepartnershipassistanceprovidedbyurbanGradeIIIhospitalstocounty-levelhospitalsshallbestrengthenedtograduallymakecounty-levelpublichospitalsreachthelevelOfhospitalsofGradeIlandLevelA.Thedivisionofdutiesandbusinessintegrationbetweencounty-levelhospitalsandprofessionalpublichealthinstitutionsshallbestrengthened,andpublichealthservicesshallbeeffectivelyprovided.Theoverallmanagementoftownshiphospitalsandvillageclinicsbycounty-levelhospitalsshallbestrengthened,theroleofmedicalstaffmembersofcounty-levelhospitalsinprovidingtechnicalsupportforfamilydoctorsshallbemaximized,andtheabilitytosafeguardresidents'healthshallbeimproved.Fullcoverageofcounty-runtraditionalChinesemedicalinstitutionsshallberealizedinanacceleratedmanner,andtraditionalChinesehospitalsshallbesupportedinleadingtheestablishmentofcounty-levelmedicalcommunities.4. Establishingandimprovingaclassified,hierarchical,andseparativemajorepidemictreatmentsystem.Byrelyingonexistingresources,theestablishmentandconstructionofnationalmedicalcenters,regionalmedicalcenters,provincialmedicalcenters,andprovincialregionalmedicalcentersinspecializedcategories,suchasinfectiousdiseases,trauma,andmajorpublichealtheventsshallbepromotedinanacceleratedmanner.Somepowerfulpublichospitalsshallbesupportedinmoderatelybuildinganddevelopingmulti-hospitalareasonthebasisofcontrollingthescaleofindividualunits,andquicklychangingtheirfunctionsintheeventofamajorepidemic.Eachprefectureandcityshallchooseageneralhospitaltoimprovetheabilityofinfectiousdiseasetreatmentinatargeted支撑作用，提升居民健康“守门人”能力。加快实现县办中医医疗机构全覆盖，支持中医医院牵头组建县域医共体。（四）建立健全分级分层分流的重大疫情救治体系。依托现有资源，加快推进传染病、创伤、重大公共卫生事件等专业类别的国家医学中心、区域医疗中心和省级医疗中心、省级区域医疗中心设置建设。支持部分实力强的公立医院在控制单体规模的基础上，适度建设发展多院区，发生重大疫情时迅速转换功能。每个地市选择1家综合医院针对性提升传染病救治能力，对现有独立传染病医院进行基础设施改善和设备升级。县域内依托1家县级医院，加强感染性疾病科和相对独立的传染病病区建设。发挥中医药在重大疫情防控救治中的独特作用，规划布局中医疫病防治及紧急医学救援基地，打造高水平中医疫病防治队mannerandimproveandupgradetheinfrastructureandequipmentofexistingindependentinfectiousdiseasehospitals.Byrelyingononecounty-levelhospitalineachcounty,theconstructionofinfectiousdiseasedepartmentsandrelativelyindependentinfectiousdiseasewardsshallbestrengthened.TheuniqueroleofTCMinthepreventionandtreatmentofmajorepidemicsshallbemaximized,traditionalChinesemedicalepidemicpreventionandemergencymedicalrescuebasesshallbeplannedanddeployed,andahigh-leveltraditionalChinesemedicalepidemicpreventionandcontrolteamshallbebuilt.Theroleofmilitaryhospitalsinthepreventionandtreatmentofmajorepidemicsandnationalbiosecuritydefenseshallbemaximized.Themanagementofhospitalinfectionpreventionandcontrolshallbecontinuouslystrengthened,andtheabilitytorespondtomajorepidemicsshallbeimproved.伍。发挥军队医院在重大疫情防控救治和国家生物安全防御中的作用。持续强化医院感染防控管理，提高重大疫情应对能力。III.Leadingthenewtrendofhigh-qualitydevelopmentofpublichospitals1. Strengtheningtheconstructionofclinicalspecialties.Clinicalspecialtiesshallbebuiltaccordingtotheclinicalneedsofmajordiseases.Clinicalspecialtiessuchascriticalillness,oncology,cardiovascularandcerebrovascular,respiratory,digestion,infection,pediatrics,anesthesia,imaging,pathology,andinspectionshallbemainlydeveloped,andthediagnosisandtreatmentcapabilitiesandlevelsshallbeimprovedthroughthedevelopmentofspecialties.Themedicalqualitymanagementsystemandstandardsystemshallbecontinuouslyimproved,andthelevelofhomogeneityofmedicalservicesinpublichospitalsindifferentregionsandat三、引领公立医院高质量发展新趋势（一）加强临床专科建设。以满足重大疾病临床需求为导向建设临床专科，重点发展重症、肿瘤、心脑血管、呼吸、消化、感染、儿科、麻醉、影像、病理、检验等临床专科，以专科发展带动诊疗能力和水平提升。持续改进医疗质量管理体系和标准体系，提高不同地区、不同级别公立医院医疗服务同质化水平。加大对中医医院的支持力度。加强中医优势专科建设。在“双一流”建设中加强相关学科建设。（二）推进医学技术创新。面向生命科学、生物医药科技 前沿，面向国家战略需求和医药卫生领域重大科学问题， 加强基础和临床研究，推动原创性疾病预防诊断治疗新技 术、新产品、新方案和新策略等的产出。强化科研攻关对 重大疫情和突发公共卫生事件应对的支撑作用。推动科技 成果转化，所获收益主要用于对作出重要贡献的人员给予 奖励。健全职务发明制度。依托现有资源建设一批国家中 医药临床研究和科技成果孵化转化基地，制定一批中医特 色诊疗方案，转化形成一批中医药先进装备、中药新药。 加快发展商业健康保险，促进医疗新技术进入临床使用。（三）推进医疗服务模式创新。推广多学科诊疗模式。大力推行日间手术，提高日间手术占择期手术的比例。做实differentlevelsshallbeimproved.SupportforTCMhospitalsshallbeintensified.TheconstructionofspecialtieswithadvantagesofTCMshallbestrengthened.Thedevelopmentofrelateddisciplinesshallbestrengthenedinthet4doublefirst-CIaSs”development.2. Promotinginnovationinmedicaltechnologies.Facingthefrontiersoflifescienceandbiomedicaltechnology,andfacingthenationalstrategicneedsandmajorscientificissuesinthefieldofmedicineandhealth,basicandclinicalresearchshallbestrengthened,andtheoutputoforiginalnewtechnologies,newproducts,newprograms,andnewstrategiesfordiseaseprevention,diagnosisandtreatmentshallbepromoted.Thesupportingroleofscientificbreakthroughsinrespondingtomajorepidemicsandpublichealthemergenciesshallbestrengthened.TheIransformationofscientificandtechnologicalachievementsshallbepromoted,andtheproceedsgeneratedtherefromshallbemainlyusedtorewardthosewhohavemadeimportantcontributions.Theserviceinventionsystemshallbeimproved.Byrelyingonexistingresources,agroupofnationalTCMclinicalresearchandscientificandtechnologicalachievementsincubationandtransformationbasesshallbebuilt,agroupofTCMcharacteristicdiagnosisandtreatmentplansshallbedeveloped,andagroupofadvancedTCMequipmentandnewTCMdrugsshallbeformedthroughtransformation.Thedevelopmentofcommercialhealthinsuranceshallbeaccelerated,andtheclinicaluseofnewmedicaltechnologiesshallbepromoted.3. Promotingtheinnovationinthemedicalservicemodel.Amultidisciplinarydiagnosisandtreatmentmodelshallbe责任制整体护理，强化基础护理，开展延续护理服务。开 设合理用药咨询或药物治疗管理门诊，开展精准用药服 务。大力推进院前医疗急救网络建设，创新急诊急救服务 模式，有效提升院前医疗急救服务能力。创新医防协同机 制，建立人员通、信息通、资源通和监督监管相互制约的 机制。推广中医综合诊疗模式、多专业一体化诊疗模式、 全链条服务模式，实施重大疑难疾病中西医临床协作试 点。(四)强化信息化支撑作用。推动云计算、大数据、物联 网、区块链、第五代移动通信(5G)等新一代信息技术与 医疗服务深度融合。推进电子病历、智慧服务、智慧管理“三位一体”的智慧医院建设和医院信息标准化建设。大 力发展远程医疗和互联网诊疗。推动手术机器人等智能医 疗设备和智能辅助诊疗系统的研发与应用。建立药品追溯 制度，探索公立医院处方信息与药品零售消费信息互联互 通。promoted.DaysurgeryshallbevigorouslypromotedandtheproportionofdaysurgerytoelectiveSUrgeryshallbeincreased.Theoverallcareundertheresponsibilitysystemshallbeeffectivelyprovided,basiccareshallbestrengthened,andcontinuouscareservicesshallbeprovided.Rationaldruguseconsultationordrugtreatmentmanagementclinicsshallbeset,andprecisedruguseservicesshallbeprovided.Theconstructionofthepre-hospitalmedicalemergencynetworkshallbevigorouslypromoted,theemergencyservicemodelshallbeinnovatedupon,andthepre-hospitalmedicalemergencyserx,icecapacityshallbeeffectivelyimproved.Themedicalpreventioncoordinationmechanismshallbeinnovatedupon,andamechanismformutualrestrictiononpersonnelcommunication,informationcommunication,resourcecommunication,andsupervisionshallbeestablished.TheTCMcomprehensivediagnosisandIreatmentmodel,themulti-specialtyprofessionalintegrateddiagnosisandtreatmentmodel,andthefull-chainservicemodelshallbepromoted,andthepilotprogramofclinicalcooperationbetweenChineseandWesternmedicineformajoranddifficultdiseasesshallbeimplemented.4. Strengtheningthesupportingroleofinformationtechnology.Thein-deepintegrationofnew-generationinformationtechnologies,suchascloudcomputing,bigdata,theInternetofThings,blockchain,andfifth-generationmobilecommunications(5G)withmedicalservicesshallbepromoted.Theconstructionofsmarthospitalsandhospitalinformationstandardizationfeaturinganintegrationofelectronicmedicalrecords,smartservices,andsmartmanagementshallbepromoted.TelemedicineandInternetdiagnosisandtreatment四、提升公立医院高质量发展新效能（一）健全运营管理体系。全面落实基本医疗卫生与健康 促进法等法律法规，为提升医院治理能力和水平提供法治 保障。整合医疗、教学、科研等业务系统和人、财、物等 资源系统，建立医院运营管理决策支持系统，推动医院运 营管理的科学化、规范化、精细化。以大数据方法建立病 种组合标准体系，形成疾病严重程度与资源消耗在每一个 病组的量化治疗标准、药品标准和耗材标准等，对医院病 例组合指数（CMD、成本产出、医生绩效等进行监测评 价，引导医院回归功能定位，提高效率、节约费用，减轻 患者就医负担。shallbevigorouslydeveloped.Theresearchanddevelopmentandapplicationofintelligentmedicalequipment,suchassurgicalrobotsandintelligentauxiliarydiagnosisandtreatmentsystems,shallbepromoted.Adrugtraceabilitysystemshallbeestablished,andexplorationshallbemadefortheinterconnectionbetweenprescriptioninformationanddrugretailconsumptioninformationinpublichospitals.IVImprovingthenewefficiencyofhigh-qualitydevelopmentofpublichospitals1. Improvingtheoperationmanagementsystem.Lawsandregulations,suchastheLawofthePeople'sRepublicofChinaonthePromotionofBasic