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民生至上，健康之路从这里拓展延伸
——2010年株洲卫生事业跨越发展纪实
www.zhuzhouwang.com 日期： 2011-01-10 09:12 株洲网
•株洲记者刘建安 刘建军 欧阳浩•
【核心阅读】
2009年岁末，卫生部部长陈竺到株洲考察，为2010年株洲卫生工作“大动作”埋下“伏笔”。
2010年，我市正式成为全国16个公立医院改革试点城市之一，也是湖南唯一的一个试点城市，引起全国瞩目。是年，卫生部副部长马晓伟、市委书记陈君文互访联动，部门人士之间更是频繁“接触”，改革试点方案终获省里批准并报国家医改办备案实施。
民生至上，健康是福。多年来，我市卫生部门一直致力于把满足城乡居民多方面、多层次的健康需求，作为改革与发展的出发点和落脚点，切实保障群众的基本健康权益，让群众共享卫生事业发展的成果，实现卫生事业发展与经济、社会、民生的和谐。“借公立医院改革试点东风，力缓老百姓‘看病贵、看病难’”，成为2010年我市卫生工作的主旋律。
有人说，检阅株洲卫生事业成就有两种方式。一种是与此前历史的纵深比较，另一种则来自老百姓的切身感受。市卫生局局长邓多福称，国内外反映市民健康的水平有3个公认的指标，即平均年龄、婴儿死亡率和生命指标。目前，我市居民人均期望寿命为73岁，与建国前的35岁相比大幅提升；全市孕产妇死亡率由建国之初的1500/10万，下降至去年的18.17/10万，5岁以下儿童死亡率由建国初的200‰下降到去年的9.73‰。这些数据充分证明和显示，我市居民的健康水平指标居发展中国家前列。
“干部要在一线工作，问题要在一线解决，业绩要在一线创造。”得益于我市大力促进卫生工作又好又快发展的科学决策，株洲卫生战线干部职工忘我工作、辛勤耕耘，秉承‘民生至上、健康至上、生命至上’的信念，留下了一个个“保二争一，科学跨越”的坚实脚印。
历经非典、人禽流感、甲流等多次重大考验洗礼的株洲，正借力公立医院改革试点，朝着健康城市的目标阔步前行，390万株洲人为自身健康而充满期待！
株洲卫生事业受陈竺夸赞
“株洲卫生事业一年一个新台阶，让市民充分享受到医改的成果。”卫生部部长陈竺在我市考察时欣喜地说。
去年，我市新农合保障水平不断提升，全市参合农民261.3万人，筹集新农合资金3.6亿元，参合率为95.34%。同时，我市开展新农合门诊统筹工作，统筹区域政策范围内住院费用补偿率达到63.2%，80%以上的市级新农合定点医疗机构实现“即时结报”。此外，50例农村先心病儿童得到免费救治，醴陵市确定为农村儿童白血病免费救治的试点县市，五保户等特殊困难人群看病就医问题得到积极落实。新农合范围内县乡两级医疗机构住院起付线全免和政策范围内基本医疗费用的报销比例在75%以上。
“基本药物制度稳步实施，市民是最大受益者。”在城区和株洲县的乡镇卫生院、社区卫生服务中心全面启动基本药物制度，覆盖城乡居民145万人。据悉，基本药物全部纳入新农合的报销范围，报销比例平均比其他药物高10%。与去年相比，实行基本药物制度后基层医疗机构次均门诊药品费用下降35.2%、次均住院药品费用下降36.9%。
“1所精神病医院、2所县级医院、4所中心卫生院全面开工, 23所村卫生室项目全面完成，7个社区卫生服务中心建设有序推进。”邓多福局长表示，2010年是基层医疗卫生服务体系建设全面加强的一年。
去年，我市公共卫生服务项目全面覆盖。全市建立起城镇人口健康档案80.87万份，建档率42%，农村人口健康档案62.4万份，建档率32.8%；在24个社区卫生服务中心和攸县、茶陵县实施了健康档案信息化管理。为3.89万名农村孕妇孕期和孕早期补服叶酸，为4048名农村妇女开展宫颈癌和乳腺癌免费筛查；实施农村孕产妇住院分娩补助2.38万人次，补助金额1262万元；为8-15岁人群补种乙肝疫苗47.36万剂次；孕产妇HIV检测率达到88.07%，开展4例艾滋病母婴阻断；完成贫困白内障患者免费复明手术3600例。
试点改革全国关注
2010年2月，我市被确定为全国16个公立医院改革试点城市之一，站在了全国医改前列，意义非凡。
先试先行，不负众望。按照“上下联动、内增活力、外加推力”的原则，我市稳步推进改革试点工作，引起了全国关注。
当年伊始，我市制订了《株洲市公立医院改革试点工作实施方案》、《株洲市公立医院改革三年攻坚计划》、《株洲市城市社区卫生服务机构管理办法》和14个配套文件，搭建了公立医院改革的政策文件框架。
随后，三级医院对口支援二级医院、二级医院对口支持社区卫生服务中心等政策出台，开展了多种形式的对口支援工作。市卫生局做好了中医伤科医院划归市管等工作，通过医疗资源布局调整和纵向联合，努力构建“首诊在社区、小病在社区、大病进医院、康复回社区”的就医格局。
减轻市民负担，这是株洲改革成功的一个重要表现。去年，株洲市卫生局在全省药品集中采购平台上，积极开展药品集中配送试点工作，14家试点单位药品配送率平均在95%以上，全年药品集中配送向老百姓让利2000万元。
医患纠纷，一直是一个令人头疼的问题，市卫生局建立医患纠纷第三方调解机制，成立了组织协调机构，建立了部门联动调处机制，效果喜人。
此外，市卫生局不断优化医院内部运行，积极推进门诊病历“一本通”、电子病历、医疗机构检查结果互认，深入开展“优质护理服务示范工程”和临床路径试点，41个临床路径试点病种平均住院费用下降7.2%、药品费用占住院费用的比例从46%下降至36.8%，有效缓解“看病贵”问题。
医疗质量明显提升
去年，我市积极创建“平安医院”，深入开展“医疗质量万里行”、“医院管理年”活动，促进医疗质量持续提升。
市卫生局组织了全市十家120网络医院急救实战演习，提升了全市院前急救的应急能力。通过医院全面提质，株洲恺德微创心血管专科医院晋升为三级专科医院、株洲市三三一医院晋升为三级综合医院。
同时，我市不断优化诊疗流程，方便群众就医。在各大医院倡导 “四多一少”服务理念，推行“六有”服务举措，实行了“一站式”结算服务，推广预约诊疗，实行同级医疗机构检查结果互认，缩短群众就医等候的时间，让患者非常满意。
“十佳无偿献血志愿者”活动如火如荼，宣传力度不断加大。去年，我市新建了1个固定无偿献血点，全市临床用血100%来自无偿献血。此外，血站内部信息化建设不断加强，网络软件升级，实现了醴陵、攸县无偿献血信息与市站联网。
我市全面推广基层常见病多发病中医药适宜技术，全市培训学员2039人，覆盖率达100%，并成立了市中医医院管理年专家组，对株洲地区的6家中医医院进行了督导和检查评估。
连续8年无重大疫情
“我市做到了连续8年无重大传染病暴发疫情！”市卫生局局长邓多福说。
去年，市卫生局不断加强预防接种工作，27.13万人次免费接种甲型H1N1流感疫苗、18.16万人次接种麻疹疫苗强化免疫、47.36万人次接种乙肝疫苗，保障群众生命安全。
此外，我市加大重大疾病、重点传染病防控力度，有效处置手足口病聚集性疫情21起，全市连续8年无重大传染病暴发疫情，并及时有效地控制了5起突发公共卫生事件。
与此同时，我市大力加强食品、公共场所、职业卫生、医疗市场等执法监督，共出动执法人员4660人次，出动执法车辆1146台次，检查餐饮单位4455家，未发现使用“地沟油”、“潲水油”、“问题乳品”等非食用物质和滥用食品添加剂的餐饮经营单位。
市卫生局不断加大非法行医和非法采供血监督检查力度，出动执法人员11560人次，车辆3458台次，检查各类医疗机构、采供血机构共4922家次，查处取缔无证行医55家。
去年，市卫生应急救援指挥中心接到求援电话35691个，安排、引导开展各种应急救援13526次，应急能力持续提升。认真做好突发事件医疗应急处置工作，圆满完成市重大活动医疗保障任务51起。
行风政风有新改善
去年，市卫生局建立健全了行风建设分级负责工作机制，层层签订了责任状。株洲市卫生系统深入开展“党员身边无事故、党员身边无纠纷、党员身边无投诉”的“三无”主题活动，表彰了卫生系统医生、护士、药师、医德标兵四个“十佳”，选树“党员示范窗口”46个，“党员示范岗”522个。
为加强卫生工作宣传，市卫生局编发《株洲卫生报》24期、《公立医院改革试点工作简报》10期、《创先争优活动简报》8期，抓好《株洲卫生网》建设，并在《株洲日报》《株洲晚报》发表文章，充分为市民服务。
此外，市卫生局注重从源头上化解和防控各类信访问题，全年受理信访事项83件次，对信访投诉事件的处理率达100%，群众满意度很高。
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| 图示∶2010年12月即将出版的《中国特色医疗金鉴》登载的刘君主任及其机构 |
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People's livelihood first, the road from here to expand the health extension
- 2010 documentary Zhuzhou health leaps and bounds
www.zhuzhouwang.com Date: 2011-01-10 09:12 Zhuzhou Network
• Zhuzhou reporter Ouyang Hao Liu Jianjun Liu Jianan •
Core Readings】 【
2009 end of the year, Health Minister Chen Zhu to visit Zhuzhou, Zhuzhou health work for the 2010 "major move" buried "foreshadowing."
In 2010, the city officially became a public hospital reform in 16 pilot cities, is one of only a pilot city in Hunan, causing the national attention. This year, Vice Minister of Health Ma Xiaowei, the party secretary Chen Junwen visits linkage, departments are more frequent among the "contact" Reform of the final report to the provincial and national health reform in the Office approved the implementation record.
People's livelihood first, health is a blessing. Over the years, the city health department has been working to meet the urban and rural residents in various aspects, levels of health needs, the reform and development as the starting point and end point, and effectively protect the basic health rights and interests of the masses, so that the people sharing the results of health development, health development and the realization of economic, social and livelihood harmony. "Through reform of public hospitals east, force slow people 'medical care, medical treatment is difficult,'" in 2010 the city became the main theme of health.
Some people say, review public health achievements of Zhuzhou in two ways. One is the comparison with the previous depth of history, and another from personal experience of ordinary people. Municipal Health Bureau, said Tang Fuk, at home and abroad reflect the level of public health indicators have three recognized that the average age, infant mortality and life indicators. Currently, the city's per capita life expectancy of 73 years, and before the founding of a substantial increase compared to the 35-year-old; the city's mortality rate was founded in 1500/10 million, down from last year 18.17/10 million, 5 years of age child mortality 200 ‰ from the early period of China fell to last year's 9.73 ‰. These data demonstrate and display indicators of the health of city residents in the forefront among developing countries.
"Cadres to work in the field, problems to solve in the field, performance in the field to create." Benefited from the city to vigorously promote sound and rapid development of health science policy-making, Zhuzhou ecstasy health cadres and workers of the front work, hard work, adhering to the 'the people's livelihood first, health first, life first' beliefs, leaving one by one "Paul the second fight of a scientific leap" solid footprints.
After SARS, bird flu, pandemic influenza and other major test of the baptism of several of Zhuzhou, is leveraging the reform of public hospitals, big strides toward the goal of healthy city forward, 3.9 million people of their own health and full of Zhuzhou look forward to!
Health Service of Zhuzhou praise by Chen Zhu
"Health Service of Zhuzhou year to a new level, healthcare reform to the public to fully enjoy the results." Health Minister Chen Zhu visited Yiwu pleased to say.
Last year, the city's new rural cooperative security ladder, and the city the urban and rural 261.3 million, the new rural cooperative fund raising 3.6 billion, the Senate combined rate of 95.34%. Meanwhile, the city launched a new rural cooperative patient co-ordination, co-ordinate regional policy within the hospital charges, 63.2% of compensation rate, 80% of the city designated the new rural cooperative medical institutions to achieve "real-time summary report." In addition, 50 cases of children with congenital heart disease in rural areas receive free medical treatment, Liling City, rural children identified as pilot cities and counties of free treatment for leukemia, five guarantees patients for vulnerable groups and other special issues have been actively implemented. The new rural cooperative medical institutions within the hospital from county and township levels, free and pay line within the basic policy of reimbursement of medical expenses above 75%.
"Steady implementation of the basic drug system, the public is the biggest beneficiary." Zhuzhou County in the city and township hospitals, community health service centers started basic drug system, covering 145 million people in urban and rural residents. It is reported that all the essential drugs included in the scope of the new rural cooperative medical reimbursement, reimbursement on average 10% higher than other drugs. Compared to last year, the implementation of the system of essential drugs were out-patient primary health care sector plays down 35.2% in drug costs, drug costs decreased hospitalization time were 36.9%.
"A mental hospital, two county hospitals, four central hospitals at full capacity, 23 village health projects completed, seven community health service center orderly." Deng said Fuk Secretary, 2010 is the primary health service system to strengthen the year-round.
Last year, the city's public health service coverage. The urban population health records to establish the city's 808,700 copies, filing rate of 42%, rural health record 624,000 copies, filing rate of 32.8%; in 24 community health centers and the You County, Chaling County implemented a health file information management. 3.89 million rural women during pregnancy and early pregnancy missed dose folic acid, for the 4048 rural women free screening for cervical and breast cancer; the implementation of hospital delivery in rural subsidies 23,800 people, grant 12.62 million yuan; 8-15 hepatitis B vaccine population aged replant 473,600 times; maternal HIV testing rate of 88.07%, carried out in 4 cases of AIDS PMTCT; completion of poor cataract patients free sight restoring 3600 cases.
Pilot reform of national concern
February 2010, the city has been identified as the reform of public hospitals in 16 cities, stood in the forefront of the national health reform, significance.
First try first, live up to expectations. In accordance with the "up and down linkage, the increase vitality, plus push" principle, the city steadily promote reform work aroused national attention.
The beginning of the year, the city developed a "Zhuzhou City public hospital reform work plan", "Zhuzhou City, tackling three years of public hospital reform plan," "Zhuzhou Urban community health services management approach" and 14 supporting documents, to build a Public hospital reform policy document framework.
Subsequently, the tertiary hospitals counterpart support two hospitals and two hospital counterparts community health service centers to support policy implementation, carried out various forms of counterpart support work. Municipal Health Bureau to do a traditional Chinese medicine hospital trauma management, etc. was placed under the city, through the adjustment of the layout of medical resources and vertical integration, efforts to build a "first diagnosed in the community, minor illnesses in the community, serious illness in the hospital, rehabilitation and return to the community," the medical situation .
Ease the burden, this is an important success of the reform of Zhuzhou performance. Last year, the Zhuzhou Municipal Health Bureau in the province centralized drug procurement platform, actively carry out pilot work centralized drug distribution, drug distribution 14 pilot units average more than 95%, the annual distribution of medicines to the people focus on none other 20 million yuan.
Medical dispute, has been a headache, the Municipal Health Bureau established third-party medical dispute mediation mechanism, organization and coordination bodies set up to establish a departmental interaction and mediation mechanism, the effect is gratifying.
In addition, the Municipal Health Bureau within the hospital to optimize operation, actively promote the out-patient medical records, "one pass", electronic medical records, medical institutions, mutual recognition of test results, carry out the "quality care demonstration project" and the pilot clinical pathway, clinical pathway in 41 pilot diseases fell 7.2% on average hospitalization costs, drug costs accounted for the proportion of hospital costs from 46% to 36.8%, effective relief "expensive" problem.
Significantly enhance the quality of medical care
Last year, the city actively create a "safe hospitals", carry out the "Medical Quality Tour", "Hospital Management" activities to promote health care quality continues to improve.
Municipal Health Bureau organized a network of 120 city hospital for treatment of ten combat exercises to enhance the city's pre-hospital emergency response capacity. Full improving quality through the hospital, Zhuzhou Kai Tak minimally invasive cardiovascular specialist hospital was promoted to three hospitals, Zhuzhou City, three Trinity Hospital was promoted to three general hospitals.
Meanwhile, the city continue to optimize the treatment process more convenient for people medical treatment. Major hospitals in the advocacy of "a little more than four" service concept, the implementation of the "six with" service initiatives, the implementation of the "one-stop" clearing and settlement services, promotion of clinic appointments, the implementation of mutual recognition of test results at the same level of medical institutions, shorten hospital waiting masses time, so that patients are very satisfied.
"Top Ten volunteer blood donation" campaign in full swing, increasing publicity. Last year, the city built by a fixed point of voluntary blood donation, 100% of the city from the voluntary blood donation blood for clinical use. In addition, blood banks continue to strengthen the internal information technology, network software upgrade, and Liling, You County Stations blood donation information and networking.
Frequently-occurring disease in our city in a comprehensive medical promotion of primary common appropriate technology, the city's 2039 trainees, 100% coverage, and the establishment of the City Hospital of Chinese Medicine Management Group of Experts on Chinese Medicine Hospital of Zhuzhou in the six supervision and inspection carried out assessment.
No major epidemic diseases for 8 years
"The city did it for 8 years without a major infectious disease outbreak!" Municipal Health Bureau, more than Deng Fu said.
Last year, the Municipal Health Bureau continue to strengthen immunization work, 271,300 people inoculated with influenza A H1N1 influenza vaccine free of charge, 181,600 people were vaccinated against measles immunization, 473,600 passengers hepatitis B vaccine to protect public safety.
In addition, the city increase the major diseases, focusing on infectious disease prevention and control, and effectively dispose of the epidemic of HFMD clusters of 21, the city for 8 years no major outbreaks of infectious diseases, and timely and effective control of the 5 from public health emergencies events.
At the same time, the city vigorously to strengthen food, public places, occupational health, the health care market and other law enforcement supervision, law enforcement officers were deployed 4660 people, law enforcement vehicles out 1146 times, and check the catering units in 4455, was not found using the "waste oil" "swill oil", "problem milk" and other non-food substances and the abuse of food additives, food and beverage business units.
Municipal Health Bureau, the illegal practice of medicine and increasing supervision and inspection of illegal blood collection and supply, sent law enforcement officers 11,560 passengers, the vehicle 3458 times, and check the various medical institutions, blood collection agencies in 4922, dealt with 55 against practicing medicine without a license.
Last year, the city health emergency rescue command center received 35,691 calls for help, arrangements, and guide to carry out a variety of emergency rescue 13526 times, emergency response capabilities continue to improve. Do a good job of medical emergencies emergency work, the successful completion of major activities of medical support tasks City 51.
MORALS new government to improve the wind
Last year, the Municipal Health Bureau to establish and improve the working mechanism of wind construction levels of responsibility, signed a liability form layers. Zhuzhou City health system carry out the "non-party members around the accident, no disputes of party members around, no complaints of party members around," the "three noes" theme, in recognition of the health system, doctors, nurses, pharmacists, medical ethics model of four "Top Ten", the election Tree "party model window" 46, "党员示范岗" 522.
To strengthen health promotion, Municipal Health Bureau compiled and distributed "Zhuzhou Health News" 24, "briefing on the work of public hospital reform," 10, "A Good event briefing," 8, do a good job, "Zhuzhou health network" construction, and in the "Zhuzhou Daily," "Zhuzhou Evening News" published an article, fully serve the public.
In addition, the Municipal Health Bureau and the emphasis on prevention and control from the source to resolve the issue various types of letters, the year 83 times receiving petitions, letters and complaints on the handling rate of 100%, people satisfaction was high. |
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