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基层卫生综合改革典型案例 2023
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本书共纳入49篇典型案例,分为6部分。第一部分介绍基层卫生健康综合试验区案例,第二部分为体系建设和机制改革,第三部分为服务能力提升,第四部分为人才队伍建设,第五部分为健康管理,第六部分为基本公共卫生服务和家庭医生签约服务。本书由国家卫生健康委员会基层卫生健康司和卫生发展研究中心组织编写,所收录典型案例来源于实践,具有原创性,而且又指导实践,具有应用性,不仅能指导各地探索创新,还为学术研究提供了宝贵资料,具有一定的社会价值。
国家卫生健康委员会基层卫生健康司是国家卫生健康委所设机构。主要职责为拟订基层卫生健康政策、标准和规范并组织实施,指导基层卫生健康服务体系建设和乡村医生相关管理工作。
第一部分 基层卫生健康综合试验区以人民健康为中心 立体重塑县域医疗卫生服务体系山西省晋中市介休市 / 003发挥绩效激励作用 不断深化基层卫生财政补偿机制改革浙江省嘉兴市海盐县 / 007实行医保基金“小包干” 推深做实慢性病保障创新试点工作安徽省淮北市濉溪县 / 011多措并举 真抓实干 推进医养结合高质量发展福建省龙岩市长汀县 / 015实施新型乡村卫生一体化管理 不断夯实基层医疗卫生服务体系网底山东省潍坊市寿光市 / 019强队伍 优内涵 建机制 推动家庭医生签约服务高质量发展河南省平顶山市郏县 / 023“三张答卷” 助推基层卫生健康工作高质量发展四川省泸州市泸县 / 027建立“六有”工作机制 实现基层卫生健康工作“六到位”新疆维吾尔自治区伊犁哈萨克自治州新源县 / 030第二部分 体系建设和机制改革数字赋能 精细管理 实施新一轮基层医疗卫生机构绩效考核浙江省 / 037改革创新 求真务实 积极探索基层卫生健康高质量发展的新疆路径新疆维吾尔自治区 / 041实施乡村一体管理 筑牢村级卫生网底福建省三明市尤溪县 / 046多举措解决看病就医难题 让基层群众共享“医改红利”湖南省郴州市汝城县 / 050打造“四圈”医疗服务 努力构建优质高效医疗卫生服务体系四川省达州市开江县 / 054第三部分 服务能力提升采取“六强化三结合”举措 保障“优质服务基层行”活动效果江苏省 / 061加强县域医疗卫生次中心建设 构建县域医共体梯次带动发展模式贵州省 / 065医疗集团托管 探索基层能力提升和持续发展的新路径广西壮族自治区南宁市 / 070谱急救新篇 铸强基先锋 全面推进县乡村一体化急救服务扩面提质浙江省湖州市长兴县 / 074创新推行“两码一票 人脸识别”应用 打造便民惠民的智慧医疗新模式山东省临沂市沂水县 / 078建设远程医学影像诊断中心 打造县域医共体高质量发展“强劲引擎”重庆市奉节县 / 082抓住“共同缔造”机遇 提升基层医疗卫生服务能力湖北省随州市广水市 / 087鼓足干劲 力争上游 打造群众家门口高品质的社区医院江苏省镇江市润州区黎明社区卫生服务中心 / 091多方赋能 提升社区卫生服务能力河南省郑州市紫荆山南路社区卫生服务中心 / 096第四部分 人才队伍建设实施卫生人才强基工程 推动基层卫生事业高质量发展江苏省 / 103多措并举 抓培训 强能力 不断筑牢基层医疗卫生人才网底甘肃省 / 108改革完善“五项机制” 加强基层卫生能力提升和队伍建设浙江省绍兴市 / 113全科医生驻村全覆盖 做好基层群众健康守门人湖南省娄底市 / 117聚焦改革创新 实施“人才兴医、人才强卫”战略福建省福州市长乐区 / 121第五部分 健康管理单病种群体管理 构建大健康服务新理念山东省潍坊市 / 127全面推进“五小”健康促进行动 提升群众健康管理水平山西省运城市万荣县 / 133聚焦医防融合 创新管理模式 探索建设标准化代谢性疾病管理中心江苏省常州市溧阳市 / 137建立“分级分类”模式 打造“健康管家”服务江苏省扬州市宝应县 / 142数字化赋能 路径化管理 指数化评价 推进两慢病医防融合综合改革浙江省杭州市余杭区 / 147创新全科诊疗模式 打通分级诊疗“最后一公里”湖南省长沙市浏阳市 / 153基层卫生综合改革典型案例2023勇于创新 强化保障 积极探索医共体下慢性病管理新模式广东省湛江市吴川市 / 158构建“三医”联动机制 探索慢性病一体化管理模式安徽省合肥市庐阳区大杨镇社区卫生服务中心 / 162第六部分 基本公共卫生和家庭医生签约服务城乡居民同质同标健康体检 推动卫生服务普惠共享浙江省 / 169深化基层卫生综合改革 创新基本公共卫生服务绩效管理机制江苏省南京市江北新区 / 173建立三项机制 保障签约服务行稳致远江苏省连云港市 / 178“三强化” 推进家庭病床服务福建省福州市 / 183着力筑牢四道保障线 落实家庭医生签约服务福建省漳州市 / 187部门联动 数字支撑 推进家庭医生签约服务高质量发展浙江省绍兴市嵊州市 / 191
党中央、国务院高度重视基层卫生健康工作。2016 年,习近平总书记在全国卫生与健康大会上提出“以基层为重点、以改革创新为动力”的卫生健康工作方针。2022 年,国家相关部门印发了一系列“十四五”卫生健康相关规划文件,如《“十四五”国民健康规划》《“十四五”全民健康信息化规划》《“十四五”卫生健康人才发展规划》《基层中医药服务能力提升工程“十四五”行动计划》等,为我国基层卫生健康工作指明了方向。各地政府和基层卫生工作者因地制宜、大胆探索,推动基层卫生健康工作取得积极进展。一是国家基层卫生健康综合试验区在原来8个市(县)基础上,新增北京市密云区、贵州省习水县、广西壮族自治区上思县、海南省东方市4 个区(市、县),并建立了动态监测机制。二是六部门印发《关于推进家庭医生签约服务高质量发展的指导意见》,指导各地推进“六个拓展”,家庭医生签约服务覆盖率持续提升。三是深入推进“优质服务基层行”活动和社区医院建设,年度达到服务能力推荐标准的基层医疗卫生机构达2 300 余家,累计达到服务能力标准的超过3 万家,累计建成社区医院超过3 700 家。四是2017—2022 年,县、乡、村三级卫生人员从515 万人增加到576 万人,增长了12%,乡村卫生队伍学历结构、能力素质得到提升。围绕以上重点工作,各地涌现了一批新典型、新经验。2023 年是《基层卫生综合改革典型案例》连续出版的第6 年。通过每年遴选、编辑出版典型案例图书,不仅宣传和传播了各地亮点、特色和典型经验,而且促进了各地在改革中积极探索、勇于创新,同时也激发了各地总结典型经验的积极性。本书采取地方推荐、现场调研、会议交流、直接投稿等形式,收集了200 余篇稿件。在遴选典型案例时,不仅考虑东部、中部、西部地区的代表性,而且注重基层卫生综合改革的创新性和先进性,同时注重撰写结构的合理性、文字表述的通畅性。《基层卫生综合改革典型案例2023》共纳入41 篇典型案例,分成六个部分:第一部分基层卫生健康综合试验区(8 篇),第二部分体系建设和机制改革(5 篇),第三部分服务能力提升(9 篇),第四部分人才队伍建设(5 篇),第五部分健康管理(8 篇),第六部分基本公共卫生服务和家庭医生签约服务(6 篇)。紧密型县域医疗卫生共同体建设独立编辑典型案例并出版图书。感谢各地卫生健康行政部门和基层医疗卫生机构提供的典型案例,感谢各位专家对典型案例的精心筛选。我们将继续围绕基层卫生健康重点工作编写典型案例,欢迎各地踊跃投稿。本书难免存在不足之处,敬请各位读者提出宝贵意见。国家卫生健康委员会基层卫生健康司国家卫生健康委卫生发展研究中心2023 年5 月
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