Notice of the General Office of the Shanghai Municipal People's Government on Printing and Distributing the "Implementation Plan for Further Improving the Municipality's Community Health Service Capabilities"
Hu Fu Ban Fa [2023] No. 7
The people's governments of all districts, all committees, offices, and bureaus of the municipal government, and all relevant units:
The "Implementation Plan for Further Improving the Municipality's Community Health Service Capabilities" has been approved by the municipal government and is now issued to you. Please follow it carefully.
General Office of Shanghai Municipal People's Government
April 20, 2023
Implementation plan to further enhance the city's community health service capabilities
In order to further enhance the city's community health service capabilities, improve the hierarchical diagnosis and treatment system, give full play to the basic role of community health services in the health service system, and enhance the people's sense of health gain, according to the "14th Five-Year Plan for Health and Health Development in Shanghai" ", formulate this implementation plan.
1. Clear development goals
Take community health as an important part of health development and an important field for improving people's livelihood, accelerate resource allocation and governance innovation, promote high-quality development of community health, and build a modern community health service system with reasonable layout, complete facilities, complete functions, and high-quality services. Continuously improve community health service capabilities, so that the people can obtain more equitable, accessible, systematic and continuous medical and health services nearby.
——The layout of the service network is more perfect. By 2025, a number of community health service institutions will be newly built or rebuilt according to local conditions in accordance with functional positioning, regional characteristics and residents' needs, and the coverage rate of community health service facilities will reach more than 90% within 15 minutes of slow walking.
——Basic medical service capabilities have reached a new level. By 2025, the horizontal homogeneity of the city's community medical services will be basically realized, the vertical homogeneity of common disease diagnosis and treatment services in the community and higher-level hospitals will be significantly improved, and the rehabilitation and nursing service capabilities will be gradually enhanced. The proportion reached more than 40%, and gradually consolidated the hierarchical diagnosis and treatment pattern of "first diagnosis at the grassroots level, two-way referral, separate treatment of acute and chronic diseases, and linkage between upper and lower levels".
——The capacity of public health services has been continuously improved. By 2025, the construction of the community health management center will be basically completed, the basic and major public health service management indicators in the community will be fully up to standard, and the prevention and control of infectious diseases and chronic diseases and health management capabilities will be significantly improved.
——Community becomes the main front of Chinese medicine service. By 2025, the services for special diseases (specialties) with TCM characteristics will be fully covered by community health service centers, the TCM service capabilities of community health service stations and village clinics will be significantly improved, and the characteristic advantages of TCM in communities will be further brought into play.
2. Strengthen functional positioning
(1) Strengthen the function of high-quality and accessible basic medical services. Guided by general practice services, we will improve the capabilities of diagnosis and treatment, differential diagnosis, triage, and referral of common diseases and frequently-occurring diseases in the community. Community outpatient clinics mainly focus on general practice, improve the level of Chinese medicine diagnosis and treatment and emergency services, and carry out appropriate surgical operations if conditions permit. Inpatient treatment is mainly rehabilitation, nursing, and palliative care, and family bed services are expanded. Strengthen community health service stations (village clinics) for simple diagnosis and treatment services for common diseases and frequently-occurring diseases, patrol services, and traditional Chinese medicine services.
(2) Strengthen the public health network bottom function of the integration of medical care and prevention. Strengthen the capacity building of community public health emergency response, improve the functions of community fever clinics (sentry clinics), implement the reporting system of infectious diseases in community health service stations (village clinics), improve community early warning capabilities and emergency medical treatment capabilities for major infectious diseases, and coordinate Do a good job in community epidemic investigation and disposal. Focus on disabled and demented elderly people, children with developmental disabilities, pregnant women, cancer patients, patients with mental disorders and other key groups and patients with major chronic diseases, adhere to the integration of medical care and prevention, and strengthen comprehensive community prevention and control.
(3) Strengthen the function of people-centered health management services. based on the family doctor system and relying on electronic health records, it gives full play to the role of traditional Chinese medicine in preventing diseases, focuses on personal residences and functional communities, and establishes a people-centered full life cycle health management model, providing screening assessment, health Education, follow-up management and other graded, continuous, whole-process health services and management. Advocate a healthy lifestyle and guide community residents to carry out self-health management such as chronic diseases and mental health.
(4) Strengthen the functions of rehabilitation nursing services for key populations. Develop community rehabilitation services that combine outpatient, inpatient, and home care. Provide functional assessment, rehabilitation treatment and nursing care, and referral services for the elderly, children, disabled people, and people with physical impairments who need rehabilitation, as well as patients transferred from higher-level hospitals. For eligible disabled, disabled and demented elderly and disabled, family bed visits, home rehabilitation nursing and round visit services are provided. Optimize contract services between community health service institutions and elderly care institutions and community nursing institutions. Carry out palliative care services connecting home with medical care and elderly care institutions.
3. Strengthen hierarchical diagnosis and treatment
(1) Promote the homogeneity of basic medical services. Relying on the existing management system and professional strength, starting from the homogenization of community medical care, strengthen the professional capacity building of health technology assessment and evidence-based decision-making. Develop a list of basic diseases for community medical services and establish a dynamic adjustment mechanism. Improve the technical catalog and clinical pathway, and strengthen the training, assessment and management of clinical pathway application. Accelerate the promotion of the application of artificial intelligence-assisted diagnosis in community health service institutions, and improve the ability of community doctors to diagnose diseases. Carry out Shanghai-style characteristic TCM special diseases (specialties) into the community action to improve the level of TCM diagnosis and treatment in the community. Accelerate the construction of community rehabilitation centers and nursing centers, and promote the homogeneity of rehabilitation and nursing services. Taking common diseases such as hypertension and diabetes as the starting point, carry out pilot projects of vertical homogeneity between community diagnosis and treatment services and higher-level hospitals. (Responsible departments and units: District governments, Municipal Health Commission (Municipal Administration of Traditional Chinese Medicine), Shenkang Hospital Development Center, Municipal Economic Information Commission)
