Family doctor contract service implementation plan

2017 Family Doctor Contracting Service Implementation Plan 1

In order to further deepen medical reform, transform medical and health service models and service concepts, build a new harmonious doctor-patient relationship, and give full play to community health service centers , standing in the three-level medical and health system's bottom-line function and "health gatekeeper" role, according to the "Nanjing Municipal Health Bureau, Nanjing Municipal Finance Bureau, Nanjing Municipal Human Resources and Social Security Bureau, and Nanjing Municipal Price Bureau jointly issued This plan is formulated based on the spirit of the document "Opinions on the Implementation of Further Improving the Family Doctor System" (Ningwei Jifu [2015] No. 16) and combined with the actual situation of our district.

1. Overall Goal

Promote the transformation of community health services into health management through the development of family doctor contract services, and gradually establish a dual gatekeeper that can protect both health and cost. Recruitment system; promote the linkage of the actual income and benefits of family doctors with the number of contracted services, promote the establishment of a new assessment and distribution mechanism for more work, more rewards, and better performance; guide family doctor students to improve their professional quality, and strive to establish community first diagnosis and hierarchical diagnosis and treatment new service model.

2. Basic principles

(1) Adhere to the nature of public welfare

Basic medical care and basic public health services are public services provided by the government to residents. The important content of services must be to firmly establish the awareness of convenience, benefit and benefit to the people, and always adhere to the public welfare nature.

(2) Adhere to the combination of prevention and treatment

Oriented by health management and comprehensive services, we strive to improve the capabilities of primary-level medical and health services, promote the effective integration of medical treatment and prevention, and allow residents to enjoy convenience and Fast, effective and safe basic medical and public health services.

(3) Adhere to voluntary contract signing

Conduct extensive publicity and launch, and fully inform the specific content of contracted services and policies to benefit the people. On the premise of fully understanding the connotation of contracted services, residents can independently choose a family doctor, sign a service agreement, and enjoy the agreed services.

(4) Adhere to the step-by-step approach

Key groups should be given priority in coverage, signing of contracts, and services. On the basis of completing the pilot, we will sum up experience, improve the plan, and steadily advance to achieve practical results.

3. Contracting parties

A family doctor team is composed of clinicians with intermediate professional titles or above from community health service centers, community nurses, preventive health doctors, rehabilitation practitioners, and community personnel. The team is composed of doctors who are over 65 years old. The elderly, children aged 0-6, pregnant women, chronic patients and mentally ill patients are the key contract targets and contract services are provided. Community health service centers and health management teams assist and provide technical support.

IV. Rights and obligations of both parties

(1) Party A (purchaser)

Rights: voluntarily choose to contract a family doctor; thirty working days after signing Enjoy the agreed service items from the date of signing; supervise the standardized implementation of the contracted service items.

Obligations: Understand the particularity of the work of family doctors, support cooperation with family doctors in their work; first visit at community health service institutions; give priority to basic drugs, accept referral suggestions from family doctors; proactively pay contract fees , participate in contract service work evaluation.

(2) Party B (service party)

Rights: to be respected and objectively evaluated by the contracting parties; to enjoy the earned income according to the contracted service policy.

Obligations: Earnestly fulfill service commitments as agreed; strictly implement diagnosis and treatment regulations, provide high-quality and safe medical and health services; strengthen learning and improve service capabilities; implement basic medical insurance policies for urban residents and control medical expenses; accept the public’s support Supervision and evaluation to continuously improve service quality and public satisfaction.

V. Signing method

(1) The contracting parties are based on household units. Family members sign a service agreement with a self-selected family doctor team based on their household registration book or residence permit. In principle, Each family can only sign a contract with one family doctor team, and it is appropriate for each family doctor team to sign contracts with no more than 500 households.

(2) The District Health and Family Planning Bureau shall formulate a unified contract service agreement to clarify specific service items, charging standards and compensation policies. The contract partner selects a "service combination" based on actual needs. If there are other special needs, a separate supplementary agreement can be made after negotiation (the fee will be determined separately).

(3) The contract period is in units of years. The first contract period is from the date of signing to December 31 of the following year. After that, it is from January 1 to December 31 of each year. a cycle. When the agreement expires, families can renew, terminate or choose another contracted doctor.

(4) During the signing period, if Party B fails to fulfill the agreed service commitments and Party A requests to withdraw from the contract, both parties must sign to confirm the termination of the service agreement and a one-time refund of all signing fees.

(5) The agreement shall be made in duplicate, with the family doctor team and the contracting family each holding one copy.

VI. Service content

Focusing on basic medical services, basic public health services and personalized services, the following service combinations are formulated:

(1) Basic service package (free)

This package focuses on: providing basic public health services stipulated by the state for contracted family members, providing graded diagnosis and treatment services for contracted family members who develop diseases, and participating in the urban residents basic medical insurance Families enjoy preferential reporting policies, the main contents include:

1. Establish electronic family health records and personal health records of family members for contracted families.

2. Provide free medical and health consultation to contracted families, make appointments for examinations, and distribute no less than 4 issues of health education materials every year.

3. Provide standardized basic public health services for patients with hypertension, diabetes, mental illness, and the elderly.

4. Provide pre-pregnancy guidance, hospital delivery guidance, and postpartum visits to family members who are preparing to become pregnant and pregnant women, and guide them to the local health center for early pregnancy card creation, regular prenatal checkups, and 42 days postpartum. examine.

5. Visit newborns and guide children aged 0-6 to go to local health centers for vaccinations, regular physical examinations, oral health care, etc.

6. Provide hierarchical diagnosis and treatment services: After a contracted family member becomes ill, the family doctor in the contracted team will first make a preliminary diagnosis and treatment of the disease. If it cannot be effectively treated, the family doctor will contact the patient. Clinicians from community health service institutions in the contracted team assist in transferring patients to community health service institutions for diagnosis and treatment. If the condition is serious, clinicians from the contracted team will assist the patient in transferring the patient to a higher-level hospital through the green channel and arrange for experts to diagnose and treat the patient.

7. Families participating in the Urban Resident Basic Medical Insurance enjoy a preferential settlement policy: contracted patients who seek medical treatment in outpatient clinics of community health service institutions are exempted from the personal out-of-pocket portion of general medical expenses.

(2) Personalized service package: Additional fees will be charged as required. Including ⑴ home bed service ⑵ home medical care ⑶ home nursing ⑷ home rehabilitation (5) medical rounds (6) house calls (7) health guidance and intervention and other services.

This package includes: 1. The outpatient clinic implements appointment services, and the contracted parties enjoy the convenience of priority treatment and are exempted from general diagnosis and treatment fees; 2. Priority appointments for referrals and examinations, the contracted parties can receive referrals from family doctors. Priority is given to medical treatment or admission to higher-level medical institutions. 3. Establish a drug prescription extension system. If the contracting party really needs to continue the long-term medication orders (drugs outside the essential medicine list) of the superior medical institution to maintain treatment, the family doctor can act on behalf of the contracting party based on the medication recommendations of the superior medical institution and the clinical diagnosis and treatment subjects. Submit an application to the center and resolve it through filing and purchasing on behalf of the patient. The policy of online purchasing and zero-margin sales will be implemented. If the prescription dosage needs to be extended, it can be extended appropriately after being reviewed and filed by the Medical Insurance Office of the medical institution. 4. Establish a combined contract.

That is, residents in this area, on the basis of choosing a family doctor to sign a contract, choose a medical insurance designated comprehensive third-level hospital (including a traditional Chinese medicine hospital) to sign a contract based on the contractee's own health needs and medical habits and other factors; the contractee can sign at the contracted medical institution You can choose any medical institution within the portfolio for medical treatment based on your own disease conditions, and you can enjoy various preferential policies for contracted medical treatment. For those who need to go to medical institutions (including specialist medical institutions) outside the contracted medical institution group due to actual circumstances, residents can go to the contracted family doctor (or contracted medical institution) to handle the referral procedures, and continue to enjoy various preferential treatment benefits under the contract. policy.

7. Implementation steps

(1) Select pilot units (early January 2017)

On the basis of voluntary declaration, select a community health unit Service agencies provide contract services (provincial model community health service centers give priority to contract services).

(2) Formation of a contract team (mid-January 2017)

Pilot community health service agencies will select clinicians with intermediate professional titles or above to form a family doctor team.

(3) Implementation of contract service (starting in mid-January 2017)

Based on extensive publicity, the contract service pilot work will be officially launched. Family doctors in the family doctor team combine daily diagnosis and treatment and health care management services, and sign contracts with service recipients. They can start from key groups such as the elderly, chronic patients, women and children, and mentally ill patients, and gradually expand the scope. Clinicians in the family doctor team Participate in contract signing and provide technical guidance. The family doctor team must conscientiously perform the contract according to the contract content, carry out services in a standardized manner, keep corresponding records, and submit monthly reports on contracted service work in a timely manner. The District Health and Family Planning Bureau regularly carries out supervision and guidance to promptly discover and solve problems encountered during the service process to ensure the smooth implementation of contracted services.

(4) Gradual expansion and advancement (from October 1, 2017)

On the basis of the pilot, the implementation plan will be revised and rolled out throughout the region, with all community health services The institution selects 2-3 communities with good foundations to carry out family doctor contract services, and gradually expands the scope to all residents.

8. Work Requirements

(1) Strengthening organizational leadership

Family doctor contract service is an important task to further deepen the reform of the medical and health system and is an important step in establishing hierarchical diagnosis and treatment. The key entry point of the model is a major measure to realize the transformation of the primary medical and health service model. The District Health and Family Planning Bureau and the District Finance Bureau jointly established a leading group to be responsible for the organization and implementation of the contract signing work in the district. Each community health service agency must also establish corresponding organizations to clarify the division of functions and promote the steady development of family doctor contract services. Higher-level referral hospitals should set up referral reception desks or hierarchical diagnosis and treatment offices to be responsible for the reception and triage of patients referred by community health service institutions, and guide contracted patients to receive medical services through hierarchical diagnosis and treatment.

(2) Create a good atmosphere

Family doctor contract service is a new thing, and awareness of it is still low among all sectors of society, including medical staff. All units should make full use of local resources and carry out extensive publicity and mobilization activities through multiple channels such as distributing materials, social media, banners, etc., to increase the awareness and acceptance of family doctor contract services among residents and the whole society, and provide family doctors with The smooth promotion of contracted services creates a good atmosphere of public opinion.

(3) Strengthen supervision and assessment

Establish a core indicator based on the number of contracted households, the number of service projects, the actual number of services, the degree of completion of service specifications, service effects and public satisfaction. Performance appraisal system, subsidy funds are allocated through performance appraisal. The District Health and Family Planning Bureau will regularly conduct random telephone follow-up visits to family doctor contract service recipients to verify the authenticity of the contract and service satisfaction, and promote a virtuous cycle of contract signing.

2017 Family Doctor Contracting Service Implementation Plan 2

In order to further deepen medical reform, transform medical and health service models and service concepts, and build a new harmonious doctor-patient relationship, give full play to the three-level services of village clinics and community health service stations This plan is formulated in accordance with the National Health and Family Planning Commission's "Guidance on Carrying out Pilot Contracting Services for Rural Doctors" and the spirit of relevant provincial and municipal documents, as well as the actual situation of our city.

1. Overall Goal

By carrying out family doctor contract services, promote the transformation of village-level health services into health management, and gradually establish a system that can both protect health and protect costs in rural areas. The new dual gatekeeper system; promote the linkage of rural doctors’ actual income and benefits with the number of contracted services, and promote the establishment of a new assessment and distribution mechanism for more work, more rewards, and better performance; guide rural doctors to improve their professional quality, and strive to establish village-level first-in-class clinics , a new service model for hierarchical diagnosis and treatment.

2. Basic principles

(1) Adhere to the nature of public welfare

Basic medical care and basic public health services are public services provided by the government to residents. The important content of services must be to firmly establish the awareness of convenience, benefit and benefit to the people, and always adhere to the public welfare nature.

(2) Adhere to the combination of prevention and treatment

Oriented by health management and comprehensive services, we strive to improve the ability of grassroots medical and health services, promote the effective integration of medical treatment and prevention, and allow residents to enjoy convenience and Fast, effective and safe basic medical and public health services.

(3) Adhere to voluntary contract signing

Conduct extensive publicity and launch, and fully inform the specific content of contracted services and policies to benefit the people. On the premise of fully understanding the connotation of contracted services, residents can independently choose a family doctor, sign a service agreement, and enjoy the agreed services.

(4) Adhere to the step-by-step approach

Key groups should be given priority in coverage, signing of contracts, and services. On the basis of completing the pilot, we will sum up experience, improve the plan, and steadily advance to achieve practical results.

3. Contracting parties

A family doctor team is formed by a clinician with an intermediate professional title or above from a township health center and a rural doctor (in principle, each clinician from a township health center can have up to Team up with 3 rural doctors) to carry out contract services with the elderly over 65 years old, children aged 0-6 years old, pregnant women, chronic patients and mental patients as key contract targets. Township health centers and health management teams assist and provide technical support.

IV. Rights and Obligations of Both Parties

(1) Party A (Purchaser)

Rights: voluntarily choose to sign a contract with a family doctor; thirty working days after signing the contract Enjoy the agreed service items from the date of signing; supervise the standardized implementation of the contracted service items.

Obligations: Understand the particularity of the work of family doctors and support cooperation with family doctors in their work; the first consultation is in the village clinic; give priority to basic drugs and accept referral suggestions from family doctors; actively pay contract fees and participate Evaluation of contract service work.

(2) Party B (service provider)

Rights: to be respected and objectively evaluated by the contracting parties; to enjoy the earned income according to the contracted service policy.

Obligations: Earnestly fulfill service commitments as agreed; strictly implement diagnosis and treatment standards, provide high-quality and safe medical and health services; strengthen learning and improve service capabilities; implement basic medical insurance policies for urban and rural residents, control medical expenses; accept public support Supervision and evaluation to continuously improve service quality and public satisfaction.