2017 Family Doctor Contracting Service Implementation Plan (2)

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 Municipal Health and Family Planning Bureau shall uniformly formulate a contract service agreement (Annex 1), clarifying 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 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 basic medical insurance for urban and rural residents. Families enjoy preferential reporting policies, the main contents include:

1. Establish electronic family health files and family members’ personal health files 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 rural doctor in the contracted team will first make a preliminary diagnosis and treatment of the disease. If it cannot be effectively treated, the rural doctor will contact the patient. Clinicians from township health centers in the contracted team will assist in transferring patients to township hospitals for diagnosis and treatment. If the condition is more serious, clinicians from the contracted team will assist the patient through the green channel (a referral reception desk or hierarchical diagnosis and treatment office set up in a secondary hospital in the city ) to a secondary hospital, where experts will be arranged for diagnosis and treatment.

7. Families participating in the Urban and Rural Resident Basic Medical Insurance enjoy preferential settlement policies: contracted patients who seek medical treatment at village clinics or township health center outpatient clinics are exempt from the personal out-of-pocket portion of general medical expenses; hospitalization at township health centers The proportion of contracted patients reporting for treatment increased by 3 percentage points (from 85 to 88).

(2) Diagnosis and treatment discount package (10 yuan per person per household)

This package focuses on providing full dynamic health management for contracted family members, mainly including:

1. Enjoy all service contents of the basic service package.

2. When family members visit hospitals or village clinics during the contract period, the auxiliary examination fee is reduced by RMB 25, and the total annual personal discount is capped at RMB 300.

(3) Health management package (300 yuan per household)

This package focuses on providing full dynamic health management for contracted family members, mainly including:

1 , enjoy all service contents of the basic service package.

2. Conduct a health examination for contracted family members (limited to 2 people) every year, including: general physical examination, blood routine, urine routine, blood sugar, blood lipids, liver function, kidney function, electrocardiogram, Chest X-ray and abdominal B-ultrasound (liver, gallbladder, pancreas, spleen and kidneys).

7. Implementation steps

(1) Select pilot units (early November 2017)

On the basis of voluntary declaration, select 3 township health units The hospital selects 1-2 village clinics to provide contract services (provincial model village clinics give priority to contract services).

(2) Formation of a contracting team (mid-November 2017)

The pilot township health center will select a clinician with an intermediate professional title or above and a rural doctor from the pilot village clinic to form a family doctor team.

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

Based on extensive publicity, the contract service pilot work will be officially launched. Rural 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 promptly submit a monthly report of the contracted service work (Annex 2). The Municipal 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 city, and each township health center will choose Carry out family doctor contract services in 2-3 villages with a good foundation, and gradually expand 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 Municipal Health and Family Planning Bureau and the Municipal Finance Bureau jointly established a leading group (Annex 3) to be responsible for the organization and implementation of the city's contract signing work. Each health center must also establish corresponding organizations to clarify the division of functions and promote the steady development of rural doctor contract services. Secondary hospitals in the city should set up referral reception desks or hierarchical diagnosis and treatment offices to be responsible for the reception and triage of patients referred by township health centers. The municipal joint management office should reasonably adjust the cooperative medical treatment settlement policy for urban and rural residents 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 and slogans 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

During the pilot period, the labor subsidy fund for contracted doctors is tentatively set at 8 yuan/household, of which rural doctors in the family doctor team will be subsidized at 5 yuan/household, township The fee for a clinician in a health center is RMB 3 per household. Establish a performance appraisal system with core indicators such as the number of contracted households, number of service projects, actual service quantity, completion of service specifications, service effects and public satisfaction, and subsidy funds will be allocated through performance appraisal. The municipal 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.