中国内地 社区卫生服务进展

中国内地社区卫生服务进展DevelopmentofCHSinMainland卫生部妇幼保健与社区卫生司DepartmentofMCHandCHS,MinistryofHealth许宗余ZongyuXu2006年11月12日November12th,20062加快城市社区卫生服务发展的背景BackgroundofacceleratingthedevelopmentofCHS人口老龄化与城市化疾病的双重负担与疾病谱的改变社区建设的推进与医疗保险制度的深化医药费用过快增长，看病难、看病贵问题突出社区卫生服务的初步成效城市卫生服务体制改革DemographictransitiontoanoldersocietyandurbanizationDualthreatfromthenon-communicablediseasesandinfectivediseaseswiththetransitionofthediseasespectrumDevelopmentintheconstructionofthecommunityandinstitutionofthemedicalinsuranceRapidincreaseinthetotalexpenditureonhealthwithexpensiveandinaccessiblemedicalcareproblemCHShavetakeeffectstepbystepThereformofurbanhealthsystem3社区卫生服务网络逐步发展CHSnetworkistakingshape2005年底：全国共有472个城市开展社区卫生服务占城市总数的71.6%全国共设置社区卫生服务中心3460个社区卫生服务站11816个约有10万名医生、7.3万名护士、1.5万预防保健人员全国创建了108个社区卫生服务示范区Bytheendof200571.6%citesinmainland(472cities)hadestablishedCHSnetwork3460CHScentersand11816CHSstationshadbeenestablishednation-wideAbout100,000doctors,73,000nursesand15,000publichealthpractitionerworkinCHSfacilitiesSetup108demonstrateddistrictswhichsucceedinCHS4国务院印发《指导意见》2006年2月，国务院印发《关于发展城市社区卫生服务的指导意见》明确了发展城市社区卫生服务的指导思想基本原则工作目标提出十二方面政策措施InFebof2006,TheStateCouncildistributedtheGuidingSuggestionsonUrbanCHSDevelopmentTheGuidingSuggestionsfurtherclarify:TheguidingphilosophyThebasicprincipleThegoalsofurbanCHSdevelopmentInaddition,concretepolicymeasureswerestipulatedin12aspects.5政策措施policymeasures1、完善社区卫生服务功能2、建立健全社区卫生服务网络3、构建两级城市卫生服务体系4、加强人才队伍建设5、完善运行机制6、加强监督管理1.ImprovingthefunctionofCHS2.Buildingupwide-coveredCHSnetwork3.Establishtwo-tierurbanhealthservicesystem4.EnhancecapacitybuildingofCHSworkers5.Rationalizingoperationmechanism6.Strengtheningsupervisionandmanagement6政策措施policymeasures7、发挥中医药优势与作用8、纳入城市经济社会发展规划9、加大财政投入10、发挥社区卫生服务在医疗保障中的作用11、落实部门职责12、加强政府领导7.MakegooduseofthepotentialsoftraditionalChinesemedicine8.IntegratingCHSintourbansocialeconomicdevelopmentplan9.FosterfinancialsubsidypolicyonCHS10.EncouragebeneficiariesofmedicalinsurancetomakefulluseofCHS11.Clarifyingrolesandresponsibilitiesoftheconcerneddepartmentsandtakeintoeffect12.Enhancetheleadershipofthegovernment7全国城市社区卫生工作会议NationalConferenceonUrbanCHS2006年2月24－25日在北京召开胡锦涛总书记、温家宝总理做重要批示吴仪同志作了重要讲话卫生部、发展改革委、财政部、劳动保障部、民政部、食品药品监管局提出工作思路和措施3个省级政府、3个省会城市政府、2个市辖区政府和2个社区卫生服务中心做了经验介绍OnFeb24thand25th,theStateCouncilheldnationalconferenceonurbanCHSinBeijing.BothPresidentHuJintaoandPremierWenJiabaogavetheirinstructionsonCHS.AndWuYi,vice-premierofthestate,attendedtheconferenceandmadeanimportantspeech.MinistryofHealth,NationalDevelopmentandReformCommittee,MinistryofFinance,MinistryofLaborandSocialSecurity,MinistryofCivilAffairs,StateFoodandDrugAdministrationofferedsomemoreconcretepolicymeasuresonthedevelopmentofCHS.Inaddition,representativesfrom3provincialgovernments,3governmentsofprovincialcapital,2municipalgovernmentsand2CHScentersintroducedtheirsuccessfulexperiencesonthepromotionofCHS.8胡锦涛总书记批示:PresidentHuJintao:发展社区卫生服务，对于缓解群众看病难、看病贵问题，为群众提供廉价、便捷的医疗保健服务，提高全社会疾病预防控制水平，具有重要意义。各级党委和政府要坚持以人为本，加强领导，明确责任，狠抓落实，积极发展这项利国利民的事业，以造福人民群众。CHSwillplayanirreplaceableroleinrelievingexpensiveandinaccessiblemedicalcareproblems,ensuringtheresidentsaccesstosafe,effective,convenientandcost-effectivepublichealthandbasichealthservices,improvingtheabilityofprevention.Inordertobenefitresidentsfurthest,GovernmentsandCPCatalllevelsshouldstrengthentheguidanceinCHS,andpromotethedevelopmentofCHSactivelyandresponsibly.9温家宝总理批示PremierWenJiabao:社区卫生服务是城市公共卫生和基本医疗服务的基础。各级政府和有关部门要认真贯彻《国务院关于发展城市社区卫生服务的指导意见》，把发展社区卫生服务作为深化城市医疗卫生体制改革的重要环节，加强领导，加大投入，改革机制，完善管理，不断改善社区卫生服务条件和水平，努力解决群众看病难、看病贵的问题，保障群众健康，促进经济社会协调发展。Beinganimportantcomponentofurbanhealthsystem,CHSisthefundamentaltoguaranteeuniversalaccesstoprimaryhealthcareandpublichealth.Inordertorelieveexpensiveandinaccessiblemedicalcareproblems,maintainpublichealthandpromotesocietyharmony,GovernmentsandCPCatalllevelsshouldeffectivelyimplementrelevantnationalguidelinesandpolicies,enhancetheguidancetoCHS,offermorefinancialinput,reformoperationmechanism,strengthensupervisionandmanagement,andimprovetheserviceandconditionofCHSfacilities.10国务院城市社区卫生工作领导小组NationalLeadershipGroupofCHS2006年2月，成立国务院城市社区卫生工作领导小组吴仪同志任领导小组组长，国务院办公厅、卫生部、财政部等12个相关部门为成员领导小组办公室设在卫生部InFebof2006,NationalLeadershipGroupofCHSwasestablished,inwhichVice-premierWuYileadsGeneralOfficeofStateCouncil,MinistryofHealth,MinistryofFinanceand9otherministriesconcernedworkingtogetherforthedevelopmentofCHS.ThereisageneralofficeoftheleadershipgroupworkinginMinistryofHealth.11研究制订配套文件工作SupportivePolicy2006年2月以来，卫生部、中央编办、国家发展改革委、人事部、财政部、劳动保障部、国家中医药管理局等部门牵头制订了9个社区卫生服务配套文件。SinceFebof2006,inordertofullyimplementtheGuidingSuggestionsandfollownationalconferenceonurbanCHS,MinistryofHealth,theStateCommissionOfficeforPublicSectorReform,NationalDevelopmentandReformCommittee,MinistryofPersonnel,MinistryofFinance,MinistryofCivilAffairs,MinistryofLaborandSocialSecurityandStateAdministrationofTraditionalChineseMedicinehavejointlypromulgated9supportivepolicydocuments.12一、完善社区卫生服务机构管理规则ManagementrulesonCHSfac