(3.1)
. Treatment and Heath Care
7/11/2003 18:19
(3.1)
. Treatment and Heath Care
Targets of community
medical service (CMS) mainly include primary triage of diseases, diagnosis and
treatment of common and frequently-occurring diseases as well as continuous
treatment of diagnosed chronic diseases; improvement of the community medical
system and community health based on psychological treatment and community
medical care as for babies and mothers in puerperium, senile chronics and the
dying.
. Health Education and Family Planning
Instruction
Community health education takes full advantages of all kinds
of promotional and educational vehicles to provide health consulting, promotion
and education on special topics; It carries out health survey and, based on
these results, applies intervention and distributes health descriptions targeted
at the main dangerous elements. The CMS operates family planning clinics,
availing instructions and services for contraception skills and technologies and
providing random visits to those receiving contraceptive operations.
3.2
Work Performance
Typical Items Yearly
Workload
Family beds 15,000
Those receiving
family bed service 37,200
seniors covered by the health file
92%
Those visiting medical service 33,000
Those being
monitored for chronic diseases 1.49 million
Those receiving community
health instruction 2.9 million
Those receiving community healing
instruction 110,700
Those receiving community nursing
service 756,700
Those receiving charity medical
service 15,900
4. CMS Management and Support
Under the
leadership and deployment of the municipal government, Shanghai has established
a complete CMS management system, enlisting strong support and aid from the
governments of all levels and their related departments.
4.1 Management
System:
Shanghai has established a CMS management system that stresses
"leadership of government, responsibility of the neighborhood communities,
coordination of the departments, participation of the whole society and
industrial management by the medical administrative body."
With
governments of all levels placing high emphasis on CMS, the municipal government
set up a "Health Improvement Committee" comprising officials from the relevant
departments and headed by the mayor in charge of the medical sector. District
and county governments each launched leadership teams for CMS (also called
primary medical leadership organization in the suburbs), to carry out and
coordinate for the district or county's CMS. The neighborhood communities (or
townships) set up "Health Improvement Committees" to apply the local community's
medical service such as charting the community's medical planning and merging it
into the community's entire development planning as well as coordinating the
relevant departments to enlist their help. The CMS centers, under the leadership
and support of the neighborhood committees (or township governments) and headed
by the committee deans, motivated all their medical staff to eagerly provide
CMS. The complete management system has effectively pushed ahead the continuous
development of the city's community medical service.
4.2 Financial
Support Channels
For years, except for the neighborhood hospitals'
increasing input to infrastructure construction, health care and monitoring,
prevention and control of the infectious chronic diseases, the lion's share of
the city's CMS financing has come from the governments and the
society.
From 2000-2002, all neighborhood hospitals of the downtown areas
were transformed into standard CMS centers, with 20 constructed as model
centers. Of the total 780 million yuan investment to the three-year program, the
municipal and district governments have shouldered half.
In a bid to support
the local CMS, the district governments have made an effort to ensure input into
the medical sector. In 2000, the input reached 80,000 yuan per capita, while in
some districts and counties, the investment far surpassed that level and reached
150,000 yuan.
With each district's finance departments arranging specific
funds for the CMS, the city's district and county government investment in 1999
mounted to 5.29 million yuan, with financing from nine district medical bureaus
topping 9.04 million yuan.
After applying a medical control policy that
stresses macro adjusting and structural tuning, the local pricing authority has
drafted specific pricing policies for the grassroots hospitals to encourage CMS
development. The medical insurance system has provided a positive support to the
CMS. When receiving urgent clinical service at these grassroots medical
institutions, the proportion of the medical fees that should be handled by the
patients is 5 percent lower than with district-level hospitals and 10 percent
lower than with city-level hospitals; From May 1997, the medical fee for the
family bed service with the CMS centers was covered by the city medical
insurance system.
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