High energy warning ahead, the county hospital to grab the job of the big hospital?
Xu Yucai
On May 12, the National Health and Family Planning Commission, Medical Administration and Medical Administration Bureau issued the Basic Standards and Recommended Standards for Medical Service Capability of County Hospitals, which clearly stipulates the setting of departments, the capabilities that should be possessed, and the equipment allocation of county hospitals. Among them, artificial joint replacement surgery, installation of cardiac pacemaker, radical cancer surgery, craniocerebral injury surgery and many other treatments and services that can only be done in provincial and municipal hospitals in the past can also be done in county hospitals in the future. For a while, it caused quite a shock in the medical circle. People were worried about whether such a positioning would rob the jobs of large hospitals?
Grab jobs 's worries are superfluous
Most of them are large hospitals, but the author believes that such concerns are superfluous. The medical service ability that a hospital can have is not available overnight. The introduction of one or two experts to perform several operations may fill some gaps, but is it far from the county hospital's ability to perform such operations?
For example, a doctor went to a large hospital for further education, and it was easy to see a large hospital perform a heart stent operation. Even in front of the "master", he could do one or two cases, but he never dared to go back to the county hospital to do it, because once he was on the operating table, he must know how to do it. Without the backing of the cardiac surgery department of the large hospital, who would tell you what to do if it failed? Medical treatment is related to human life. No matter when, safety is the first priority of medical service.
Therefore, the author believes that there is no need to fry the pot as soon as the Health and Family Planning Commission has issued a standard. It is still a long way from the county hospital to the big hospital. The document only indicates that the county hospital should have this ability, but after ten years of sharpening, the patients should believe that the county hospital has this ability. In short, there is a long way to go.
Can such a positioning ensure that serious diseases do not leave the county?
What I want to discuss is that, as a supporting document for graded diagnosis and treatment《 Guiding Opinions of the General Office of the State Council on Promoting the Construction of Hierarchical Diagnosis and Treatment System 》（ GBF [2015] No. 70 ）The specific implementation of the sentence in. This sentence is“ Comprehensively improve the comprehensive capacity of county-level public hospitals ”Clear aspects“ On the premise of having the ability and ensuring safety, the restrictions on the clinical application of medical technology in county-level public hospitals should be appropriately relaxed ”。 Also based on this, the country wants to delegate some technologies of tertiary hospitals to county hospitals. However, the previous sentence should not be ignored“ On the premise of capability and security ”。
Therefore, does this "decentralization" mean that serious illness can not be out of the county? Not necessarily. Because the flow of patients is not completely determined by doctors and hospitals. What the hospital can do is to work towards this goal in a long-term and planned way, and persevere until it gains the trust of patients.
Is there a huge gap between county hospitals and this standard at present?
This is for sure. It must be understood that China has a vast territory, and there is a big gap between the county hospitals in the eastern and western regions. Although the country has a hospital grade review and a unified standard, even in the same province, the difference is not small. For example, in the standards of Grade II A hospitals, there are different reviews for key specialties and general specialties; Even if it is a key specialty, whether it has the ability to independently complete a certain technology is questionable. Many times, in order to have one or several cases, there are also many people who invite experts from large hospitals to fill the gaps, and few can really be completed independently.
To paraphrase a short line: goals are only goals and can be achieved, but they are not. Even after many years of hard work, they may not be achieved. However, it is better to have goals than not! (This article was published in the 16th issue of "Public Talk Hall" of Physicians in Grass roots Hospitals Online in 2016)
