四、医疗卫生服务质量大幅提高
IV. Great Improvement in the Quality of Medical and Health Services文章源自英文巴士-https://www.en84.com/3765.html
文章源自英文巴士-https://www.en84.com/3765.html
中国致力于提升医疗卫生资源的可及性和便利性，同步推动医疗服务质量和效率的不断提高，加快建立优质高效的整合型医疗卫生服务体系，药品供应体系不断完善，居民就医感受明显改善。文章源自英文巴士-https://www.en84.com/3765.html
文章源自英文巴士-https://www.en84.com/3765.html
China is committed to improving the accessibility and convenience of medical and health resources, and the quality and efficiency of medical services at the same time. It aims to accelerate the building of an integrated medical and health service system of good quality and high efficiency, and improve the medicine supply system. More and more people are satisfied with their visits to hospitals.文章源自英文巴士-https://www.en84.com/3765.html
文章源自英文巴士-https://www.en84.com/3765.html
医疗卫生服务体系资源要素持续增加。2011年至2015年，国家投入420亿元，重点支持建设1500多个县级医院、1.8万个乡镇卫生院、10余万个村卫生室和社区卫生服务中心。截至2016年底，全国医疗卫生机构达983394个，其中医院29140个（公立医院12708个，民营医院16432个），乡镇卫生院36795个，社区卫生服务中心（站）34327个，疾病预防控制中心3481个，卫生监督所（中心）2986个，村卫生室638763个；全国统计的万元以上医疗设备共529.1万台，其中100万元以上的设备12.5万台。2016年，医疗机构床位数比2015年增加39.5万张，每千人口拥有床位数达到5.37张，医院床位数增加35.8万张；全国少数民族医医院有266所，床位数达26484张，年总诊疗968.7万人次，出院58.8万人次。文章源自英文巴士-https://www.en84.com/3765.html
文章源自英文巴士-https://www.en84.com/3765.html
The resource factors of the medical and health-service system keep increasing. From 2011 to 2015, China invested RMB42 billion to support the building of 1,500 county-level hospitals, 18,000 town and township health centers, and more than 100,000 village clinics and community health centers. By the end of 2016, there were 983,394 medical and health institutions in China, among which 29,140 were hospitals (12,708 public hospitals and 16,432 private ones), 36,795 town and township health centers, 34,327 community health centers (stations), 3,481 disease prevention and control centers, 2,986 health inspection institutes (centers), and 638,763 village clinics; there were also 5.291 million items of medical equipment each worth RMB10,000 or more, among which 125,000 were worth more than RMB1 million each. In 2016, the number of beds in medical institutions increased by 395,000 compared with 2015 – 5.37 beds for every 1,000 people; the number of beds in hospitals increased by 358,000. There were 266 hospitals of ethnic healthcare, with 26,484 beds, providing 9.687 million treatment sessions annually, and the number of discharged patients reached 588,000.文章源自英文巴士-https://www.en84.com/3765.html
文章源自英文巴士-https://www.en84.com/3765.html
医药卫生人才队伍更加优化。国家已构建起全世界规模最大的医学教育体系。截至2016年底，全国共有922所高等医学院校、1564所中等学校开办医学教育，硕士授予单位238个、博士授予单位92个，在校学生总数达395万人，其中临床类专业在校生达到114万人、护理类专业达到180万人。全国共有14所教育机构开设了少数民族医药专业和中医专业少数民族医药方向，在校生约17万人。云南、广西、贵州等地的中医学院先后设立中医学本科傣医、壮医、苗药等专业方向。部分少数民族医药院校与高等中医药院校合作，联合培养少数民族医药人才。截至2016年底，全国卫生人员总量达1117.3万人，卫生技术人员845.4万人，每千人口医师数达到2.31人，执业（助理）医师大学专科及以上学历人员比例为81.2%，高层次专业人才逐年增加。每千人口护士数达到2.54人，医护比达到1:1.1。
Health personnel optimized. China has built a medical education system of the largest scale in the world. By the end of 2016, there were 922 medical colleges and universities in China, 1,564 secondary schools with medical courses, 238 organizations granting master’s degrees, and 92 granting doctoral degrees. The number of students at these schools had reached 3.95 million, among whom 1.14 million were students of clinical majors and 1.8 million of nursing majors. Fourteen educational institutions now offer specialties in ethnic healthcare, and research into ethnic healthcare in TCM majors, with about 170,000 students. TCM colleges in Yunnan, Guangxi and Guizhou offer undergraduate specialties of healthcare of the Dai, Zhuang and Miao peoples. Some ethnic-healthcare colleges and TCM colleges cooperate to cultivate personnel specializing in ethnic healthcare. By the end of 2016, the number of health workers totaled 11.173 million, with 8.454 million technical personnel, and 2.31 physicians for every 1,000 people; practicing (assistant) physicians with a college degree or above made up 81.2 percent of the total. The number of high-caliber professionals is increasing year by year. The number of nurses for every 1,000 people has reached 2.54, and the ratio of doctors to nurses has reached 1:1.1.
社会力量办医不断增长。优先支持社会力量举办非营利性医疗机构，推进非营利性民营医院与公立医院同等待遇。鼓励医师利用业余时间、退休医师到基层医疗卫生机构执业或开设工作室。全国民营医院占比超过57%，社会办医疗卫生机构床位总数比2011年增长81%，门诊量已占全国门诊总量的22%。截至目前，在全国注册多点执业的医生中，到社会办医疗机构执业的超过70%。
The non-governmental sectors operating hospitals are growing. China supports non-governmental sectors in starting non-profit medical institutions, and promotes equal treatment between non-profit private hospitals and public hospitals. We encourage physicians to make use of their spare time, and retired physicians to work in community medical and health institutions or open clinics. Private hospitals now account for more than 57 percent of all hospitals, the number of beds in medical and health institutions operated by non-governmental sectors has increased by 81 percent compared with 2011, and their outpatient visits take up 22 percent of the total in China. Now, of the physicians who have obtained licenses that give them permission to work for more than one organization, more than 70 percent also work in medical institutions operated by non-governmental sectors.
基层和农村医疗条件进一步改善。从医疗卫生体制、医疗服务机构设置、医疗服务人员配备等多个方面向基层和农村倾斜。将县级医院定位为县域内的医疗卫生中心和农村三级医疗卫生服务网络的核心，在每个县（市）重点办好1至2所县级医院（含中医医院）。基本实现每个乡镇建好1所卫生院，平均每个行政村设有1个村卫生室，每千农村居民配有1名乡村医生。
Community and rural medical conditions further improve. China gives priority to community and rural medical development in terms of the establishment of medical and health systems, the setting up of medical service institutions and the team building of medical service personnel. It takes county-level hospitals as the medical and health centers of the county, and places them at the core of the three-tier rural medical and health service network at the county, township and village levels. It focuses on the operation of one or two county-level hospitals (including TCM hospitals) in each county (city). Now, almost every town or township has a health center, every administrative village has a village clinic, and every 1,000 rural residents have a village doctor.
医疗卫生服务供给更具层次性。建立专业公共卫生机构、综合和专科医院、基层医疗卫生机构“三位一体”的重大疾病防控机制，强化信息共享、互联互通机制，推进慢性病防、治、管整体融合发展，实现医防结合。全面建立分级诊疗制度，引导形成基层首诊、双向转诊、上下联动、急慢分治的合理就医秩序，健全治疗——康复——长期护理的服务链。全国三级医院预约诊疗率达到38.6%，近400家医疗机构设置了日间手术中心。开展家庭医生签约服务，居民对家庭医生的专业技术和服务态度的满意度达80%以上，群众就医感受得到明显改善。
Medical and health service supply is becoming more refined and targeted. China has established a mechanism for serious illness prevention and control that combines professional public health institutions, general and specialized hospitals, and community medical and health institutions. We are enhancing the mechanism for information sharing and inter-connection, promoting the integrated development of chronic disease prevention, control and management, and realizing the combination of treatment and prevention. We are building a comprehensive classified diagnosis and treatment system, guiding the formation of a rational medical treatment order featuring primary treatment at the community level, two-way transfer treatment, interconnection between different levels and different treatments for acute and chronic diseases, and improving the service chain of treatment, rehabilitation and long-term care. The diagnosis and treatment rate based on appointments in Grade III hospitals has reached 38.6 percent, and nearly 400 medical institutions have set up ambulatory surgery centers. We are also providing family physician contracted services. More than 80 percent of citizens are satisfied with the skills and attitude of family physicians. The people’s service experience has greatly improved.
医疗质量安全水平持续提高。制定《医疗质量管理办法》，逐步建立并完善医疗质量管理与控制体系，发布质控指标，开展信息化质量监测与反馈。推进医疗机构临床路径管理，制定1212个临床路径，基本覆盖常见病和多发病。发布实施《遏制细菌耐药国家行动计划（2016－2020年）》，综合治理细菌耐药问题。加强处方和用药监管。2016年，全国住院患者抗菌药物使用率为37.5%，较2011年降低21.9个百分点；门诊处方抗菌药物使用率为8.7%，较2011年降低8.5个百分点。医疗责任保险覆盖超过90%的二级以上医院。高度重视血液安全和血液供应，截至2015年底，实现血站核酸检测全覆盖，血液安全水平与发达国家基本一致。推进无偿献血和临床合理用血。2016年，共有1400万人次参加无偿献血，比2015年增长6.1%，基本满足临床用血需求。公民逝世后器官捐献已成为器官移植的主要来源。
The quality and the safety level of medical services continues to rise. We have formulated Medical Quality Management Measures, gradually established and improved the medical quality management and control system, released quality control indicators, and conducted informationalized quality monitoring and feedback. We have promoted clinical pathway management (CPM) by developing 1,212 clinical pathways, which cover almost all common and frequently occurring diseases. We have released and implemented the National Action Plan to Contain Antimicrobial Resistance (2016-2020), to resolve the problem of antimicrobial resistance in a comprehensive way. We have also strengthened supervision over prescription and drug use. In 2016, the rate of inpatients using antibacterial drugs was 37.5 percent, 21.9 percentage points lower than in 2011; the usage rate in outpatient prescriptions was 8.7 percent, a decrease of 8.5 percentage points compared with the rate in 2011. Medical liability insurance covers more than 90 percent of hospitals at Grade II and above. We attach great importance to blood safety and supply. By the end of 2015, we had realized the full coverage of nucleic acid tests in blood stations, with a blood safety level equivalent to that of developed countries. We also encourage voluntary unpaid blood donations and rational clinical use of blood. In 2016, 14 million people donated blood gratis, an increase of 6.1 percent over 2015 and almost satisfying the demand for clinical blood use. Donation has become the main source of organs for transplants.
药品供应保障体系进一步完善。以国家基本药物制度为基础的药品供应保障体系取得长足发展，相比制度实施前，基本药物销售价格平均下降30%左右，并在基层医疗卫生机构实行零差率销售，患者用药负担大为减轻。启动首轮国家药品价格谈判试点，乙肝、非小细胞肺癌等谈判药品的采购价格下降50%以上，价格处于全球低位，截至2016年底，患者减少支出近亿元。完善罕见病药品供应保障政策。增加艾滋病防治等特殊药物免费供给。深入推进医药创新，实施“重大新药创制”科技重大专项。2011年至2015年，全国共有323个创新药获批开展临床研究，埃克替尼等16个创新药获批生产，139个新化学仿制药上市，累计600多个原料药品种和60多家制剂企业达到国际先进水平GMP要求，PET－CT、128排CT等一批大型医疗设备和脑起搏器、介入人工生物心脏瓣膜、人工耳蜗等高端植入介入产品获批上市。推动建设遍及城乡的现代医药流通网络，基层和边远地区的药品供应保障能力不断提高。
The drug supply security system keeps improving. This system, based on the national basic drug system, has made great headway. Since the implementation of the policy, the prices of basic drugs have dropped by about 30 percent on average, and basic drugs have been sold in community-level medical and health institutions with zero markup, easing the financial burden on patients. We initiated the first round of pilot projects of national drug price negotiation, reducing the purchasing prices of drugs for hepatitis B and non-small-cell lung cancer by over 50 percent, making them the lowest in the world. By the end of 2016, the patients’ expenses had been reduced by nearly RMB100 million. We have also improved the policy that ensures drug supply for rare diseases, and increased the free supply of special drugs, for instance, drugs for the prevention and treatment of HIV/AIDS. China encourages medical and pharmaceutical innovation, launching a key project named the National New Drug Innovation Program. From 2011 to 2015, 323 innovative drugs in China were approved for clinical research, 16 innovative drugs including Icotinib Hydrochloride Tablets were approved for production, 139 new chemical generic drugs entered the market, a total of more than 600 Active Pharmaceutical Ingredients (API) and over 60 pharmaceutical companies reached the international advanced GMP standard, and a number of large medical equipment such as PET-CT and 128-MSCT, and advanced implantable products including brain pacemaker, bioprosthetic valve and artificial cochlea have been approved and entered the market. We have promoted the building of a modern medical and pharmaceutical distribution network that covers both the urban and rural areas, and strengthened drug supply security at the community level and in remote areas.
传统医药发展更受国家支持。2013年至2015年，国家投入专项资金46亿元支持中医药服务能力建设。2016年，国家印发《中医药发展战略规划纲要（2016－2030年）》。中药工业规模以上企业主营业务收入8653亿元，约占全国医药工业规模以上企业主营业务收入的三分之一。2011年以来，49项中医药科研成果获得国家科技奖励。青蒿素及治疗急性早幼粒细胞白血病等中西医药研究成果获全球关注。
TCM is receiving more support from the government. From 2013 to 2015, China invested a special fund of RMB4.6 billion to support the capacity building of TCM. In 2016, it issued the Outline of the Strategic Plan on the Development of Traditional Chinese Medicine (2016-2030). The revenue generated by Chinese medicine producers each with turnover over RMB20 million per annum reached RMB865.3 billion in that year, accounting for about one third of the total revenue generated by all the drug producers each with turnover over RMB20 million per annum in China. Since 2011, 49 achievements in TCM scientific research have received national science and technology awards. Artemisinin, medicines for curing acute promyelocytic leukemia and other TCM and Western medicine research findings have attracted worldwide attention.
