三、健康与康复
III. Health and Rehabilitation文章源自英文巴士-https://www.en84.com/7286.html
文章源自英文巴士-https://www.en84.com/7286.html
中国高度重视残疾人健康权利保障，全面开展残疾预防，大力推进康复服务，努力实现残疾人“人人享有康复服务”的目标。文章源自英文巴士-https://www.en84.com/7286.html
文章源自英文巴士-https://www.en84.com/7286.html
China attaches great importance to ensuring the right to health for persons with disabilities. It makes comprehensive efforts in preventing disability, and works hard to improve rehabilitation services, in pursuit of the goal that “everyone in need has access to rehabilitation services.”文章源自英文巴士-https://www.en84.com/7286.html
文章源自英文巴士-https://www.en84.com/7286.html
残疾人健康保障政策务实全面。《“健康中国2030”规划纲要》《“十三五”卫生与健康规划》《“十三五”深化医药卫生体制改革规划》等对维护残疾人健康、加强基层医疗康复能力建设等提出明确要求。《残疾预防和残疾人康复条例》颁布实施。建立重度残疾人护理补贴制度，向残疾人提供残疾特需医疗卫生服务，将残疾人作为家庭医生签约服务的优先对象，鼓励各地将基本康复服务纳入个性化签约范围。运动疗法等29项医疗康复项目纳入基本医疗保险支付范围。自20世纪90年代以来，中国政府和社会各界出资，对白内障患者开展手术治疗，累计使1000余万人复明。特别关注农村贫困残疾人医疗卫生服务状况，制定发布《关于实施健康扶贫工程的指导意见》《健康扶贫工程“三个一批”行动计划》《着力解决因残致贫家庭突出困难的实施方案》和《医疗保障扶贫三年行动实施方案（2018－2020年）》，将农村贫困残疾人纳入基本医保、大病保险、医疗救助范围，充分发挥三项制度综合保障作用，切实提高建档立卡贫困残疾人医疗保障受益水平，加强县级残疾人康复服务中心建设，提升基层康复服务能力，建立医疗机构与残疾人专业康复机构协调配合的工作机制。文章源自英文巴士-https://www.en84.com/7286.html
文章源自英文巴士-https://www.en84.com/7286.html
Policies for ensuring health services for people with disabilities are pragmatic and comprehensive. The “Outline of Healthy China 2030”, the “Plan for Health in the 13th Five-year Plan Period”, and the “Plan for Deepening Medical and Healthcare Reform in the 13th Five-year Plan Period” have raised explicit requirements for ensuring healthcare for persons with disabilities, and improving the ability of community-level institutions to deliver medical and rehabilitation services. The Regulations on Disability Prevention and Rehabilitation of Persons with Disabilities have been enacted and implemented. A subsidy system for nursing persons with severe disabilities has been established. Persons with disabilities are provided with special medical services, and they are also priority targets in family doctors’ contracting services. Local governments are encouraged to incorporate basic rehabilitation services into personalized contracts with family doctors. Exercise therapy and 28 other medical rehabilitation items are covered by basic medical insurance. Since the 1990s, the Chinese government and various sectors of the society have funded surgeries for cataract patients, and more than 10 million people have recovered eyesight through this campaign.文章源自英文巴士-https://www.en84.com/7286.html
文章源自英文巴士-https://www.en84.com/7286.html
Special attention has been paid to medical and healthcare services for impoverished people with disabilities in rural areas. The government has issued the “Guiding Opinions on Programs of Poverty Alleviation Through Healthcare”, “Action Plan for Three Groups of People in Programs of Poverty Alleviation Through Healthcare”, “Implementation Plan for Addressing the Difficulties of Poor Households Caused by Disabilities”, and the “Three-year Action Plan for Poverty Alleviation Through Medical Security (2018-2020)”. In rural areas, poor people with disabilities are now covered by basic medical insurance, serious disease insurance, and medical assistance, all of which play an effective role in securing comprehensive healthcare for them. Medical insurance benefits for registered poor people with disabilities have been improved. More efforts have been made to build county-level rehabilitation service centers for persons with disabilities, with the goal of improving the capabilities of community-level institutions in providing rehabilitation services. A working mechanism has been established to coordinate medical institutions and professional rehabilitation institutions for persons with disabilities.
残疾预防工作取得积极成效。制定发布《国家残疾预防行动计划（2016－2020年）》，采取有效措施减少和控制残疾发生。在全国开展残疾预防综合试验区试点工作，探索完善残疾筛查、评定、报告及干预一体化工作机制。实施国家免疫规划，加强婚前孕前健康检查、孕产妇产前筛查诊断以及新生儿和儿童残疾筛查。制定《0－6岁儿童残疾筛查工作规范（试行）》，实现5类儿童残疾的早筛早诊早治。加强传染病、地方病、慢性病等疾病防治，实施食盐加碘、增补叶酸等重点预防工程，基本消除了脊髓灰质炎、碘缺乏病等致残因素。加强安全举措，减少意外伤害致残因素。科技部积极推进残疾预防技术攻关，通过“生殖健康及重大出生缺陷防控研究”和“重大慢性非传染性疾病防控研究”重点专项，部署开展出生缺陷防控和主要致残性重大慢性疾病防控技术研究，有效减少因病致残的发生。2017年国务院正式批准将每年8月25日设立为“残疾预防日”，在“残疾预防日”、爱耳日、防治碘缺乏病日、爱眼日、预防出生缺陷日、精神卫生日等节点开展宣传活动，提高公众残疾预防意识。截至2016年，全国共为8091万名农村围孕期妇女提供免费补服叶酸服务，为97.8万对夫妇免费提供地中海贫血筛查服务，为469万名新生儿提供免费先天性疾病筛查。
Positive results have been achieved in preventing disability. The “National Disability Prevention Action Plan (2016-2020)” has been promulgated, by which effective measures are being taken to reduce and control the occurrence of disabilities. Pilot work on comprehensive disability prevention has been carried out around China to improve the integrated mechanism for disability screening, assessment, report and intervention. The national immunization program has been implemented, and pre-marriage and pre-pregnancy health checks, maternal prenatal screening and tests, and screening for newborns and children with disabilities have been strengthened. The Specifications for Disability Screening for Children Aged 0-6 Years (Trial) has been formulated to realize early screening and treatment of children with five types of disability. More efforts have been made in the prevention and treatment of infectious diseases, endemic diseases, and chronic diseases, with a focus on key prevention projects such as salt iodization and folic acid supplementation. These have basically eliminated poliomyelitis and iodine deficiency disorders, and other causes for disabilities. Safety measures have been strengthened to reduce accidental injuries that cause disabilities.
The Ministry of Science and Technology (MOST) actively pursues breakthroughs in disability prevention technologies. Through two key programs – “reproductive health and prevention and control of major birth defects” and “prevention and control of major non-communicable chronic diseases” – the MOST has planned and conducted prevention and control of birth defects and technical research on the prevention and control of major chronic diseases that will lead to disabilities, effectively reducing the occurrence of disabilities caused by illnesses. In 2017, the State Council officially designated August 25 as the Disability Prevention Day. Promotional activities to raise public awareness of disability prevention have been carried out on Disability Prevention Day, Ear Care Day (March 3), Global Iodine Deficiency Disorders Prevention Day (October 21), National Eye Care Day (June 6), World Birth Defects Day (March 3), and World Mental Health Day (October 10).
As of 2016, the Chinese government had provided free folic acid to 81 million rural perinatal women, free thalassemia screening for 978,000 couples, and free congenital disease screening for 4.69 million newborns.
残疾人康复条件逐步完善。残疾人康复机构从无到有，专业队伍建设不断加强，工作体系、业务格局、运行机制逐步建立，服务能力日益提高。截至2018年，全国已竣工的省、市、县三级康复设施914个，总建筑面积344.9万平方米；全国残疾人专业康复服务机构9036个，在岗人员25万人，2750个县（市、区）开展社区康复服务。康复工作内容由三项抢救性康复项目发展成为覆盖多学科领域、满足各类别残疾人需要、预防与康复并重的服务体系。2018年，全国621所中等、高等职业技术学校和普通本专科院校开设康复专业，毕业生人数为29334人。为进一步加强康复专业人才培养，建设中国康复大学已纳入“十三五”规划和《“十三五”加快残疾人小康进程规划纲要》，筹建工作正式启动。大力开展社区康复服务，提升社区康复能力。截至2018年，开展社区康复服务的市辖区为1001个，县（市）为1749个，有社区康复协调员47.8万人。建立残疾儿童康复救助制度，为残疾儿童接受基本康复救助提供制度性保障。全国9个省（区、市）建立了残疾人辅助器具补贴制度，减轻了残疾人家庭经济负担。实施残疾人精准康复服务行动，为残疾儿童和持证残疾人提供康复医疗、康复训练、支持性服务、辅助器具适配等基本康复服务。科技部着力推进助残、惠残产品研发，通过“主动健康和老龄化科技应对”和“生物医用材料研发与组织器官修复替代”重点专项，部署开展康复辅助器具、人工组织器官修复材料等研发。完善工伤康复制度，提高伤残抚恤标准。2006年至2016年，2178.1万残疾人次得到不同程度康复。2018年，1074.7万名残疾儿童及持证残疾人得到基本康复服务，残疾人康复服务覆盖率达到79.8%。
Rehabilitation services for persons with disabilities have gradually improved. Starting from scratch, rehabilitation institutions for persons with disabilities have developed a team of professionals, established a work system, business structure and operational mechanism, and improved their service capabilities. By 2018, 914 rehabilitation facilities at provincial, municipal and county levels had been completed, with a total floor area of 3.4 million sq m. There were 9,036 rehabilitation institutions for persons with disabilities, which employed 250,000 people, and 2,750 counties (cities or districts) offered community rehabilitation services. Rehabilitation institutions, which used to provide services only for cataract patients, post-polio patients, and hearing-impaired children, have evolved into to a multi-disciplinary service system with equal emphasis on prevention and rehabilitation that meets the needs of a wide range of people with disabilities.
In 2018, 621 secondary and higher vocational technical schools and regular colleges and universities began to offer degree programs on rehabilitation services, with 29,334 graduates. To train more rehabilitation professionals, preparatory work has officially started for China Rehabilitation University, which is included in the 13th Five-year Plan for National Economic and Social Development and the “Outline for Accelerating the Process Toward Prosperity for Persons with Disabilities in the 13th Five-year Plan Period”.
Vigorous efforts are being made to offer community rehabilitation services and enhance the service capacity. By 2018, 1,001 municipal districts and 1,749 counties (cities) were offering community rehabilitation services, employing 478,000 community rehabilitation coordinators. A rehabilitation and assistance system for children with disabilities has been established, providing institutional guarantee for these children to receive basic rehabilitation assistance. A system subsidizing assistive devices for persons with disabilities has been established in nine provinces, autonomous regions and municipalities directly under the central government, reducing the financial burden on families with disabled members. A campaign has been launched to offer targeted rehabilitation services, such as rehabilitation therapy, rehabilitation training, support services, and assistive devices, to disabled children and those with certified disabilities. The MOST encourages the R&D of products that help and benefit persons with disabilities. It has carried out R&D programs on rehabilitation aids and repair materials for artificial tissues and organs, with a focus on two key projects – “active health and technological response to aging” and “R&D of biomedical materials and repair and replacement of tissues and organs”. The rehabilitation system for work-related injuries has been improved, and pensions for injuries and disabilities have been enhanced.
From 2006 to 2016, 21.8 million persons with disabilities made progress in rehabilitation. In 2018, 10.7 million disabled children and persons with certified disabilities received basic rehabilitation services, and the coverage of rehabilitation services for persons with disabilities reached 79.8 percent.
残疾儿童健康得到特别关注。遵循儿童利益最大化原则，高度关注残疾儿童健康。第二次全国残疾人抽样调查数据显示，0－14岁残疾儿童占残疾人总人数的4.69%，比1987年第一次全国残疾人抽样调查数据下降11.21个百分点。优先开展0－6岁残疾儿童抢救性治疗和康复，实施精准康复服务。2018年，15.7万名0－6岁残疾儿童得到基本康复服务。为更全面更可持续地保障残疾儿童的基本康复权利，国务院2018年6月发布《关于建立残疾儿童康复救助制度的意见》，正式建立残疾儿童康复救助制度。推进残疾儿童康复救助项目，对患有脑瘫、弱视、听障等重大疾病儿童进行救助。建立包括残疾孤儿在内的孤儿基本生活保障制度，实施“儿童福利机构建设蓝天计划”和“全国残疾孤儿手术康复明天计划”。截至2018年6月，“全国残疾孤儿手术康复明天计划”已为12.5万名手术适应症残疾孤儿、弃婴实施了手术矫治和康复训练。
Special attention has been paid to the health of children with disabilities. Following the principle of maximizing the interests of children, the Chinese government pays close attention to the health of children with disabilities. According to the results of the second national sample survey on disability published in 2006, children aged 0-14 years accounted for 4.69 percent of the total population with disabilities, 11.21 percentage points lower than data from the first survey published in 1987. Priority has been given to the rescue therapy and rehabilitation of children with disabilities aged 0-6, with targeted rehabilitation services. In 2018, 157,000 children with disabilities aged 0-6 years were provided with basic rehabilitation services.
To protect the basic rehabilitation rights of children with disabilities in a more comprehensive and sustainable way, the State Council issued the “Directives on Establishing a Rehabilitation and Assistance System for Children with Disabilities” in June 2018, marking the formal establishment of the system. Efforts have been made to promote rehabilitation and assistance services for children with major diseases such as cerebral palsy, amblyopia, and hearing impairments. A basic living allowance system has been established for orphans, including those with disabilities. China has carried out the Blue Sky Plan on Developing Child Welfare Institutions and the Tomorrow Plan on Surgical Rehabilitation for Orphans with Disabilities. In the framework of the latter, by June 2018, 125,000 disabled orphans and abandoned infants with surgical indications had received surgical correction and rehabilitation training.
