A circular on guidelines to promote family doctor contracting services

1. Why should we promote family doctor contract service?

At present, China's medical and health services are facing many challenges such as population aging, urbanization and high incidence of chronic diseases, and the hospital and disease-centered medical and health service model is difficult to meet the needs of the people for long-term and continuous health care. At the same time, residents are concentrated in large hospitals, which is not conducive to improving the medical environment, balancing medical resources, and reasonable control of medical costs. International experience and domestic practice have proved that promoting contracted family doctor services at the grassroots level is an important way to safeguard and maintain people's health under the new situation. Family doctors are people-oriented, oriented to families and communities, and oriented to maintaining and promoting overall health, providing long-term contracted services for the masses, which is conducive to changing the medical and health service model, promoting the shift of the focus of medical and health work and the sinking of resources, allowing the masses to have a health gatekeeper, enhancing the masses' sense of access to the reform, and laying the foundation for the realization of grassroots first diagnosis and graded diagnosis and treatment.

2. What is the current situation of contracting services for family doctors?

Since the issuance of The State Council's "Guiding Opinions on Establishing a General Practitioner System" (Guofa [2011] No. 23), various forms of contract service pilots have been carried out at the national level and in various localities, and new mechanisms such as team formation, financing, incentive and assessment have been actively explored, and have been recognized and welcomed by the masses, accumulating valuable experience and a broad mass foundation for the reform.

At the same time, there are also some problems that restrict the promotion of contract services. It mainly includes the connotation of contract service to be improved, the financing mechanism of contract service is not perfect, and the incentive of family doctors to carry out contract service is insufficient. At the same time, there is a big gap in salary and career development space between family doctors serving at the grass-roots level and medical personnel in superior medical institutions, and it is difficult to attract and retain high-quality talents. These problems need to be solved gradually through reform to ensure the smooth promotion of family doctor contract services.

3. What is the general idea and main goal of developing family doctor contract service?

The general idea of promoting family doctor contract services is to, in accordance with the overall deployment and requirements of deepening the reform of the medical and health system, focus on the goal of promoting the construction of a healthy China and realizing everyone's access to basic medical and health services, take health as the center, promote the focus of medical and health work to move down and resources to sink, and combine the comprehensive reform of primary medical and health institutions and the construction of the general practitioner system. We will accelerate contracting services for family doctors. Constantly improve the content of contract services, highlight the integration of traditional Chinese and western medicine, and enhance the willingness of the masses to take the initiative to use contract services; Establish and improve the internal incentive and external support of contract service, and mobilize the enthusiasm of family doctors to carry out contract service; We will encourage and guide hospitals at or above secondary levels and non-governmental medical and health institutions to participate, improve the coverage and level of contracted services, promote the first diagnosis and treatment at the grass-roots level, provide comprehensive, continuous and coordinated basic medical and health services to the people, and enhance the people's sense of gain.

The main goal of promoting family doctor contract services is to carry out family doctor contract services in 200 pilot cities of public hospital comprehensive reform in 2016, and encourage other areas with conditions to actively carry out pilot projects. The focus is on achieving breakthroughs in the ways, contents, payment, assessment and incentive mechanisms of contracted services, giving priority to the elderly, pregnant women, children, the disabled and other groups, as well as patients with chronic diseases such as hypertension, diabetes, tuberculosis and serious mental disorders. By 2017, the coverage of contracted services for family doctors will reach more than 30 percent, and the coverage of contracted services for key groups will reach more than 60 percent. By 2020, we will strive to expand contract services to the whole population, form a long-term and stable contract service relationship with residents, and basically achieve full coverage of the family doctor contract service system.