More than 45% of county hospitals in the reform of medical and health integration have reached the level of tertiary hospital service capacity

County hospitals are the leader of rural medical and health service networks and the link between urban and rural medical and health service systems, covering a population of about 900 million. Promoting the integration reform of county-level medical and health care, in accordance with the goal of solving common diseases in cities and counties, the health systems in various regions of China are striving to promote the sinking of high-quality medical resources, so that more people can enjoy more convenient and affordable medical services.

The National Health Commission recently announced the "2021-2022 County Hospital Medical Service Capacity Assessment", which shows that as of the end of 2022, more than 87% of county hospitals have reached the service capacity of second level hospitals, and more than 45% of county hospitals have reached the service capacity of third level hospitals.

According to the evaluation, in 2022, the number of types of diseases admitted to county hospitals nationwide increased by 133 compared to 2020; The number of surgeries and procedures increased by 134 compared to 2020; The number of minimally invasive surgeries that can be performed has increased by 2.87 percentage points compared to 2020. More than 97% of county hospitals are able to implement standardized emergency management for critical illnesses such as cardiac arrest and cardiogenic shock; More than 95% of county hospitals are able to diagnose and provide emergency treatment for heart failure, kidney failure, and respiratory failure. More than 95% of county hospitals are able to master standardized diagnosis and treatment of common and frequently occurring diseases such as pediatrics, ophthalmology, respiratory medicine, and endocrinology; The average establishment rate of intensive care and rehabilitation medicine departments has increased to over 80%.

In 2022, the average number of diagnosed and treated patients and the average number of discharged patients in county hospitals have slightly increased compared to 2020; The number of surgeries and procedures has increased by 17.50% compared to 2020. The utilization rate of hospital beds in county hospitals has remained stable at 80%.

The functional positioning of county hospitals has been further implemented, highlighting the role of county leaders and urban-rural linkages. In 2022, over 90% of county hospitals took the lead in forming county-level medical communities, with a total of 7.24 million two-way referrals, an increase of 8.62% compared to 2020.

Establishing a "Medical Community" to Enhance County level Medical Service Capacity

In recent years, hospitals in various counties have accelerated the construction of a closely knit county-level medical community, implemented integrated management of counties and townships, promoted the sinking of high-quality medical resources, and facilitated people's medical treatment.

The county-level medical community refers to a county-level medical service system that is led by county-level hospitals, centered around township health centers, and based on village clinics, with three levels of linkage.

The People's Hospital of Jinxiang County, Shandong Province, in collaboration with 14 township and community medical and health institutions, has formed a medical community and selected 56 business elites to establish an "expert grassroots workshop" in township health centers. At the Xiaoyun Town Health Center, Zhuo Qinchao, an expert in the Department of Anorectal Surgery at the County People's Hospital, visits the clinic twice a week. With his help, the health center has launched a series of daytime surgeries, including colonoscopic early cancer radical surgery.

Zheng Shimin, Secretary of the Jinxiang County Party Committee in Shandong Province: Through the mobility of doctors and the interconnection of information, we can effectively improve our ability to provide grassroots medical services. In this way, 90% of patients can receive treatment within the county.

Fuyuan City, Heilongjiang Province, is led by the Municipal People's Hospital and the Municipal Traditional Chinese Medicine Hospital to form two medical communities and establish a two-way referral mechanism with township health centers. Villager Zhang Fengchun suffered from coronary heart disease and was treated at the Municipal People's Hospital. After his condition stabilized, he was transferred back to the town health center for rehabilitation treatment.

Zhao Zuquan, the director of the Health Center in Nongqiao Town, Fuyuan City, Heilongjiang Province: For example, in the past, some patients with coronary heart disease, atrial fibrillation, and ventricular fibrillation needed to go to the county. However, after the establishment of the medical community, doctors and drugs supported our town, so there was no need to go to the county.

In Longli, Guizhou, 18 common disease departments of county-level hospitals are connected to provincial-level hospitals and township and village level medical institutions through a remote digital medical cooperation platform. Regular online training and remote consultations are conducted to achieve interconnection, interoperability, and mutual recognition of patient medical information and examination data within the medical community.

Deng Wei, Executive Director of the General Hospital of the Medical Community in Longli County, Guizhou: Let our village doctor participate in our training, participate in our medical record discussion. He has the ability, and the people believe it again, so that graded diagnosis and treatment can truly be implemented.

Tian Wensong, Secretary of the Party Committee of the Health Bureau of Longli County, Guizhou: In 2021, the number of people receiving medical treatment at the township level clinics in our county was 520000. In 2022, the number of people receiving medical treatment in our village and township increased by about 55000.

More than 14000 county-level "Five Centers" have been established nationwide

In order to enhance the ability of emergency and critical care, county-level hospitals in various regions are accelerating the construction of five emergency and first aid centers, including chest pain, stroke, trauma, critical care for pregnant and postpartum women, and critical care for children and newborns. At present, more than 14000 "five major centers" have been built nationwide.

Changxing County, Zhejiang Province, relies on the County Maternal and Child Health Hospital and the County People's Hospital to build a standardized center for the treatment of critically ill pregnant women and newborns. It will establish a coordinated and efficient referral and consultation mechanism with townships and communities, strengthen the guarantee mechanism for blood use for pregnant women, and conduct quarterly special skills training and emergency drills for common critical diseases such as postpartum hemorrhage and neonatal asphyxia.

Huang Hangzhen, Director of the Emergency Department of Changxing County Maternal and Child Health Hospital in Zhejiang Province: Currently, the average time from deciding the surgery to delivering the fetus during emergency cesarean section in our hospital is controlled within 18 minutes, which is further shortened from the required 30 minutes. This better ensures the safety of mother and baby.

Jinxiang County People's Hospital in Shandong Province is accelerating the construction of a chest pain center, equipping more than 100 village clinics with electrocardiogram collection equipment, and creating a "electrocardiogram network". A 91 year old villager named Fu Li suddenly experienced chest pain. The village doctor suspected that she had an acute myocardial infarction and immediately performed an electrocardiogram on her. The examination data was uploaded to the remote consultation center of the County People's Hospital, and she was diagnosed with acute myocardial infarction. A 120 ambulance immediately took her to the County People's Hospital.

Patient Fu Jiawen, the son of the Li family, said: The rescue was timely, and both the rural and urban areas were connected to the internet. As soon as the electrocardiogram was taken, surgery should be performed as soon as possible.

Dai Jianjun, Secretary of the Party Committee and Dean of Jinxiang County People's Hospital in Shandong Province: Through the construction of five emergency and first aid centers, it can be said that a 30 minute golden treatment circle covering the entire county has been built.

The National Health Commission requires that through the construction of the "Five Centers" for emergency and first aid, a pre hospital and intra hospital information sharing network be constructed to provide patients with a green channel for medical treatment and a "one-stop first aid" service, with a focus on improving the ability to treat critical and critical illnesses, and achieving the goal of preventing major illnesses from leaving the county.