Family doctor contracted services are here. Have you signed up?
Original title: "Family doctors" are here!
Full coverage of the family doctor contracted service system to be basically achieved by 2020
Chen Jun (right), a family doctor at the Pengpu Xincun Subdistrict Community Health Service Center in Jing'an District, Shanghai, instructs community residents on daily medication. Photo by Xinhua News Agency reporter Pei Xin
The guiding opinions on advancing family doctor contracted services, jointly formulated by six departments including the State Council Medical Reform Office and the National Health and Family Planning Commission, were officially released on the 6th. The guiding opinions propose that by 2020, efforts should be made to expand family doctor contracted services to the entire population, form long-term and stable contractual service relationships with residents, and basically achieve full coverage of the family doctor contracted service system.
The guiding opinions propose that in 2016, family doctor contracted services will be carried out in 200 pilot cities for comprehensive public hospital reform, and other areas with the capacity will be encouraged to actively carry out pilots. By 2017, the coverage rate of family doctor contracted services should reach more than 30 percent, and the coverage rate of contracted services for key populations should reach more than 60 percent.
At the current stage, family doctors mainly include registered general practitioners at primary-level medical and health institutions, as well as capable township health center physicians and village doctors. Family doctor teams provide residents with basic medical care, public health and agreed health management services. Basic medical services cover traditional Chinese and Western medicine diagnosis and treatment of common and frequently occurring diseases, rational medication use, guidance on medical treatment pathways, and referral appointments.
What should you know about family doctor contracted services?
What is a family doctor?
Family doctors mainly undertake integrated services at the primary level, including preventive health care, diagnosis and treatment of common and frequently occurring diseases and referrals, patient rehabilitation and chronic disease management, and health management. Family doctors are people-centered, take the family as the unit, and orient themselves toward maintaining and promoting overall health. They provide long-term contracted care and integrate individual and population health care. High-quality family doctor contracted services can make family doctors the gatekeepers of residents' health, the gatekeepers of medical costs, and the gatekeepers of humanistic care.
How do family doctors provide services?
In principle, family doctor contracted services should take the form of team services, mainly composed of family doctors, community nurses, public health physicians (including assistant public health physicians) and others, with physicians from hospitals at or above the secondary level (including physicians in the traditional Chinese medicine category) providing technical support and professional guidance. Areas with the capacity may also absorb pharmacists, health managers, psychological counselors, social workers (volunteers) and others into the teams to jointly provide high-quality services to contracted residents.
Where does the contracted service fee come from?
Family doctor teams collect contracted service fees annually according to the number of contracted service recipients, shared jointly through methods such as the medical insurance fund, basic public health service funds and payments by contracted residents. The specific standards and sharing ratios are determined through consultation by local departments of health and family planning, human resources and social security, finance, and pricing according to factors such as the content of contracted services, the structure of contracted residents, and the capacity of the basic medical insurance fund and public health funds to bear the costs.
What goals should contracted services achieve?
According to the guiding opinions, in 2016, family doctor contracted services will be carried out in 200 pilot cities for comprehensive public hospital reform. Priority will be given to covering groups such as the elderly, pregnant and postpartum women, children, and people with disabilities, as well as patients with chronic diseases such as hypertension, diabetes and tuberculosis, and patients with severe mental disorders. By 2017, the coverage rate of family doctor contracted services should reach more than 30 percent, and the coverage rate of contracted services for key populations should reach more than 60 percent. By 2020, full coverage of the family doctor contracted service system should be basically achieved.
What services and benefits can ordinary people receive?
1. Medical treatment
Family doctor teams will, according to the agreement, provide contracted residents with whole-process services, door-to-door services, off-hour services, appointment services and others.
2. Referrals
Family doctor teams will have a certain proportion of resources such as hospital expert appointments, appointment registration, and reserved beds, making it convenient for contracted residents to receive priority medical treatment and hospitalization.
3. Medication
For contracted patients with chronic diseases, family doctors may, as appropriate, extend the amount of medication dispensed at one time, reducing the frequency of patients traveling back and forth to have prescriptions filled.
4. Medical insurance
Differentiated medical insurance payment policies will be implemented for contracted residents; for example, contracted residents receiving treatment at the primary level will receive a higher proportion of medical insurance reimbursement.
(Xinhua News Agency, Beijing, June 6 dispatch, reporter Hu Hao)