Gwbf [2020] No. 23

Health committees, civil affairs departments (bureaus) and administration of traditional Chinese medicine of all provinces, autonomous regions, municipalities directly under the central government and Xinjiang production and Construction Corps:

In order to further standardize the signing and cooperation service behavior between medical and health institutions and elderly care service institutions and effectively improve the signing service quality of medical and elderly care, the National Health Commission, the Ministry of civil affairs The State Administration of traditional Chinese medicine has organized and formulated the service guide for signing and cooperation between medical and health institutions and elderly care service institutions (for Trial Implementation) (which can be downloaded from the website of the State Health Commission). It is hereby printed and distributed to you for reference. The health, civil affairs and traditional Chinese medicine administration departments at all levels shall timely guide medical and health institutions to sign and cooperate with elderly care service institutions.

Local health administrative departments can take the lead in formulating the reference text of the signing agreement according to local conditions, and guide local medical and health institutions and elderly care service institutions to standardize the signing and cooperation. Local governments are encouraged to purchase contracted services from medical and health institutions by purchasing services, so as to effectively reduce the operation pressure of elderly care service institutions.

General Office of National Health Commission and general office of Ministry of Civil Affairs

Office of the State Administration of traditional Chinese Medicine

December 11, 2020

(information disclosure form: active disclosure)

Service guide for signing cooperation between medical and health institutions and elderly care service institutions (for Trial Implementation)

In order to implement the notice of the general office of the State Council Transmitting the guiding opinions of the health and Family Planning Commission and other departments on promoting the combination of medical health and elderly care services (GBF [2015] No. 84) and the opinions on further promoting the development of the combination of medical care and elderly care issued by the State Health Commission and other departments In the spirit of (gwysf [2019] No. 60), this guide is formulated to guide medical and health institutions and elderly care service institutions with civil subject qualification (including elderly care institutions and home-based community elderly care service institutions, the same below) to sign and cooperate, and effectively improve the quality of medical and elderly care signing services.

one

Scope of application and service mode

This guide is applicable to the signing and cooperation services of medical and health institutions and elderly care service institutions, including two situations: first, medical and health institutions sign and cooperate with elderly care service institutions without medical and health institutions; Second, medical and health institutions have signed cooperation contracts with pension service institutions that have established medical and health institutions but can not meet the medical and health service needs of the elderly.

Contracted medical and health institutions can regularly or irregularly arrange medical and health personnel to visit, or set up branches or outpatient departments in elderly care service institutions according to needs, and arrange medical and health personnel to reside in elderly care service institutions to provide medical and health services. On the basis of meeting the wishes of both parties, pension institutions can explore to hand over the internal medical and health institutions to the contracted medical and health institutions for management and operation.

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Basic Requirements

（1） Institutional requirements. Medical and health institutions shall have corresponding qualifications and capabilities. Pension institutions shall record. Day care institutions shall register according to law and be included in the comprehensive supervision of pension services.

（2） Personnel requirements. Medical and health personnel in medical and health institutions who provide medical and health services for the elderly in contracted elderly care service institutions shall hold the professional qualification certificate issued by relevant departments, work with certificates in accordance with the requirements of the law of the people's Republic of China on licensed doctors and the regulations on nurses, have good professional ethics and master corresponding knowledge and skills.

（3） Cooperation principle. In cooperation, medical and health institutions and elderly care service institutions should take the principle of "equality, voluntariness and openness", coordinate resources, complement each other's advantages, form a joint force, improve the quality of integrated medical and elderly care services and achieve win-win results.

three

service content

The medical and health services provided by medical and health institutions for the elderly living in contracted elderly care service institutions mainly include: basic public health services, disease diagnosis and treatment services, medical rehabilitation services, medical care services, traditional Chinese medicine services, mental health services, hospice care services, family sickbed services, emergency first aid green channel services, two-way referral services Pharmaceutical management guidance, professional training, guidance on infectious disease prevention and control and nosocomial infection risk control, telemedicine services, etc. Relevant services can be provided according to the type and qualification of medical and health institutions. For example, general hospitals and traditional Chinese medicine hospitals can focus on disease diagnosis and treatment, traditional Chinese medicine services, green channel for emergency first aid, professional training and other services, Rehabilitation hospital (Rehabilitation Medical Center), nursing home (stations, centers) and hospice care centers can focus on providing medical rehabilitation, medical care, hospice care, professional training and other services. Grass roots medical and health institutions can focus on providing basic public health services, disease diagnosis and treatment, traditional Chinese medicine services, family sickbeds, professional training and other services. Medical and health institutions can also carry out double cooperation with qualified elderly care institutions Referral and telemedicine services.

（1） Basic public health services. Grass roots medical and health institutions guide contracted elderly care service institutions to do a good job in health education. Qualified medical and health institutions can carry out health education publicity activities, special health consultation, hold health lectures in contracted elderly care service institutions, and provide guidance on disease prevention, dietary nutrition, mental health, etc. for the elderly living in elderly care service institutions Guide the elderly to establish healthy lifestyles such as reasonable diet, weight control, appropriate exercise, psychological balance, improving sleep, smoking cessation and alcohol restriction, and scientific medical treatment, so as to improve the awareness and ability of self-care of the elderly. For the elderly with risk factors, targeted health education and risk factor intervention were carried out.

The contracted grass-roots medical and health institutions shall be in accordance with the national code for basic public health services (Third Edition) It is required to provide free physical examination and health management services for the eligible elderly aged 65 and above in the contracted elderly care service institutions. For the elderly patients with diagnosed essential hypertension and type 2 diabetes, the corresponding health management of patients with chronic diseases should be carried out. If the elderly care service institutions and other elderly residents need physical examination, they can negotiate and sign contracts with grass-roots medical and health institutions to provide paid services. Provide vaccination health guidance for the elderly in contracted elderly care service institutions, and guide the eligible elderly to receive vaccination services in the local vaccination clinic according to the national and local immunization plan. Where conditions permit, integrated medical and nursing services (twice a year, including blood pressure measurement, peripheral blood glucose detection, rehabilitation guidance, nursing skill guidance, health consultation and nutrition improvement guidance) and health assessment and health services for the elderly aged 65 and above can be provided.

（2） Disease diagnosis and treatment services. Medical and health institutions arrange licensed doctors to provide diagnosis and treatment services for common diseases, frequently occurring diseases and other diseases for the elderly living in contracted elderly care service institutions. Grass roots medical and health institutions provide family doctor contracted services according to the wishes of the elderly, and the service items shall be implemented in accordance with the service agreement. They provide long-term prescription services for elderly patients with chronic diseases.

（3） Medical rehabilitation services. Qualified medical and health institutions can arrange professional rehabilitation doctors to provide professional medical rehabilitation services and rehabilitation skills guidance for the elderly who need rehabilitation in the contracted elderly care service institutions.

（4） Medical and nursing services. Medical and health institutions can arrange medical personnel to provide pipeline care, pressure ulcer management and other professional medical and nursing services for the elderly in need of contracted elderly care service institutions. Qualified medical and health institutions can carry out elderly care needs assessment, and provide services for the elderly in need according to the health status and nursing needs assessment results of the elderly For targeted medical care services.

（5） Chinese medicine service. Medical and health institutions with Chinese medicine service qualification and ability provide Chinese medicine diagnosis and treatment, Chinese medicine rehabilitation, Chinese medicine health status identification and evaluation, consultation and guidance, health management and other services for the elderly living in the contracted elderly care service institutions. They can provide Chinese medicine skill guidance for the staff of the contracted elderly care service institutions according to the signed agreements and promote them in the elderly care service institutions Widely popularize TCM health care knowledge and easy to master TCM Massage, application, scraping, cupping, TCM health exercises and other TCM health care technologies and methods.

（6） Mental health services. Qualified medical and health institutions can arrange mental health professionals to provide mental health or mental health-related services for the elderly in need in the contracted elderly care service institutions. According to the psychological characteristics, cognitive function and psychological support needs of the elderly, they can provide professional disease diagnosis and treatment, emotion regulation, psychological support, crisis intervention and communication Personalized services such as streaming communication.

（7） Hospice care services. Qualified medical and health institutions can arrange professional medical and health personnel to provide symptom control, comfort care, psychological support and humanistic care for the elderly at the end of life in the contracted elderly care service institutions, and guide the contracted elderly care service institutions to provide psychological care services such as emotional counseling and grief counseling for the family members of the elderly at the end of life.

（8） Family sickbed service. Under the guidance and regulations of the local health administrative department, medical and health institutions can set up family sickbeds in contracted elderly care service institutions to provide necessary bed examination, nursing, consultation and referral services for the elderly with clear diagnosis, stable condition and meeting the conditions for bed establishment.

（9） Emergency first aid green channel service. Medical and health institutions, especially secondary and above medical and health institutions, provide emergency first aid green channels for the elderly in need in the contracted elderly care service institutions, focusing on providing corresponding services for patients with acute and critical diseases. If necessary, transfer patients with acute and critical diseases to the contracted medical and health institutions or superior medical and health institutions for emergency treatment.

（10） Two way referral service. For elderly care institutions with internal medical and health institutions, the contracted medical and health institutions may establish a two-way referral mechanism with qualified elderly care institutions. Referral shall provide continuous and whole process medical and health services for the elderly in strict accordance with the admission and exit standards and two-way referral indications of medical and health institutions.

（11） Pharmaceutical management guidance. Qualified medical and health institutions can provide pharmaceutical management guidance for contracted elderly care service institutions, including daily drug dispensing, storage, quality management, etc., and provide guidance on rational drug use for the elderly in elderly care service institutions.

（12） Professional training. Qualified medical and health institutions can regularly organize the medical personnel of the medical and health institutions in the contracted elderly care institutions to participate in continuing medical education; if they have the ability and corresponding conditions, they can organize special training on medical and health professional knowledge and skills such as emergency rescue for the staff of the contracted elderly care service institutions.

（13） Guidance on infectious disease prevention and control and nosocomial infection risk prevention and control. Qualified medical and health institutions can guide contracted elderly care service institutions to strictly implement relevant management systems and operation specifications, assist in the standardized disposal of medical waste of medical institutions in elderly care institutions, improve their awareness and ability of infectious disease prevention and control and nosocomial infection risk prevention and control, and guide them to strengthen the prevention and control of nosocomial infection Control work, and do a good job in infectious disease prevention and control, epidemic situation monitoring and information reporting.

（14） Telemedicine services. If the corresponding conditions are met, the contracted medical and health institutions can carry out telemedicine services for the medical and health institutions in the elderly care institutions.

The annex is the recommended items of agreed medical and health services provided by medical and health institutions to elderly care service institutions. Each medical and health institution and elderly care service institution can select and negotiate the specific service items according to the actual situation.

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Responsibilities of both parties

（1） Responsibilities of medical and health institutions. Medical and health institutions provide corresponding medical and health services for the elderly living in the contracted elderly care service institutions according to the signed agreement, and complete the door-to-door visit to the contracted elderly care service institutions, the filing of practice places of medical and health personnel in multiple institutions, and the declaration and payment of medical liability insurance for medical and health personnel in accordance with relevant regulations In case of any change in service content and frequency, it shall coordinate and communicate with the elderly care service institution in advance.

（2） Responsibilities of elderly care service institutions. Elderly care service institutions shall provide necessary places, facilities and equipment and other service conditions to contracted medical and health institutions according to the signed agreement, receive guidance and training, implement the requirements of contracted medical and health institutions on health education, disease prevention, rehabilitation nursing, hospital sense management, epidemic prevention and control for the elderly, and provide services to contracted medical and health institutions Information related to the health of the elderly, explain the cooperation with contracted medical and health institutions to the elderly, timely transfer the elderly to medical and health institutions for treatment when they are in critical condition and need rescue treatment, and contact their relatives; Maintain the human dignity and personal safety of the medical and health personnel of the contracted medical and health institutions during their practice activities; Assist the elderly in handling medical insurance transfer and other relevant procedures.

In case of medical damage or dispute during diagnosis and treatment, the contracted elderly care service institution shall assist the contracted medical and health institution to negotiate and communicate with the elderly and their relatives for settlement. If it cannot be settled through negotiation, the medical and health institution shall deal with it in accordance with relevant laws and regulations.

five

Cooperation funds

（1） The medical expenses incurred by medical and health institutions in providing medical and health services to the elderly in contracted elderly care service institutions. If they are designated institutions of medical insurance, the individual payment shall be paid by the elderly themselves after being paid in accordance with the provisions of medical insurance. The medical expenses of the extremely poor are still insufficient after being paid in accordance with the provisions of medical security systems such as basic medical insurance, serious illness insurance and medical assistance , supported by relief and support funds.

（2） If the basic public health services provided by grass-roots medical and health institutions for the elderly in the contracted elderly care service institutions meet the provisions of the national basic public health service projects, the local health administrative department shall allocate funds to the contracted grass-roots medical and health institutions in accordance with the provisions; the rest shall be determined by both parties through consultation.

（3） Elderly care service institutions and contracted medical and health institutions can negotiate and determine the service cooperation funds and specify the service cooperation funds according to the local economic development level, the scale of contracted cooperative elderly care service institutions, the health status of the elderly, the workload of medical and health services, the professional title of medical and health personnel and the distance between institutions, and the facilities and equipment support provided by elderly care service institutions Contents, quality, requirements, etc. The salary payment method of medical and health personnel stationed in contracted elderly care service institutions for a long time shall be determined by both parties through negotiation.

（4） Public medical and health institutions may charge the cooperation fees of contracted elderly care service institutions according to relevant regulations. For public medical and health institutions that provide counterpart cooperation determined by the government and its relevant competent departments, it shall ensure the normal professional and Technical Title Evaluation and reasonable remuneration of medical and health personnel stationed in contracted elderly care service institutions for a long time.

（5） Medical and health institutions shall list the received medical and health service cooperation funds for audit management, and accept inspection and supervision according to law.

six

Signing and performance of service agreement

（1） Elderly care service institutions shall scientifically and reasonably determine the medical and health institutions that intend to sign contracts in accordance with the principles of convenience nearby and matching demand services, and determine the medical and health service cooperation contents and cooperation funds through consultation and agreement between both parties. Elderly care service institutions are encouraged to give priority to signing contracts with surrounding grass-roots medical and health institutions and rehabilitation, nursing, hospice and other continuing medical institutions 。

（2） The term of cooperation between medical and health institutions and elderly care service institutions shall be agreed by both parties themselves. After the expiration of the term, the agreement shall be renewed or stopped in writing according to the cooperation situation. The renewal of the agreement shall be given priority if the cooperation is normal. The content of the agreement can be adjusted according to the actual situation during renewal.

（3） After signing the agreement between the medical and health institutions and the elderly care service institutions, the contracting parties shall establish a communication and cooperation mechanism to timely study and solve relevant cooperation matters.

（4） Within one month after signing the agreement between the signed medical and health institutions and the elderly care service institutions, the local county-level health administration department and civil affairs department shall be informed in time.

seven

Dispute resolution

When signing an agreement between a medical and health institution and an elderly care service institution, it shall clarify the disposal responsibilities of both parties after a dispute. Any dispute arising from the performance of the agreement shall be settled by both parties through negotiation in accordance with the existing legal provisions. If both parties fail to reach an agreement through consultation, they may bring a lawsuit to the people's court with jurisdiction in the place where they are located.

eight

Confidentiality clause

（1） The contracted medical and health institutions and elderly care service institutions shall keep confidential the other party's relevant business information and technology learned during the performance of the signed agreement