Notice on Issuing the Health Service Plan for Key Coronavirus Populations
Guowei Mingdian [2022] No. 509
All provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps responding to Novel Coronavirus Pneumonia Epidemic Joint Prevention and Control Mechanism (Leading Group, Command Center), and the State Council’s Joint Prevention and Control Mechanism for the New Coronavirus Pneumonia Epidemic Member Units:
In accordance with the relevant requirements for further optimizing and implementing the prevention and control measures for the new coronavirus pneumonia epidemic, in order to do a good job in health services for key populations of New Coronavirus and protecting the lives and health of the people, the Comprehensive Group of the Joint Prevention and Control Mechanism for the New Coronavirus Pneumonia Epidemic has studied and formulated the "Health Service Plan for Key Coronavirus Populations". It is now issued to you, please conscientiously implement it in light of the actual situation.
The State Council responds to the novel coronavirus pneumonia
Comprehensive group of the joint prevention and control mechanism of the epidemic
December 9, 2022
(Information disclosure form: active disclosure)
Work plan for health services for key populations of the new crown
According to the "Notice on Carrying out Health Survey of Key Populations of the New Coronavirus" (Guowei Mingdian [2022] No. 487), the elderly (65 years old and above, the same below) are vaccinated with basic diseases and their new crown virus vaccine . This plan is now formulated for providing health services for registered key groups.
1. Clarify the principles of carrying out health services
adheres to the principles of classification and grading and highlighting key points. It is divided into three categories according to the underlying disease, the vaccination status of the new coronavirus, and the risk level after infection: key groups (high risk), subkey groups (medium risk), and general groups (low risk). They are marked with red, yellow and green respectively. The colors are different and the service content is different.
2. Carry out classified and grading services
(one) level one service.
1.Serve the crowd. General population (low risk, green mark).
2. Service content.
(1) Community (village) is responsible for mobilizing and promoting it. For those who have not completed strengthening immunization of and meet the vaccination conditions after evaluation by the doctor, they will be guided to be vaccinated as soon as possible.
(2) Give full play to the role of street (township), community residents (village) committees, their public health committees, grassroots medical and health institutions, and family doctors, strengthen health education, advocate a healthy lifestyle, and do a good job in personal health protection.
(3) provides consulting services related to COVID-19. The community (village) promotes the current COVID-19 prevention and control policies through small speakers, a letter, WeChat, text messages, APPs, etc., and notifies each key group of families of key groups of people.
(two) secondary service.
1.Serve the crowd. Sub-key population (medium risk, yellow mark).
2. Service content. Carry out secondary services on the basis of first-level services.
(1) Asymptomatic or mildly symptomatic infected persons treated at home will actively report to the community (village) and contact the primary medical and health institutions in the jurisdiction. The primary medical and health institutions will guide antigen testing and health monitoring through the Internet, video, telephone, remote or offline methods based on actual conditions, and provide health consultation , medication guidance, etc. After evaluation, wearable health monitoring equipment, finger clip pulse oximeters, etc. are provided to infected people in need, and health monitoring will be carried out. If there is continuous high fever, difficulty breathing, and 93% finger oxygen saturation, referral as soon as possible. Grassroots medical and health institutions can follow up once every 3 days, and the follow-up frequency can be encrypted as needed until the home treatment observation is over.
(2) Community (village) assists in implementing the management of infected people at home treatment, guides and assists in seeking medical treatment if you need regular medical treatment, and assists in providing services such as purchasing and delivering medicines.
(three) level 3 service.
1.Serve the crowd.
(1) Focus group (high risk, red mark).
(2) Key groups with urgent medical needs.
(3) Other groups of infants, pregnant women and other people with urgent medical needs.
2. Service content. Carry out third-level services based on secondary services.
(1) Disabled elderly people or elderly people infected with mobility insecurity will determine the treatment method after evaluation by the expert team or superior hospital determined by the county (city, district) health department or the superior hospital. For those who can stay at home after evaluation, under the guidance of the superior hospital, primary medical and health institutions provide necessary services such as health consultation, health guidance, health monitoring, and antigen testing. If the evaluation is not suitable for home use, the primary medical and health institutions will provide guidance and assistance in referral.
(2) Key populations (high risk, red mark) infected people and people with emergency medical needs, communities (villages) and primary medical and health institutions assist in referrals, and those with emergency medical needs can also go through the emergency department.
3. Strengthen organizational guarantee
(I) Clarify the division of responsibilities. The joint prevention and control mechanisms of various localities take the lead in taking the lead, and relevant departments implement them separately according to their responsibilities. Taking the municipal level as the unit, the health and health department will determine designated (sub-designated) medical institutions, form superior institutions and professional teams that provide technical support to primary medical and health institutions, guide medical and health institutions to provide health management and medical treatment for key groups according to the division of labor, and strengthen training on classified and graded services for each relevant institution. The civil affairs department is responsible for guiding nursing homes, child welfare institutions and other key places to strengthen management, mobilize communities (villages) to provide key population management services under the unified leadership of the local epidemic prevention and control mechanism, and guides residents' committees to cooperate with grassroots medical and health institutions to provide drugs, antigen testing, contact superior hospitals, etc. around the elderly and other high-risk groups. Relevant departments should implement funding guarantees for key population surveys, tiered health services and necessary equipment.
(II) Strengthen the reserve of drug and antigen detection kits for primary medical and health institutions. All localities should increase supply guarantee efforts to ensure that primary medical and health institutions dynamically reserve Chinese medicine, antipyretic and cough-relieving drugs, antigen detection reagents, etc., based on the list of traditional Chinese medicines recommended by the state and the province, and dynamically reserve Chinese medicines, antipyretic and cough-relieving drugs, and antigen detection reagents, based on the list of traditional Chinese medicines recommended by the state and the province. The densely populated areas can increase them as appropriate. County-level health and health departments should organize pharmacists to provide patients with drug use guidance such as taboos, compatibility, precautions, etc. for drug use.
(III) Improve the service level of primary medical and health institutions.
First, strengthen the equipment and upgrade and transformation of primary medical and health institutions. Accelerate the construction of fever clinics (outpatient clinics) in township health centers and community health service centers, and strive to increase the coverage rate to about 90% by the end of March 2023. Improve equipment configuration, including oxygen therapy equipment, portable lung function instruments, finger clip pulse oximeters, wearable health monitoring equipment, etc.; upgrade the electronic health record information system, and encourage qualified equipment of smart health stations for densely populated communities or remote villages.
The second is to effectively increase the manpower of primary medical and health institutions. It is necessary to establish a system for doctors from relevant departments of in urban second and third-level hospitals to visit the grassroots level. The leading hospitals of medical alliance (urban medical group or county medical community , the same below) should send doctors to the grassroots level. According to the increase in the number of people and services, the staffing of primary medical and health institutions can be strengthened in a timely manner. Retired medical personnel within the past five years and health professionals in other positions can be temporarily rehired to primary medical and health institutions. Township health centers and community health service centers are allowed to hire personnel or entrust non-medical and health services to them through third-party services. It is necessary to establish and improve a telemedicine service network, and extend the high-quality medical services of second- and third-level hospitals to the grassroots level through telemedicine.
The third is to implement family doctor contract services for key groups. Accelerate the coverage of contract services for the elderly over 65 years old, achieve full coverage of contract services for the elderly with underlying diseases, and do a good job in health management and health monitoring in accordance with the principles of classification and grading. Strengthen the contact between family doctors and contracted elderly people to ensure that when they have medical needs, they or their families can contact the family doctor in a timely manner.
(IV) Implement the management responsibilities of communities (villages) for key groups. Give full play to the active role of grassroots governments, residential (village) committees and their public health committees, and assist in daily publicity, education and services for key groups.Establish a direct hotline between communities (villages) and medical institutions and pharmacies. Cities use streets, rural areas and townships to configure or update medical vehicles to guide and assist in referrals.
(V) Strengthen the health management of key populations in rural areas. All localities should strengthen guidance, support and dispatch on health surveys and management of key populations in rural areas. Determined (sub-determined) medical institutions are determined based on the municipal level, and the process and path for referrals to designated medical institutions in are clarified. The county-level medical community leads the hospital to provide necessary support for the provision of manpower, technology, equipment and other services for township health centers and village health centers in the jurisdiction. The villagers' committee and its public health committee will coordinate and coordinate with the village clinic, mobilize social organizations, social workers, , volunteers, and social charitable resources to assist in purchasing and delivering medicines, assisting in medical referrals, etc.; guide villagers to improve their personal health awareness and take good self-protection.
(VI) Strengthen the management of key institutions such as nursing homes and child welfare institutions. All localities should guide nursing homes and child welfare institutions to formulate in-hospital classification and grading service plans in accordance with this plan, establish a collaboration mechanism with medical and health institutions and pharmacies in the jurisdiction, and clarify the referral process. Medical staff of nursing homes and child welfare institutions that have medical institutions or have established cooperative relationships with them to provide classified and grading services to key personnel. Nursing homes and children's welfare institutions should dynamically reserve Chinese medicine, antipyretic and cough-relieving drugs, and antigen detection reagents.
(VII) Play the role of medical alliance. Actively play the role of medical alliance medical community leading hospitals and strengthen technical guidance on the construction and operation of fever clinics (outpatient clinics) of its member units. Coordinate the allocation of personnel within the medical alliance, and dispatch professional forces to guide and support the daily diagnosis and treatment of fever clinics (outpatients) in grassroots medical and health institutions. Open up the two-way referral channel, and make good connections with hierarchical diagnosis and treatment. The leading hospital should form a specialized treatment team composed of relevant departments such as respiratory department, pediatric department, critical care department, traditional Chinese medicine department, etc. to strengthen technical support, training, guidance and quality control at the grassroots level.
(8) Encourage social forces to participate. Coordinate the forces of all parties, encourage and guide social forces to participate in the guarantee of grassroots medical services, strengthen medical service resources, and meet the needs of the people's medical and health service.
Source: National Health Commission website editor: Li Qian
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