看病不用出远门 “家门口的医改”如何进行？

Core Viewpoint - The article highlights the successful implementation of a tightly-knit county medical community reform in Jinzhai County, Anhui Province, which transformed healthcare access from "difficult to see a doctor" to "medical care at the doorstep" through significant upgrades in local medical facilities and resources [1][7][10]. Group 1: Medical Reform Implementation - Jinzhai County was one of the first regions in China to implement county-level medical community reforms, addressing the issue of patient outflow and significant healthcare fund losses [1][24]. - The reform began in 2019, with the establishment of medical centers and the upgrading of local health facilities, allowing previously limited services to expand significantly [7][10]. - The county's health commission reported a decrease of over 10% in outpatient and inpatient volumes at the leading hospital, while grassroots treatment volumes increased by over 20% [14]. Group 2: Financial Management and Resource Allocation - Before the reform, the hospitalization rate within the county was 68.32%, with only 45% of the medical insurance funds utilized locally, leading to a significant outflow of funds [24]. - Post-reform, the hospitalization rate rose to 82%, and the local utilization of medical insurance funds increased to 71.32% [24]. - The county managed to turn around a previous deficit of nearly 80 million yuan in the medical insurance fund to a surplus of 33.16 million yuan by 2024, allowing for the hiring of external experts and improving local healthcare services [26]. Group 3: Talent Development and Retention - The establishment of the county medical community led to the creation of 221 standardized village health clinics and financial support for village doctors, enhancing their income and job security [34]. - A recruitment mechanism was implemented to attract and retain local medical talent, including free training programs for medical students from the county [34][36]. - The reforms have encouraged former village doctors to return to their positions, improving local healthcare delivery and community trust [28][34].