国务院近日公布的《卫生事业发展“十二五”规划》提出，“使90%的常见病、多发病、危急重症和部分疑难复杂疾病的诊治、康复能够在县域内基本解决”；此前，《关于县级公立医院综合改革试点的意见》也曾提出，“力争使县域内就诊率提高到90%左右，基本实现大病不出县”。

The state council released recently[Health development"1025"planning]Put forward,"Make 90% of the common diseases/Frequently encountered disease/For emergency and severe cases and some difficult complex diseases, clinical diagnosis and treatment/Rehabilitation can be solved in the county";after,[At or above the county level about public hospital comprehensive reform pilot opinion]Was also put forward,"Strive to make in the county JiuZhenLv increased to 90%,The basic realization of a serious illness county".

　　“大病不出县”——我国中心城市大医院人满为患，基层群众看病不惜千里奔波的局面或将改观？两个文件连续传递的这一信号，无疑是缓解“看病难、看病贵”问题的福音。

"Serious illness a county"In China, central city of big hospital packed,The masses at miles to see a doctor the situation or will change?Two files continuous transmission of the signal,Is undoubtedly ease"See a doctor difficult/The doctor your"The Gospel of the problem.

　　“大病不出县”将如何实现？新华社记者专访了卫生部副部长马晓伟。

"Serious illness a county"Will how to realize?The xinhua news agency reporter the interview, vice minister of health MaXiaoWei.

　　问：提出“大病不出县”目标有何背景？实现这一目标有无具体时间表？

ask:Put forward"Serious illness a county"What is the background of the target?The realization of this goal for timetable?

　　答：“大病不出县”目标的提出，是切实解决农村群众“看病难、看病贵”问题的必然要求，是我国县域医疗服务能力持续提升的必然结果。

a:"Serious illness a county"The proposing of the goal of,Is solve the rural masses"See a doctor difficult/The doctor your"The inevitable demand of the problem,Is the county medical service ability the inevitable result of continued ascension.

　　实现“大病不出县”，也是三级医疗服务体系落实功能定位的重要体现。有助于城市医院缓解诊疗压力，将更多精力放在疑难重症诊治上；也利于提升医疗服务体系整体绩效，控制医药费用。

realize"Serious illness a county",Also level 3 medical service system implement the important embodiment of function orientation.Help city hospital ease pressure diagnosis and treatment,Will be more focused on the complicated severe diagnosis and treatment;Also conducive to improve medical service system overall performance,Control medical expenses.

　　当前，在我国城乡经济社会发展水平仍存在一定差距、新型农村合作医疗保障水平还不高的背景下，农民一旦进城看病，就会背负沉重的医药费用负担，甚至导致因病致贫、因病返贫等问题。切实缓解群众就医负担，就必须让农村群众能在县域内解决看病就医问题。

The current,In our country's urban and rural economic and social development level there still exists certain gaps/The new rural cooperative medical security level is not high background,Farmers once into the city to see a doctor,Can bear a heavy burden of medical expenses,Even lead to become financially-difficult/Problems such as poverty due to illness.To alleviate the burden of a doctor,We must let the rural county in solving problems in hospital.

　　从各地实践来看，无论是经济发达、医疗资源丰富的东部沿海地区，还是中西部较为贫困的地区，都有不少县已经将县域内就诊率提高到90%以上。这提示我们：只要改革方向正确、措施得当、实施有力，就可以实现改革的目标。

From all around to practice,Whether the economy developed/Medical resources rich eastern coastal areas,Or the Midwest poorer areas,There are many county has in the county JiuZhenLv raises 90% above.This suggests that we:So long as the reforms in the right direction/Proper measures/Implementation strong,Can realize the goal of reform.

　　与此同时，我们也要认识到，实现“大病不出县”的目标是一个动态过程。特别是随着生活水平的提升和疾病谱的变化，人民群众的医疗服务需求呈现出多样化的特点。县域医疗服务能力建设要以群众需求为导向，不断提高质量、提升水平，才能满足群众需求。

meanwhile,We also want to realize,realize"Serious illness a county"Goal is a dynamic process.Especially with the life level of ascension and the change of disease,People's medical service demand presents the characteristics of diversification.County medical service ability construction to the masses demand as the guide,Continue to improve quality/Level of ascension,To satisfy the masses demand.

　　问：我国县域内医疗机构为何留不住患者？这反映出哪些深层次问题？

ask:Our country in the county medical institutions why cannot keep patients?This reflects what deep problems?

　　答：优质医疗资源总量不足和配置不均衡，医疗服务供需矛盾突出，是导致人民群众“看病贵、看病难”的一个重要原因。虽然我国每千人口执业(助理)医师数达到1.82人，但其中本科及以上学历的不足一半。特别是农村和基层卫生人才严重短缺，难以满足人民群众日益增长的医疗卫生服务需求。缺少合格的医务人员，就难以提供优质的医疗服务，医疗机构因此留不住患者。

a:High quality medical resources quantity is not enough and configuration is not balanced,Medical service outstanding contradiction between supply and demand,Is lead to the people"The doctor your/See a doctor difficult"One of the important reasons.Although our country's per thousand population practice(assistant)Doctor number 1.82 people,But the bachelor degree or above in less than half of the.Especially in rural and grassroots health serious shortage of talents,Difficult to satisfy the people's growing medical and health services demand.The lack of qualified medical personnel,It will be difficult to provide the high quality medical service,Medical institutions so cannot keep patients.

　　让群众信任基层医疗卫生机构，根子在于让群众信任基层医生。人才瓶颈是实现“大病不出县”目标的关键障碍。特别是在我国城乡经济社会发展水平还存在一定差距的背景下，使得大批受过多年专业培训的医务人员长期在基层服务，仍存在一定困难。事实上，这也是包括发达国家在内的很多国家在解决农村医疗问题时都面临的一个重要问题。

Let people trust basic medical and health institutions,Source is to make people trust grassroots doctors.Talent is the realization of bottleneck"Serious illness a county"Target the key obstacles.Especially in our country urban and rural economic and social development level still exists a certain gap between the background,Make a large number of trained many years of professional training of medical personnel in basic-level service for a long time,There still exists certain difficulties.In fact,It is also including the developed countries, many countries in solving rural medical problems are facing an important problem.

　　问：下一步将如何解决人才短缺等困难，实现“大病不出县”的目标？

ask:The next step will be how to solve the talent shortage difficult,realize"Serious illness a county"goal?

　　答：为了解决这一问题，我们从2005年开始启动了“万名医师支援农村卫生工程”，使城市医务人员动态化地加入农村医疗服务队伍，促进优质医疗服务伴随城市医务人员的流动向基层下沉；同时，通过城市医务人员在县级医院手把手地带教，提高县级医院服务能力。

a:In order to solve this problem,We begin from 2005 launched"Physicians support rural health project",Make the city medical personnel to join dynamic rural medical service team,To promote the quality of medical service with city medical personnel flow to grassroots sink;At the same time,Through the city medical staff at or above the county level in the hospital hand-on zone to teach,To improve hospital service ability at or above the county level.

　　今后，我们将进一步采取“输血”与“造血”并举的方针。一方面，通过开展城乡对口支援，使城市大医院医务人员长期在县级医院工作，让群众不出县域便能接受城市大医院的医生服务。同时，我们设立特岗，为有志于在县级医院长期工作的医务人员提供支持；另一方面，通过建立健全住院医师规范化培训制度和全科医生制度，实行县级医院骨干医师培训，提升县级医院医务人员的服务能力，促进医疗服务的有效提供。

In the future,We will take further"Blood transfusion"and"hematopoietic"And policy.On the one hand,Through the development of urban and rural support,Make the city big hospital medical staff at or above the county level for a long time in hospital,Let the masses a county can accept big city hospital doctor service.At the same time,We set up special duty,For interested in at or above the county level in the hospital the long-term work of the medical personnel to provide support;On the other hand,Through the establish and perfect the resident standardization training system and general practitioners system,A hospital backbone physician training at or above the county level,At or above the county level shall improve hospital medical staff service ability,To improve medical services to provide effective.

　　问：实现“大病不出县”的改革目标，还需提高县级医院技术能力、管理能力和服务能力。在这方面将采取哪些措施？

ask:realize"Serious illness a county"Objectives of the reform of,Still need to improve hospital technology ability at or above the county level/Management ability and service capacity.In this respect what measures will be taken?

　　答：提高县级医院技术水平，要结合疾病谱和县外转诊率情况，有重点地加强县级医院科室能力建设，同时推广与县级医院功能定位相适应的临床路径；提高县级医院管理水平，要在做好“万名医师支援农村卫生工程”的基础上，将业务支援拓展到管理支援，从城市三级医院选聘一批有管理经验的业务骨干，到对口支援的县级医院担任院长、副院长或科主任，提高县级医院管理的规范化水平；提高县级医院服务水平，要开展便民惠民服务，建立以病人为中心的服务模式，优化服务流程，改善服务态度和质量，加强医患沟通。(记者吕诺)

a:To improve the level of hospital technology at or above the county level,According to the disease and county the referral rate condition,A key to strengthen hospital departments at or above the county level capacity building,At the same time at or above the county level promotion and hospital function orientation adapt to the clinical pathway;At or above the county level to improve hospital management level,To do"Physicians support rural health project"Based on,Will business support extended to management support,From the city tertiary hospital hiring a batch of management experience of business backbone,With the support of the hospital at or above the county level as a director/Vice President or section head,At or above the county level to improve the standardization of the hospital management level;To improve hospital service level at or above the county level,To carry out we for the convenience of the service,Establish patient-centered service mode,Optimization service process,To improve service attitude and quality,Strengthen the doctor-patient communication.(Reporter LvNuo)