Recently, the official website of the Health Commission issued the notice on the issuance of opinions on strengthening and improving anesthesia medical services, which brought a series of good news to anesthesiologists.

Increase the number of anesthesiologists

According to the 2017 China Health and Family Planning Statistical Yearbook, there were about 76600 anesthesiologists practicing (assistant) in China in 2016, with only 0.5 anesthesiologists per 10,000 people, compared with 2.5 in the United States and 2.8 in the United Kingdom.

According to European and American standards, the gap between Chinese anesthesiologists is about 300000-even larger than that of pediatric 200000 with the same serious gap. However, anesthesiologists get far less attention than pediatricians.

In this regard, the notice issued by the Health and Health Commission clearly states that it should adhere to the problem and demand-oriented approach, strengthen the training and team building of anesthesiologists, optimize the structure of anesthesia professionals and technicians, and strive to increase the number of anesthesiologists to 90000 and 0.65 per 10,000 population by 2020. By 2030, the number of anesthesiologists will increase to 140000, with nearly one anesthesiologist per 10,000 population. By 2035, the number of anesthesiologists increased to 160000, and the number of anesthesiologists per 10,000 population reached more than 1 and remained stable. The ratio of anesthesiologists to doctors in surgical departments is more reasonable, the job responsibilities are more clear, and the field of anesthesia and analgesia services is constantly expanding, so that the people can enjoy higher quality and more comfortable medical services.

Improve anesthesia services for surgery and open anesthesia clinics

The notice emphasized that medical institutions should further improve surgical anesthesia services and carry out anesthesia work that is compatible with day surgery. We should actively promote the treatment of acute pain in perioperative period, strengthen postoperative monitoring and analgesia, and accelerate the process of postoperative rehabilitation. Conditional medical institutions can set up anesthesiology outpatient clinics and intensive care units for post-anesthesia patients. Anesthesiology outpatient clinics carry out inpatient surgery, day surgery, anesthesia assessment, appointment, and preparation before invasive diagnosis and treatment of outpatient and inpatient operations, and provide services such as surgical risk assessment, preoperative preparation guidance, postoperative follow-up and recovery guidance.

Adjusting the price of anesthesia medical services

The notice made it clear that the relationship between the price of anesthesia medical services should be straightened out. Incorporate the price of anesthesia medical services into the reform of medical service prices for comprehensive consideration, coordinate progress, and gradually establish a dynamic adjustment mechanism based on changes in cost and income structure. According to the severity of the disease, operation time, the particularity of the patient's age, the professional ability of medical personnel to cultivate investment and other factors, the reasonable calculation of the cost of anesthesia, straighten out the price relationship, reflect the value of medical personnel technical labor. Accelerate the approval of new charges for anesthesia medical services. Do a good job of price adjustment, medical insurance payment and medical control fees and other policies to ensure that the overall burden of basic medical expenses for patients does not increase.

Encourage anesthesiologists to practice more

The notice pointed out that the health administrative departments (including the competent departments of traditional Chinese medicine) should strengthen the training and training of anesthesia medical personnel, promote the development of standardized anesthesia medical services, strengthen service supervision, improve medical quality, and ensure medical safety. Guide public hospitals to improve the internal distribution mechanism, encourage anesthesiologists to practice more, and mobilize the enthusiasm of anesthesia medical staff. Education departments should strengthen the training of medical students in anesthesiology. The financial department should implement the investment responsibility and further increase the support for the training and use of anesthesiologists and the construction of anesthesia clinical Junior College. The medical security department and the price supervision department should coordinate the price adjustment and supervision of anesthesia medical services in the reform of medical service prices. The medical security department shall, in accordance with the provisions, include the items of anesthesia medical services that meet the conditions into the scope of payment. Human resources and social security departments should work with relevant departments to accelerate the reform of the salary system in public hospitals.

Notice on Issuing Opinions on Strengthening and Improving Anesthesia Medical Services

Guowei Medical Fa [2018] No. 21

All provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps Health and Family Planning Commission, Development and Reform Commission, Education Department (Bureau), Finance (Affairs) Department (Bureau), Human Resources and Social Security Department (Bureau), Administration of Traditional Chinese Medicine, Fujian Medical Insurance Office:

In order to implement the spirit of the notice of the general office of the State Council on printing and distributing the outline of the national medical and health service system planning (2015-2020) (No.14 [2015] of the State Council), alleviate the shortage of anesthesiologists in China, strengthen the construction of anesthesia talents, and promote the high-quality development of medical services. The National Health Commission, the National Development and Reform Commission, the Ministry of Education, the Ministry of Finance, the Ministry of Human Resources and Social Security, the State Administration of Traditional Chinese Medicine and the National Medical Insurance Administration have formulated the "Opinions on Strengthening and Improving Anesthesia Medical Services" (available from the National Health The official website of the Commission is downloaded), which is now printed and distributed to you, please earnestly implement it.

National Health Commission National Development and Reform Commission

Ministry of Education Ministry of Finance

Ministry of Human Resources and Social Security State Administration of Traditional Chinese Medicine

National Medical Security Bureau

August 8, 2018

(Information disclosure form: active disclosure)

Opinions on Strengthening and Improving Anesthesia Medical Services

Anesthesiology is an important part of clinical medicine, and anesthesiology is an important clinical Junior College that reflects the comprehensive ability of medical institutions. Strengthening and improving anesthesia medical services is an important part of the construction of a healthy China and the development of health services. It is of great significance for improving medical service capabilities, adapting to the growing demand for medical services, and meeting the people's growing needs for a better life. In order to implement the important decisions and deployments of the Party Central Committee and the State Council, alleviate the shortage of anesthesiologists in my country, promote the sustainable and healthy development of the anesthesia talent team, and strengthen and improve anesthesia medical services, the following opinions are hereby put forward.

General requirements and main objectives of the 1.

(I) general requirements. We will thoroughly implement the spirit of the 19th CPC National Congress and the healthy China strategy, adhere to the problem and demand-oriented approach, deepen supply-side structural reform, strengthen the training and team building of anesthesiologists, increase the number of anesthesiologists, and optimize the structure of anesthesia professionals and technicians. Expand the field of anesthesia medical services, innovate and promote analgesia services to meet the new needs of anesthesia medical services. By improving the relevant policies of anesthesia medical services, mobilize the enthusiasm of medical staff, and ensure the quality and safety of anesthesia medical services.

(II) the main objectives. Strive to increase the number of anesthesiologists to 90000 by 2020, and increase the number of anesthesiologists per 10,000 population to 0.65; by 2030, the number of anesthesiologists will increase to 140000, and the number of anesthesiologists per 10,000 population will be close to 1; by 2035, The number of anesthesiologists has increased to 160000, and the number of anesthesiologists per 10,000 population has reached more than 1 and remained stable. The ratio of anesthesiologists to doctors in surgical departments is more reasonable, the job responsibilities are more clear, and the field of anesthesia and analgesia services is constantly expanding, so that the people can enjoy higher quality and more comfortable medical services.

2. Strengthening the Training and Team Building of Anesthesiologists

(III) increase the number of anesthesiologist cultures. Implement the "Opinions of the General Office of the State Council on Deepening the Coordination of Medical Education and Further Promoting the Reform and Development of Medical Education", explore the establishment of a talent supply and demand balance mechanism oriented to the needs of clinical positions, and insist on determining recruitment based on needs and use. Stabilize the enrollment scale of undergraduate major in anesthesiology, strengthen the cultivation of anesthesiology-related knowledge and ability of medical students in the undergraduate education of clinical medicine, and encourage qualified colleges and universities to set up anesthesiology courses separately. Gradually increase the recruitment of standardized training for residents in the Department of Anesthesiology, rationally regulate the recruitment ratio of various specialties, and tilt towards the central and western regions. Focus on the on-the-job anesthesiologists in medical institutions in the central and western regions and below the prefecture level, and strengthen targeted continuing medical education and training.

(IV) optimization of anesthesia professional and technical personnel structure. Additional post settings for anesthesiology nurses, technicians and other auxiliary personnel. The anesthesiology department of medical institutions above the second level is equipped with anesthesiology nurses, who are engaged in perioperative nursing, pain patient management, and anesthesia-related equipment, consumables, drugs, document information sorting and other management work under the guidance of anesthesiologists. Conditional medical institutions can be equipped with anesthesiology technicians, engaged in anesthesia-related equipment maintenance, maintenance and repair.

3. expand the field of anesthesia medical services

(V) optimization of anesthesia related to surgery. Medical institutions should further improve surgical anesthesia services and carry out anesthesia work that is compatible with day surgery. We should actively promote the treatment of acute pain in perioperative period, strengthen postoperative monitoring and analgesia, and accelerate the process of postoperative rehabilitation. Conditional medical institutions can set up anesthesiology outpatient clinics and intensive care units for post-anesthesia patients. Anesthesiology outpatient clinics carry out inpatient surgery, day surgery, anesthesia assessment, appointment, and preparation before invasive diagnosis and treatment of outpatient and inpatient operations, and provide services such as surgical risk assessment, preoperative preparation guidance, postoperative follow-up and recovery guidance.

(VI) strengthen the operation of outdoor anesthesia and analgesia. On the basis of ensuring surgical anesthesia, medical institutions must actively carry out anesthesia and analgesia outside the operating room to continuously meet the people's new needs for comfortable diagnosis and treatment. Give priority to the development of painless gastrointestinal endoscopy, painless fiberoptic bronchoscopy and other diagnosis and treatment operations and labor analgesia, painless rehabilitation of anesthesia, to carry out cancer pain, chronic pain, hospice care and other pain management. Through the medical association, pain management is extended to primary medical and health institutions, and a new model of home pain management is explored. Conditional medical institutions can open pain clinics and provide pain management services.

(VII) strengthen the anesthesiology nursing service. Operating room nursing services by the Department of Anesthesiology unified management. Anesthesiology nurses should strengthen the nursing service for anesthesia patients, cooperate with anesthesiologists to carry out anesthesia education, psychological counseling, information check, position placement, pipeline nursing, patient escort and other work, so as to improve the professional level of anesthesia nursing service.

4. Ensuring the Quality and Safety of Anesthesia Medical Services

(VIII) improve the ability of anesthesia medical services. We will increase the supply of anesthesia resources as the focus of building a high-quality and efficient medical and health service system, and support the construction of anesthesia departments in county-level and prefecture-level medical institutions and regional medical centers. Encourage qualified medical institutions to increase the number of anesthesia-related medical personnel and establish anesthesia professional groups or subspecialties according to the setting of anesthesiology and surgical departments and the demand for painless medical services. Continuously improve the level of first aid services for anesthesiologists, and provide first aid, sedation, analgesia and life support for critically ill patients. Further improve the anesthesia-related content in clinical pathways and diagnosis and treatment guidelines, formulate anesthesia technical operation specifications, and focus on enhancing the anesthesia medical service capabilities of difficult and critical patients. Improve the information level of anesthesia management and improve the overall efficiency of medical services.

(IX) strengthen the quality and safety management of anesthesia care. Strengthen the quality control of anesthesia medical care, improve the quality control indicators of anesthesia medical care, apply information technology to strengthen the collection, analysis and feedback of anesthesia information, and continuously improve the quality of anesthesia medical care. Strengthen the construction of anesthesiology medical quality control centers at the provincial, prefectural and municipal levels, improve the organizational structure of the quality control system, and strengthen the training of anesthesia professional quality control talents. Medical institutions should strengthen the medical quality management of anesthesiology, anesthesia clinics, and pain clinics, improve work systems and technical specifications, optimize service processes, and ensure patient safety.

5. Improve the Enthusiasm of Anesthesia Medical Staff

(X) rationalize the price-to-price relationship of anesthesia medical services. Incorporate the price of anesthesia medical services into the reform of medical service prices for comprehensive consideration, coordinate progress, and gradually establish a dynamic adjustment mechanism based on changes in cost and income structure. According to the severity of the disease, operation time, the particularity of the patient's age, the professional ability of medical personnel to cultivate investment and other factors, the reasonable calculation of the cost of anesthesia, straighten out the price relationship, reflect the value of medical personnel technical labor. Accelerate the approval of new charges for anesthesia medical services. Do a good job of price adjustment, medical insurance payment and medical control fees and other policies to ensure that the overall burden of basic medical expenses for patients does not increase.

(11) Adjust the ratio of human resources in medical institutions. Accelerate the establishment of a modern hospital management system, implement the autonomy of hospital employment, and realize the establishment of posts and management according to needs. Reasonably adjust the ratio of human resources in medical institutions, so that the proportion of anesthesiologists and surgical doctors can reach a reasonable range, scientifically adjust the workload of anesthesiologists, and ensure medical safety. The proportion of anesthesiologists and surgical department physicians in tertiary general hospitals gradually reached 1:3. Level II and below general hospitals can reasonably determine the proportion according to the diagnosis and treatment, but not less than 1:5. Junior College hospital according to the need to determine a reasonable proportion. When recruiting anesthesiologists, medical institutions should strengthen the qualified requirements for standardized training of anesthesiology residents, and dilute the requirements for academic qualifications and papers.

(12) Enhancing the occupational attractiveness of anesthesia medical staff. In the post employment, evaluation and evaluation, performance evaluation and income distribution of medical institutions, we should fully consider the characteristics of anesthesia work and the value of technical labor, and incline to the medical staff of Anesthesiology Department. Provide good living and working conditions for anesthesia medical staff, relieve the pressure of anesthesia medical staff, and fully mobilize the enthusiasm of anesthesia medical staff to expand service areas.

Six, do a good job in the organization and implementation of anesthesia medical services

(xiii) Strengthening organizational leadership. All regions and relevant departments should attach great importance to strengthening and improving anesthesia medical services, incorporate them into the overall deployment of key tasks for the construction of a healthy China and the deepening of medical reform, strengthen organizational leadership and policy coordination, close collaboration and cooperation, strengthen the implementation of responsibilities, and improve supporting measures, Coordinate and advance. By the end of November 2018, all localities should formulate anesthesiologist training plans and specific implementation plans for strengthening anesthesia medical and health services to ensure the effectiveness of various policies and measures.

(14) Strengthen departmental collaboration. The health administrative department (including the competent department of traditional Chinese medicine) should strengthen the training and training of anesthesia medical personnel, promote the development of standardized anesthesia medical services, strengthen service supervision, improve medical quality, and ensure medical safety. Guide public hospitals to improve the internal distribution mechanism, encourage anesthesiologists to practice more, and mobilize the enthusiasm of anesthesia medical staff. Education departments should strengthen the training of medical students in anesthesiology. The financial department should implement the investment responsibility and further increase the support for the training and use of anesthesiologists and the construction of anesthesia clinical Junior College. The medical security department and the price supervision department should coordinate the price adjustment and supervision of anesthesia medical services in the reform of medical service prices. The medical security department shall, in accordance with the provisions, include the items of anesthesia medical services that meet the conditions into the scope of payment. Human resources and social security departments should work with relevant departments to accelerate the reform of the salary system in public hospitals.

(15) Strengthen publicity and supervision. All regions and relevant departments should attach great importance to strengthening and improving the publicity of anesthesia medical services, make full use of various publicity methods to strengthen policy interpretation, strengthen anesthesia-related health education, and create a good social atmosphere for the implementation of various policies and measures. The National Health Commission shall, in conjunction with relevant departments, establish a key work tracking and regular supervision system, strengthen policy guidance and supervision and inspection, sum up experience in a timely manner and regularly report work progress.