Due to some chronic and common diseases, patients come to township health centers and community health service centers for treatment, but are told that 'there is no medicine'.

In response to the problem of difficult medication at the grassroots level, the National Health Commission and six other departments recently jointly issued the "Opinions on Reforming and Improving the Grassroots Drug Linkage Management Mechanism to Expand the Types of Grassroots Drugs", striving to smooth the channels for drug connection between urban and rural areas, counties and townships, enhance the ability of grassroots drug allocation and use, and meet the basic medication needs of the masses.

Expand types

Make the medicine at the doorstep more comprehensive

The proportion of grassroots diagnosis and treatment in China has reached 52% by 2023. However, some medical staff have previously reported that there are few types of drugs available at the grassroots level, limited space for self medication, and difficulty in connecting medication catalogs at different levels of medical institutions. Especially for patients referred from higher-level hospitals, some of their medications cannot be prescribed at the grassroots level.

The latest document proposes to standardize and optimize the types of medication used at the grassroots level. Under the guidance of provincial and municipal health commissions, with a focus on drugs selected from the National Essential Medicines List, National Medical Insurance Drug List, and National Centralized Quantity based Procurement, the leading hospital of the closely knit medical consortium will coordinate the determination of drug catalogs and standardize the expansion of grassroots linkage drug types.

At the same time, we will promote the use of drugs for chronic and common diseases listed in the drug catalogs of second - and third tier hospitals to reach the grassroots level. Tight medical consortia can be used as a whole to study and determine the number of varieties of essential drugs to be used, and through real-time prescription consultation, mutual recognition and sharing, they can issue prescriptions for patients with chronic diseases and common diseases who need follow-up visits.

Wu Hao, one of the experts who participated in the drafting and formulation of the above document, and the dean of the College of General Medicine and Continuing Education of Capital Medical University, said that this has broken through the situation that the drug catalog of grass-roots medical and health institutions has been restricted for a long time, and the expansion and allocation of grass-roots drugs ushered in a "Xintiandi".

Prevent shortages

Ensure the supply and distribution of grassroots drugs

A special survey conducted by the National Health Commission shows that there are a large number of primary healthcare institutions, low drug usage, and high distribution costs, especially in central, western, and remote areas. This has led to low delivery enthusiasm among some enterprises, unstable drug supply, and even supply interruptions.

The above documents require the improvement of the centralized supply and distribution mechanism for grassroots drugs. The county-level health administrative department guides closely knit medical consortia to lead hospitals and other units to timely summarize and review grassroots drug demand plans within the county. Provincial health departments, in conjunction with medical insurance departments, will establish communication channels for grassroots drug distribution issues, establish collaborative mechanisms, and improve the management system of drug supply enterprises.

At the same time, establish a sound mechanism for early warning and handling of drug shortages at the grassroots level. Establish a shortage registration system for closely knit medical consortia. If there is a high frequency of shortage registration and it is deemed necessary after evaluation, it will be promptly included in the scope of the next year's upper and lower medication linkage.

Experts say that the management of grassroots drug services involves multiple entities, a long policy chain, and a wide range of related fields, requiring the joint efforts of multiple departments. Provide a complete set of "prescriptions" for the problem of "difficult medication" at the grassroots level, while strengthening the grassroots level, promoting further implementation of hierarchical diagnosis and treatment.

Benefit people's livelihoods

Adapt to local conditions and ensure medication use

It is understood that various provinces have actively explored the issue of medication at the grassroots level.

Hebei has formulated a unified drug catalog in 201 medical communities across 14 cities in the province, with a drug overlap rate of over 70% between upper and lower level medical and health institutions.

Beijing has established a shortage drug demand registration service system in community health service centers throughout the city to meet patients' differentiated medication needs.

Fujian Sanming provides 39 basic drug intervention guarantees for patients with six types of chronic diseases (hypertension, diabetes, serious mental disease, chronic obstructive pulmonary disease, bronchial asthma, stroke and sequelae) that have been diagnosed at the grass-roots level, and the medical insurance fund is fully reimbursed.

The relevant person in charge of the Drug Policy and Essential Medicines System Department of the National Health Commission stated that it is necessary to continue to promote the sinking of drug supply and services. The National Health Commission will coordinate and guide monitoring and evaluation, strengthen departmental collaboration, and study and improve policy measures to enhance the mechanization level of grassroots drug linkage management.

According to Xinhua News Agency, Beijing, November 26th