Opinions on Accelerating the Development of Rehabilitation Medical Work

Rehabilitation medical work is an important part of health care. Accelerating the development of rehabilitation medical work is of great significance to comprehensively promote the construction of a healthy China, implement the national strategy of actively responding to population aging, and ensure and improve people's livelihood. In order to implement the important decisions and deployments of the Party Central Committee and the State Council, increase the supply of rehabilitation medical services, and improve the ability of rehabilitation medical services to respond to major public health emergencies, the following opinions on accelerating the development of rehabilitation medical work are hereby offered.

1. General Requirements and Main Objectives

1) General requirements. Fully implement the spirit of the Fifth Plenary Session of the 19th CPC Central Committee and implement the national strategy of healthy China and actively respond to population aging. Focus on people's health and social needs as the guide, improve the rehabilitation me

dical service system, and strengthen the rehabilitation medical professional team Construction, improve rehabilitation medical service capabilities, promote reform and innovation in the rehabilitation medical field, and promote high-quality development of rehabilitation medical services.   

2) Main objectives. Strive to gradually establish a professional rehabilitation medical team with a reasonable number and high quality by 2022, with 6 rehabilitation physicians and 10 rehabilitation therapists per 100,000 population. By 2025, there will be 8 rehabilitation physicians

 and 12 rehabilitation therapists per 100,000 population. The ability of rehabilitation medical services has been steadily improved, the service methods have become more diversified, the field of rehabilitation medical services has been continuously expanded, and the people enjoy comprehensive and full-cycle rehabilitation medical services.

2. Improve the rehabilitation medical service system

3) Increase the number of medical institutions and beds that provide rehabilitation medical services. Local health administrative departments (including the competent department of traditional Chinese medicine, the same below) shall complete the rehabilitation medical service system covering the whole population and the whole life cycle in accordance with the requirements of hierarchical diagnosis and treatment work and the planning requirements of the medical and health service system, combined with the needs of rehabilitation medical treatment in the region . Promote the transformation of some primary and secondary hospitals in areas rich in medical resources into rehabilitation hospitals. Support and guide social forces to organize large-scale and chain rehabilitation medical centers, and increase the number of medical institutions providing rehabilitation medical services within the jurisdiction. Encourage qualified grassroots medical institutions to set up and increase beds for rehabilitation medical services as needed. 

4) Strengthen the construction of rehabilitation hospitals and rehabilitation medicine departments of general hospitals. All localities should strengthen the construction of software and hardware in accordance with the basic standards and construction management specifications issued by the state for rehabilitation hospitals, rehabilitation medicine departments of general hospitals, and rehabilitation departments of traditional Chinese medicine hospitals. Encourage localities to increase the supply of rehabilitation medical service resources into the construction of the "14th Five-Year Plan" health service system, and focus on supporting the construction of rehabilitation medicine departments in prefecture-level rehabilitation hospitals and county-level general hospitals. It is necessary to scientifically coordinate public medical institutions and social medical resources in the region, and reasonably increase the number of rehabilitation hospitals. In principle, each provincial capital city and prefecture-level city with a resident population of more than 3 million should set up at least one rehabilitation hospital of grade II or above; counties with a resident population of more than 300,000 should have at least one county-level public hospital with a rehabilitation department; In counties with less than 300,000 people, at least one county-level public hospital has set up a rehabilitation medicine clinic. 

5) Strengthen the rehabilitation medical capacity building of county-level hospitals and grassroots medical institutions. Combined with the relevant requirements of the state to strengthen the comprehensive service capacity of county-level hospitals, encourage localities to strengthen rehabilitation medical services as a key area of strengths and weaknesses in light of actual conditions, and effectively improve the level of rehabilitation medical services in county-level hospitals. Relying on the work platform for the construction of community hospitals and the continuous improvement of grassroots medical service capabilities, support qualified grassroots medical institutions to open rehabilitation medical clinics to provide the masses with convenient and professional rehabilitation medical services.

6) Improve the rehabilitation medical service network. With the help of urban medical groups, county-level medical communities, specialist alliances, telemedicine and other forms, a rehabilitation medical service network with clear positioning, division of labor and cooperation, and linkage between different medical institutions is established. Medical institutions shall provide rehabilitation medical services according to the requirements of graded diagnosis and treatment, combined with functional positioning and classification according to needs. The rehabilitation medicine department of the tertiary general hospital, the rehabilitation department of the tertiary traditional Chinese medicine hospital and the tertiary rehabilitation hospital focus on providing rehabilitation medical services for patients with acute, critical and complicated diseases. Public tertiary hospitals should undertake tasks such as the construction of rehabilitation medical disciplines, personnel training, technical support, and promotion of research results within their jurisdictions, play a supporting and leading role, and encourage tertiary hospitals run by social forces to actively participate. Rehabilitation medicine departments of secondary general hospitals, rehabilitation departments of secondary traditional Chinese medicine hospitals, secondary rehabilitation hospitals, rehabilitation medical centers, and primary medical institutions provide rehabilitation medical services for patients with clear diagnoses, stable conditions or long-term rehabilitation. Relying on grassroots medical institutions, encourage the active development of community and home rehabilitation medical services.

3. Strengthen rehabilitation medical personnel training and team building

7) Strengthen the education and training of rehabilitation medical personnel. Qualified colleges and universities should actively set up shortage majors such as rehabilitation therapy and rehabilitation engineering, and set up rehabilitation physical therapy, rehabilitation occupational therapy, hearing and speech rehabilitation and other majors according to the actual situation, and increase the supply of rehabilitation professionals. Improve clinical practice ability. Encourage the cultivation of medical students' knowledge and ability of rehabilitation medicine in the professional education of clinical medicine, and popularize the professional knowledge of rehabilitation medicine. Continue to promote the standardized training of resident physicians in the Department of Rehabilitation Medicine, explore the transfer training of physicians in the Department of Rehabilitation Medicine, and increase the number of physicians engaged in rehabilitation medical work.

8) Strengthen job training for rehabilitation medical professionals. Gradually establish a training mechanism for rehabilitation medical professionals that is demand-oriented and centered on job competency. According to the functional positioning of medical institutions and the clinical needs of rehabilitation medicine, carry out training in a planned and hierarchical manner for personnel who are engaged in or plan to engage in rehabilitation medical work in medical institutions to improve the ability of rehabilitation medical services. Strengthen the training of the basic knowledge of rehabilitation for all medical staff, enhance the awareness of early intervention and the whole process of rehabilitation, and integrate the concept of rehabilitation into the whole process of disease prevention, diagnosis and treatment, and rehabilitation.    

9) Strengthen the reserve of rehabilitation medical teams in emergencies. All localities should rely on qualified and capable general hospital rehabilitation medicine departments, traditional Chinese medicine hospital rehabilitation departments, and rehabilitation hospitals to form or reserve rehabilitation medical expert databases, and establish a team of high-quality, professional, and timely mobilization to deal with major epidemics, disasters, and other emergencies. Public health incident rehabilitation medical professional team, strengthen personnel, material reserves and emergency drills, and effectively improve the ability of rehabilitation medical services in emergencies.

4. Improving the ability of rehabilitation medical services

10) Improve the rehabilitation medical work system, service guidelines and technical specifications. Combining the professional characteristics of rehabilitation medicine and the development of clinical needs, formulate (revise) and improve the rehabilitation medical work system, rehabilitation medical service guidelines and technical specifications of medical institutions, especially the rehabilitation technical guidelines for major diseases and emerging infectious diseases, etc., to standardize clinical practice Rehabilitation medical service behavior, improve the professionalism and standardization of rehabilitation medical service, and further enhance the medical effect.   

11) Strengthen rehabilitation medical capacity building. With the improvement of rehabilitation medical service capabilities as the core, focus on strengthening the rehabilitation medical service capabilities of the rehabilitation medicine department of the tertiary general hospital, the rehabilitation department of the tertiary traditional Chinese medicine hospital and the rehabilitation early intervention, multidisciplinary cooperation, and difficult and critically ill patients of the tertiary rehabilitation hospital. According to the disease characteristics of different groups of people and the urgent needs of rehabilitation medical services, actively promote the construction of neurological rehabilitation, orthopedic rehabilitation, cardiopulmonary rehabilitation, tumor rehabilitation, children's rehabilitation, elderly rehabilitation, pain rehabilitation, severe rehabilitation, traditional Chinese medicine rehabilitation, psychological rehabilitation and other rehabilitation medicine subspecialties , carry out sub-specialty detailed rehabilitation assessment, rehabilitation treatment, rehabilitation guidance and rehabilitation follow-up services.

12) Improving the ability of grass-roots rehabilitation and medical treatment. Through medical alliances, counterpart support, remote training, etc., give play to the radiating and leading role of high-quality rehabilitation medical resources, and improve the rehabilitation medical service capabilities and levels of grassroots medical institutions such as rehabilitation medical centers, community health service centers, and township health centers. Encourage qualified second-level and above hospitals in the medical consortium to help grass-roots medical institutions improve their rehabilitation medical capabilities by establishing joint rehabilitation medical teams, one-on-one assistance, and selecting rehabilitation experts to regularly sink to grass-roots medical institutions for outpatient visits, ward rounds, and training . At the same time, it is necessary to strengthen the training of contracted teams of general practitioners and family doctors to improve their rehabilitation medical service capabilities. Support qualified medical institutions to strengthen cooperation with professional rehabilitation institutions for the disabled and child welfare institutions to improve their rehabilitation level.

13) Improve the ability of traditional Chinese medicine rehabilitation services. Implement the "Notice on Printing and Distributing the Implementation Plan for the Improvement of Chinese Medicine Rehabilitation Service Capabilities (2021-2025)", and give full play to the important role of Chinese medicine in disease rehabilitation. Encourage qualified medical institutions to actively provide traditional Chinese medicine rehabilitation services. Strengthen the construction and management of TCM rehabilitation service institutions, strengthen the training and team building of TCM rehabilitation professionals, conduct research on TCM rehabilitation programs and technical specifications, actively develop TCM characteristic rehabilitation services, increase the supply of TCM rehabilitation services at the grassroots level, and effectively improve TCM rehabilitation services ability and level.    

5. Innovative rehabilitation medical service model

 14) Gradually promote the rehabilitation and clinical multidisciplinary cooperation model. Encourage qualified medical institutions to innovate and carry out the model of close cooperation between rehabilitation medicine and clinical related disciplines such as surgery, neurology, orthopedics, cardiovascular, respiratory, critical care, and traditional Chinese medicine. Take the patient as the center, strengthen early intervention in rehabilitation, promote accelerated rehabilitation surgery, integrate rehabilitation throughout the whole process of disease diagnosis and treatment, improve medical effects, and promote rapid recovery and functional recovery of patients.   

 15) Actively develop community and home rehabilitation medicine. Encourage qualified medical institutions to extend rehabilitation medical services in institutions to communities and homes through "Internet +", family beds, and door-to-door visits. Support grassroots medical institutions to enrich and innovate rehabilitation medical service models, and give priority to providing services such as home rehabilitation medical care, daytime rehabilitation training, and rehabilitation guidance for people with urgent needs for rehabilitation medical services, such as disabled or elderly people, patients with chronic diseases, and severely disabled people. .

 16) Promote the connection and integration of rehabilitation medical treatment and rehabilitation assistive device configuration services. Implement the "Several Opinions on Accelerating the Development of the Rehabilitation Aids Industry", and promote the deep integration of rehabilitation medical services and rehabilitation aids configuration services. Medical institutions should, in accordance with relevant requirements, rationally configure rehabilitation aids to adapt to equipment and facilities, strengthen the training of relevant personnel, establish a teamwork mechanism for rehabilitation physicians, rehabilitation therapists and rehabilitation assistive devices allocation personnel, and improve professional skills and service capabilities.

6. Increase support and guarantee     

  17) Coordinate and improve rehabilitation medical service prices and medical insurance payment management. Incorporate the price of rehabilitation medical services into overall consideration in deepening the reform of medical service prices, and do a good job in adjusting and optimizing the prices of related items. Guide the implementation of 29 medical rehabilitation projects including comprehensive rehabilitation assessment, strengthen the payment management of medical rehabilitation projects, and effectively guarantee the basic rehabilitation medical needs of the masses.   

   18) Mobilize the enthusiasm of rehabilitation medical professionals. Medical institutions should establish and improve the management system for rehabilitation medical professionals. Improve the performance appraisal mechanism centered on the performance of post responsibilities, clinical workload, service quality, behavioral norms, medical quality and safety, medical ethics, patient satisfaction, etc. Performance distribution, rewards and evaluations are linked to achieve more pay for more work, better pay for better performance, and mobilize their enthusiasm.

    19) Strengthen the construction of rehabilitation medical information. It is necessary to make full use of cloud computing, big data, Internet of Things, smart medical care, mobile Internet and other information technologies to vigorously promote the construction of rehabilitation medical information and implement a network security level protection system. With the help of information technology, innovate and develop new models, new formats, and new technologies of rehabilitation medical services, optimize the rehabilitation medical service process, and improve the efficiency of rehabilitation medical services. Actively carry out telemedicine, consultation, training, technical guidance, etc. in the field of rehabilitation medicine to benefit more grassroots people.   

     20) Promote the development of rehabilitation medical related industries. Encourage localities to foster industries related to rehabilitation and medical care through scientific and technological innovation, industrial transformation, and achievement transformation, combined with actual conditions and unique advantages. Prioritize the promotion of medical-industrial integration in the rehabilitation of the elderly, the disabled, the injured, and children. Actively support the research and development and innovation of a batch of high-intelligence, high-tech, high-quality rehabilitation aid products and rehabilitation treatment equipment, etc., to gradually meet the health needs of the people.

7. Organization and implementation   

    21) Strengthen organizational leadership. All relevant departments should fully understand the significance of accelerating the development of rehabilitation medical work from the perspective of comprehensively promoting the construction of a healthy China, implementing the national strategy of actively responding to population aging, and improving the health and well-being of the people. Effectively strengthen organizational leadership, form a policy synergy, and improve supporting supporting policies. All provincial health administrative departments shall, in conjunction with relevant departments, formulate and issue specific implementation plans for accelerating the development of rehabilitation medical services in the region by the end of October 2021.  

    22) Clarify departmental responsibilities. All relevant departments should clarify the division of responsibilities, strengthen policy linkage, and work together to promote the development of rehabilitation medical services. Local health administrative departments should reasonably plan and distribute rehabilitation medical resources in the region according to requirements, strengthen the training and team building of rehabilitation medical professionals, standardize rehabilitation medical behavior, improve rehabilitation medical service capabilities, and ensure medical quality and safety. The education department should strengthen the education and training of professionals related to rehabilitation medicine. Development and reform and financial departments must implement government investment policies in accordance with regulations. The medical insurance department should promote the reform of medical insurance payment methods and improve the medical service price management mechanism. Civil affairs departments should actively promote the development of rehabilitation assistive device industry. The competent departments of traditional Chinese medicine should vigorously develop rehabilitation services with traditional Chinese medicine characteristics. The Disabled Persons' Federation organizes the rehabilitation and assistance work for disabled children and cooperates with the work related to the rehabilitation and medical treatment of disabled children.

    23) Strengthen guidance and evaluation. Local health administrative departments shall, in conjunction with relevant departments, establish a mechanism for regular guidance and evaluation, and follow-up of key tasks, and promptly study and solve emerging difficulties and problems. Pay attention to summing up experience and promoting beneficial experience. Encourage all localities to explore the inclusion of public rehabilitation hospitals in the comprehensive performance assessment system of public hospitals, give full play to the incentive role of performance assessment, and guide the sustainable and healthy development of rehabilitation hospitals.    

    24) Increase publicity efforts. All localities should attach importance to and strengthen the publicity of rehabilitation medical services, increase rehabilitation medical related policy and professional training for medical personnel in medical institutions, and improve service capabilities. It is necessary to widely publicize the concept of rehabilitation, rehabilitation knowledge and rehabilitation technology, popularize and increase the public's awareness and attention to rehabilitation, and create a good atmosphere in the whole society to promote the development of rehabilitation medicine.