Lay a good "social vaccine" for diabetes prevention

There are many diabetic patients in our country, and the prevention and treatment situation is severe and the pressure is huge. Prevention and treatment work is related to the health rights and welfare of the people and is a difficult problem to be solved in order to build a healthy China.

Recently, at the Promise-Public Hospital High-Quality Development Leaders Seminar Cloud Conference hosted by Health News and supported by Novo Nordisk, experts and scholars from related fields focused on diabetes management topics, with authoritative data interpretation and a professional perspective Analyze and put forward policy recommendations for diabetes prevention and treatment.

National Health Commission Health Development Research Center

Deputy Director Zhang Yuhui:

Make good use of increments, revitalize stocks, innovate management, improve quality and efficiency

Diabetes has now become an important issue endangering the health of residents. According to survey data, there were more than 100 million people with diabetes in my country among adults over the age of 18 in 2013. my country has the largest number of diabetic patients in the world, and it is growing rapidly. In 1980, the prevalence of diabetes in the population was only 0.8%. In 1989, it was close to 3%, and now it has exceeded 10%. Diabetes has become the main factor affecting the health of residents. If diabetes cannot be effectively controlled, the cost of diabetes treatment will exceed 400 billion yuan by 2030, which will severely impact the sustainability of the entire health financing system, including the sustainability of medical insurance funds.

Currently, it is necessary to effectively control diabetes, reduce related medical expenses, and reduce the economic burden and disease burden of residents. However, from the actual situation, the residents' awareness rate, treatment rate and effective control rate of diabetes are very low. It is necessary to strengthen research and solve it through improving services and improving various policies. First of all, under the background of the new normal, economic growth and fiscal revenue will slow down, and the growth of medical insurance financing and government investment will also slow down in the future. This requires good use of increments, revitalization of stocks, innovative management, and improvement of quality and efficiency. In the future, it is necessary to further strengthen the role of “gatekeeper” in grassroots institutions, implement the contracted services of excellent family doctors, and give full play to the role of disease management. Second, improve the service effect of outpatient clinics, especially to control the blood sugar level of patients and reduce the occurrence of diabetes complications. Third, further deepen the reform of the medical insurance side, improve the level of financing, and optimize the reimbursement policy, such as increasing the level of outpatient compensation, from the treatment of serious illnesses at the end, to the control of early disease factors, in accordance with the overall requirements centered on people's health , Adjust and improve related payment policies to solve the problem of fragmentation and decentralization of payment.

In general, to promote diabetes prevention and treatment, the joint efforts of the medical and health service system and the medical insurance system are required to achieve high-quality and coordinated development. At the same time, residents are also required to play the role of the first responsible person for health, and the whole society to build and share the health of the whole people.

Shanghai Hygiene and Health Development Research Center

Director Jin Chunlin:

Maximize the effectiveness of medical insurance funds

The 1.0 version of the medical reform takes the rectification of falsely high prices as a breakthrough. The 2.0 version of the medical reform should take the reform of the payment system as the entry point, be guided by curative effects and health outcomes, and improve medical technology as the carrier, establish a positive incentive mechanism, and give full play to the benefits of medical insurance funds. Maximum utility. For example, there are three realms in medical insurance payment reform: the first realm is to pursue clinical value, which means that a certain type of medicine, a certain technology or a certain treatment strategy should be optimal; the second realm is to pursue economic value, which is a single medical institution With health outcomes as the goal, efficient operation, effective division of labor and cooperation between different types and levels of medical institutions; the third realm must promote the optimization of the integration and allocation of medical and health resources to achieve the best results.

Under the condition that financial investment and medical insurance financing cannot increase significantly, how to transform service-driven development into value-driven development is a problem that all hospital managers must consider when carrying out medical work for each disease. There are 4 key factors in value medical care—informatization, benchmarking, payment, and organization. Without informatization, there is no way to judge whether the treatment effect is good or not; there is no means of payment, everyone is living Lei Feng is not sustainable, the means of payment must be linked to the health results; the organizational system must change, and the hospital’s internal medical and defense must be integrated , Medical treatment and preventive rehabilitation work between different medical institutions should be integrated; benchmarking research and analysis, for example, for the same diabetes, which general practitioner does well, it is important to learn from good doctors.

To prevent and treat diabetes, it is necessary to combine the internationally advanced value medical concepts and integrated medical service concepts to accurately identify people with diabetes at different risks to promote the integration of medical and prevention. According to different groups of people, different intervention measures and assessment indicators should be formulated. The result-oriented allocation of prevention and treatment funds will truly realize the transformation from a medical-centric to a health-centric.

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Sun Hui, Deputy Secretary of the Party Committee:

Stand at the forefront of the times and carry out diabetes management

With the economic development and the improvement of people’s living standards, the incidence of diabetes and the total number of diabetes in China have also increased year by year. Nearly half of adults have abnormal blood sugar. That is to say, one out of every two adults is a reserve army for diabetes. Without timely intervention, these people are very likely to develop into diabetic patients in the near future. In 2019, the State Council issued the "Opinions on the Implementation of the Healthy China Action" and proposed the implementation of 15 special actions, of which "diabetes prevention" was included in the special action for the first time, which is sufficient to illustrate the urgency and importance of diabetes prevention and treatment.

Diabetes is a serious public health problem facing China, and it is also a large aspect of national medical expenditure. How do clinicians control diabetes in their positions? How can public health experts better control the direction and implementation of policies from the national policy and health economy level, so that fewer people get diabetes, and more concerted efforts are needed. Hard work. Similarly, how to do a good job in the overall social prevention and treatment of diabetes through the full-cycle management of diabetic patients requires the state and individuals to act together.

Diabetes prevention and treatment work has a long way to go. It requires not only top-level design, but also grassroots practice support. At the macro level, we should vigorously integrate expert power and media resources, fully mobilize medical staff, volunteers and other forces, enrich the carriers and forms of health education, and lay the "social vaccine" for diabetes prevention. At the micro level, medical staff must continue to innovate management methods, apply the latest information technology to the management of diabetic patients, and stand at the forefront of the times to carry out diabetes management. Similarly, medical staff must also promote diabetes prevention and treatment from the perspective of patients, and solve problems such as whether technology is in place, community medical treatment is in place, and whether patient counseling is in place.

Shunde Hospital of Southern Medical University

Dean Shen Jie:

Currently is the best time to land on diabetes graded diagnosis and treatment

Diabetes, as one of the first chronic diseases to sink in, is very scarce of grassroots professionals, which has become a bottleneck problem in graded diagnosis and treatment. For example, in the economically developed Shunde area of ​​Guangdong, it is conservatively estimated that there are 200,000 diabetic patients, but the total number of professional doctors is less than 50, and there are less than 20 senior titles. Not to mention community management, it is difficult for patients to be treated at the grassroots level. In the post-epidemic era, the improvement of community grid management capabilities and the vigorous promotion of "Internet +" have become the best time to implement hierarchical diagnosis and treatment. To this end, the Shunde area was led by the government to establish the "Diabetes Prevention and Medical Prevention Collaborative Alliance". Through the training of regional chief diabetes nurses, doctors and pharmacists, the hospital walls were broken to truly form a three-level management, allowing specialists to promote general practice, clinical promotion of public health, Individuals promote the family to form a regional model of "orderly, standardized, and standardized" diabetes management, which is specifically manifested in four aspects of innovation:

One is based on the hospital's informationized blood glucose management system, forming a hospital-wide blood glucose management centered on the endocrinology department.

The second is to set up an MDT team, including endocrinology specialists, diabetes specialist nurses, nutritionists and clinical pharmacists, the whole hospital cares for diabetic patients who need attention, and improves blood glucose management.

The third is the extension of blood glucose management in the hospital to the medical consortium outside the hospital, cooperating with member units and lower-level hospitals to achieve standardization of management and homogenization of information, forming a seamless management network.

The fourth is to improve the basic medical capabilities of community doctors. Regularly send experts to the community to teach, ward rounds, and sit for consultations. Every time grassroots doctors are trained, pharmacy experts are added to teach. At the same time, the chief diabetes doctor is trained at the grassroots level to ensure the health of each community. The service center has a general practitioner to provide basic support for diabetes prevention and treatment.