——基本藥物制度從無到有。初步形成了基本藥物遴選、生產供應、使用和醫(yī)療保險報銷的體系。2011年，基本藥物制度實現(xiàn)基層全覆蓋，所有政府辦基層醫(yī)療衛(wèi)生機構全部配備使用基本藥物，并實行零差率銷售，取消了以藥補醫(yī)機制。制定國家基本藥物臨床應用指南和處方集，規(guī)范基層用藥行為，促進合理用藥。建立基本藥物采購新機制，基本藥物實行以省為單位集中采購，基層醫(yī)療衛(wèi)生機構基本藥物銷售價格比改革前平均下降了30%?；舅幬锶考{入基本醫(yī)療保障藥品報銷目錄。有序推進基本藥物制度向村衛(wèi)生室和非政府辦基層醫(yī)療衛(wèi)生機構延伸。藥品生產流通領域改革步伐加快，藥品供應保障水平進一步提高。
——城鄉(xiāng)基層醫(yī)療衛(wèi)生服務體系進一步健全。加大政府投入，完善基層醫(yī)療衛(wèi)生機構經費保障機制，2009—2011年，中央財政投資471.5億元人民幣支持基層醫(yī)療機構建設發(fā)展。采取多種形式加強基層衛(wèi)生人才隊伍建設，制定優(yōu)惠政策，為農村和社區(qū)培養(yǎng)、培訓、引進衛(wèi)生人才。建立全科醫(yī)生制度，開展全科醫(yī)生規(guī)范化培養(yǎng)，安排基層醫(yī)療衛(wèi)生機構人員參加全科醫(yī)生轉崗培訓，組織實施中西部地區(qū)農村訂單定向醫(yī)學生免費培養(yǎng)等。實施萬名醫(yī)師支援農村衛(wèi)生工程，2009—2011年，1100余家城市三級醫(yī)院支援了955個縣級醫(yī)院，中西部地區(qū)城市二級以上醫(yī)療衛(wèi)生機構每年支援3600多所鄉(xiāng)鎮(zhèn)衛(wèi)生院，提高了縣級醫(yī)院和鄉(xiāng)鎮(zhèn)衛(wèi)生院醫(yī)療技術水平和管理能力。轉變基層醫(yī)療服務模式，在鄉(xiāng)鎮(zhèn)衛(wèi)生院開展巡回醫(yī)療服務，在市轄區(qū)推行社區(qū)全科醫(yī)生團隊、家庭簽約醫(yī)生制度，實行防治結合，保障居民看病就醫(yī)的基本需求，使常見病、多發(fā)病等絕大多數(shù)疾病的診療在基層可以得到解決。經過努力，基層醫(yī)療衛(wèi)生服務體系不斷強化，農村和偏遠地區(qū)醫(yī)療服務設施落后、服務能力薄弱的狀況明顯改變，基層衛(wèi)生人才隊伍的數(shù)量、學歷、知識結構出現(xiàn)向好趨勢。2011年，全國基層醫(yī)療衛(wèi)生機構達到91.8萬個，包括社區(qū)衛(wèi)生服務機構2.6萬個、鄉(xiāng)鎮(zhèn)衛(wèi)生院3.8萬所、村衛(wèi)生室66.3萬個，床位123.4萬張。
A basic system of drugs has been developed from scratch. A system for the selection, production, supply and use of basic drugs, and cover of them in medical insurance has been put into place. In 2011, the coverage of this system was extended to all grass-roots medical and health-care institutions run by the government, where these drugs were sold at zero profit, practically eliminating the practice of hospitals subsidizing their medical services with drug sales. A national guideline for the clinical application of basic drugs and a formulary have been drawn up to ensure that basic drugs are used according to due procedures at grass-roots medical institutions. A new mechanism has been established for the procurement of basic drugs, under which the basic drugs are to be purchased by provinces. As a result, the prices of basic drugs at grass-roots medical and healthcare institutions have dropped by 30% on average, as compared with those before the reform. The basic drugs have all been included in the list of reimbursable drugs covered by basic medical insurance. Also, efforts have been made to supply basic drugs in an orderly way to village clinics and non-governmental medical institutions at the grass-roots level. The steps of reform have been quickened in drug production and circulation, and the supply of drugs has been better ensured.
Urban and rural grass-roots level medical and health services have been further improved. The government has invested more to ensure the funding for grass-roots medical and healthcare institutions. From 2009 to 2011, the central government invested 47.15 billion yuan to support the building and development of grass-roots level medical institutions. Diverse forms have been adopted to strengthen the ranks of healthcare workers at the grass-roots level, and preferential policies have been made to train and introduce competent personnel for rural and community healthcare. A system of general practitioners (medical workers with sufficient knowledge in all branches of medicine) has been established, under which general practitioners are trained in the regular way; grass-roots medical and healthcare workers are enrolled in training courses for upgrading them to general practitioners; and medical students are specially trained for the needs of central and western urban areas, for which they do not have to pay their tuition fees. A project, known as "ten thousand doctors extending support to rural medical care," has been launched. From 2009 to 2011, over 1,100 Grade-III urban hospitals extended support to 955 rural county-level hospitals every year, and urban medical institutions above Grade II in central and western China granted aid to over 3,600 township hospitals every year, thus helping improve the overall technological level and management of the county and township hospitals. Meanwhile, the mode of medical services has been changed. Touring medical services have been provided in township hospitals; and in the urban districts ranks of general practitioners have been formed and a system of family doctors has been set up. Prevention has been combined with the treatment, measures have been taken to ensure basic needs of the residents to see doctors and make it possible that the diagnosis and treatment of most commonly seen and frequently occurring diseases are performed at the community level. After years of effort, community-level medical and healthcare system has been strengthened; marked changes have taken place to the situation of backward facilities and poor services in rural and remote areas; community-level medical workers have increased in number, and their educational background and knowledge have improved. In 2011, the number of grass-roots medical and healthcare institutions across the country reached 918,000, including 26,000 urban community service centers, 38,000 township hospitals and 663,000 village clinics, and the number of hospital beds reached 1,234,000.
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