On December 12, the National Health Commission issued the "Notice on Guiding Primary Medical and Health Institutions to Do a Good Job in Health Services for Respiratory Diseases in Winter and Spring", requiring local primary medical and health institutions to be fully open to children. In response to this round of high incidence of respiratory diseases, how to strengthen the capacity of primary medical institutions? And how to better promote the hierarchical diagnosis and treatment of children?
"News 1+1" invited Ni Xin, director of the National Children's Medical Center and president of Beijing Children's Hospital affiliated to Capital Medical University, to pay attention to: How to implement hierarchical diagnosis and treatment due to the surge in pediatric visits?
Why has this round of winter respiratory diseases caused so much pressure on hospitals?
Ni Xin: This peak of infections is often referred to as "the debt owed by the three-year epidemic".
In fact, in the autumn and winter of this year, judging from the state of respiratory infection, it is true that in the past three years, many children have worn masks and not going out at home for a series of reasons, so that their own immunity will be affected, which is one thing.
On the other hand, there will be these infectious viruses every autumn and winter, including mycoplasma, which also has a high epidemic period in an average of 3-4 years, and this year is also a high epidemic period, which may lead to a sense of a sharp increase in pediatric infections in autumn and winter this year.
Children have cold symptoms, how do parents choose medical institutions?
Ni Xin: At the peak of infections in the autumn and winter of this year, on the one hand, we are doing health education to let parents know what the first symptoms of mycoplasma and influenza are. For the child's disease, we must look at the child's mental head, the child's mental head is very good, he will definitely not develop to a bad disease, but it is possible when the child's mental head is not good.
Second, in hierarchical medical institutions, doctors can quickly identify whether the child's condition has changed, whether there is a development of severe disease, and if so, it needs to be referred in time. Therefore, from the parents' own understanding of the disease and the medical institution's understanding of the disease, the hierarchical diagnosis and treatment can be realized, so that our children can first see the common diseases and common diseases nearby, and then refer difficult and complex diseases, which can be realized.
There are relatively few pediatrics in primary medical institutions, how to change and improve?
Ni Xin: Previously, the relevant person in charge of the National Health Commission required that pediatric outpatient clinics at all levels and types of medical institutions such as maternal and child health hospitals should be opened as much as possible. In fact, in the process of building a pediatric system in the past, due to the overall shortage of pediatric talents, a complete pediatric diagnosis and treatment system has not been established in some communities, including some primary medical institutions.
The overall cycle of training pediatricians is relatively long, and pediatrics is often called "dumb medicine", and children often can't tell where they are uncomfortable, which is relatively difficult. So, that's probably one of the reasons why they don't choose pediatrics.
This is also one of the things we need to invest in in the future, that is, how to increase the attractiveness of pediatrics, how to get more people to study pediatrics and engage in pediatrics, which may be the most critical.
How to provide primary pediatric care in rural areas where people live in scattered areas and lack talents?
Ni Xin: During the medical reform, the state clearly proposed that the pediatric system should make the pediatrics of county-level hospitals stable and strong, so as to achieve an effective foundation. How can rural children be treated effectively?
After the pediatrics of county-level hospitals need to be strengthened, it is hoped that they will be linked with rural health centers to support the overall construction of pediatrics in our rural health centers, and leave doctors in county-level hospitals to be responsible for the construction of rural health centers. This method may be able to enable rural children to see pediatrics in time in the future, and it should be promoted.
How to make up for the lack of manpower and material resources in pediatric hierarchical diagnosis and treatment?
Ni Xin: Pediatrics in public hospitals need the support of the state and local governments at all levels. In order to cultivate and retain pediatric talents, from the national to local policy formulation, it is necessary to give some special policies to children's hospitals, especially pediatric service personnel. How to retain pediatric talents and cultivate more pediatric talents is one of the most critical factors in child health services. In addition, we should also pay attention to children's health care, so that children do not get sick as much as possible. (CCTV News Client)