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三部门发文 推进家庭医生签约服务_我的网站

A |     GUATEMALA CITY -- One of the leaders of the nationwide protests against efforts to undermine Guatemala’s elections that have paralyzed much of the country’s commerce for nearly two weeks is a young one-time law student who now heads up one of the country’s most important Indigenous organizations.While Guatemala President Alejandro Giammattei tries to draw President-elect Bernardo Arévalo into a dialogue aimed at ending the protests, Luis Pacheco says that it isn’t Arévalo’s call to make and that Giammattei could end them by meeting their demands.Guatemala has been roiled throughout much of this year’s election cycle and even a resounding victory by Arévalo in August did not calm it. The academic and former diplomat ran on a platform of battling corruption that observers say has unnerved Guatemala’s entrenched power structure.This month's protests have been the largest public display rejecting the administration's questioning of the election. Protesters have peacefully blocked key roadways at more than 100 points across the country. Giammattei this week made clear his intention to clear them by force if necessary.The protesters have made Attorney General Consuelo Porras the target of their ire. Since Arévalo was the surprise second-place finisher in an initial round of voting in June, her office has pursued investigations related to how Arévalo's Seed Movement party collected signatures required to register years earlier and multiple investigations related to the election itself.For Pacheco and the 48 Indigenous communities he represents northwest of Guatemala’s capital, the solution is simple: Porras, one of her prosecutors and a judge who suspended Arévalo’s party have to go.“We’re not asking for something that can’t be done, we are not asking for constitutional reforms, which would be more complicated,” Pacheco said late Tuesday. He stood a block from one of the roadblocks in Guatemala City, holding the wooden staff that signals his position and his customary wide-brimmed hat and shoulder bag. His manner of speaking was measured and calm.Pacheco said the galvanizing moment for the K’iche’ people he represents was a raid on electoral offices broadcast live in which federal agents opened and took away — despite resistance from some electoral officials — boxes containing precinct vote tally sheets. “The people already voted and you have to respect the decision taken,” he said.“We know that they don’t want to lose the power they have,” Pacheco said.The protests have been largely peaceful. Demonstrators allow ambulances to pass, as well as trucks carrying basic food stuffs and gasoline. “We don’t want to kill ourselves as people,” he said. “What we want to show is that we want to defend and take back democracy.”Pacheco cited Atanasio Tzul, an Indigenous leader who led an uprising in 1820 demanding rights, as an influence.Álvaro Pop, former chairman of the United Nations Permanent Forum on Indigenous Issues, said that what is happening now in Guatemala is the end of a cycle in which the government has tried to eliminate or transform the protest.In 2015, thousands of Guatemalans took to the streets, eventually forcing then-President Otto Pérez Molina to resign over corruption allegations. In 2020, Giammattei violently put down protests against his administration.Guatemalans are much more conscious than in previous years of the pervasive corruption in their government, Pop said, in large part because of the years of work by a U.N.-backed anticorruption mission.“The Indigenous peoples (call for the protests) because they are the ones with the moral standing to do so and that is why there is a response and support, but there is the risk that the protests are undermined by racism,” Pop said.Pacheco, mayor of the town of Juchanep, will only hold the rotating post of president of the 48 cantons for a year, but is aware that his role in the protests could lead to persecution.Recently, a far-right activist closely aligned with Porras filed a complaint against Pacheco alleging damage committed by protesters. Often this is a prelude to criminal charges.“We’re not here on behalf of a political party, we’re not defending Arévalo so he can assume the presidency, no one else decided this,” Pacheco said. “Not even if Arévalo told us to stop the protests, we’re not going to do it. The negotiation is between the Indigenous peoples and the government.”。    　　讯 国家卫生健康委、国家中医药局、国家疾控局近日印发《关于印发进一步深化“六个拓展” 做实家庭医生签约服务若干措施的通知》。　　通知提出，到2026年底，基层机构临床类别内科专业、儿科专业和中医类别执业医师均应作为家庭医生开展签约服务。到2027年底，二、三级医院派驻基层机构１年以上的医生，原则上应开展家庭医生签约服务。　　有序推进家庭医生首诊负责制被写进通知。基层机构要加快推进预约就诊和有序分诊，原则上签约居民到基层机构就诊时优先安排家庭医生接诊。

B | 　　签约居民病情超出家庭医生业务能力范围的，经患者同意，家庭医生应当优先转诊到本机构其他专科医生。确需向上级医院转诊的，应当利用紧密型医联体上级医院预留号源、床位等资源或转诊绿色通道及时上转。　　同时，上级医院应当将恢复期、康复期患者下转至基层机构，由家庭医生做好接续服务，上级医院给予必要技术支持。　　由慢性病管理向慢性病和传染病共管拓展，签约“菜单”更丰富。　　从对“一老一小”等重点人群提供常见呼吸道、消化道、虫媒传播疾病以及结核病、艾滋病等防控知识宣教、转介治疗、随访管理和疫苗接种服务，到鼓励具备相应资质的家庭医生为有需要的签约居民开具疫苗处方……到2027年底，基层机构均应将传染病防控服务纳入家庭医生签约服务内容。

C | 　　通知要求，分类开展不同人群的签约履约服务。　　对于老年人、儿童、孕产妇、残疾人等重点人群，推行以居住地基层机构为主开展签约；对于工作地和居住地分离的职业人群，推行以功能单位所在地基层机构为主开展签约；支持居民健康档案随签约机构变动自由流转……　　通知同时提出，要加强签约服务工作监测，开展签约居民满意度调查，进一步做实做细家庭医生签约服务。版权申明：凡注有“”或电头为“”的稿件，均为独家版权所有，未经许可不得转载或镜像；授权转载必须注明来源为“”，并保留“”的电头。    。

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