15 hospital pilot projects at county level of Jiangsu " The medical reform " Cancel the addition of medicines

15 hospital pilot projects at county level of Jiangsu " The medical reform " Cancel the addition of medicines
15 hospital pilot projects at county level of Jiangsu " The medical reform " Cancel the addition of medicines
Yesterday, Zhang Mao, Vice Minister of Ministry of Public Health, claimed, at present, have already started the hospital comprehensive reform pilot project at county level formally in 18 provinces such as Shaanxi, Hubei, Jiangsu, the pilot hospital adds up to 561. Regard cancelling and mending and curing the mechanism the breach, the way of realization of exploring actively medicine separates with medicine as. Increase the input in government finance in Shaanxi Province, try " two lines of revenue and expenditure " in some pilot counties Manage; A difference rate of hospital medicines at county level of pilot project in Zhejiang Province is sold, improve compensation mechanism through rationalizing the price system. Department of public health learnt from Jiangsu Province yesterday the reporter, this year, 15 hospitals at county level of Jiangsu have already listed in the public hospital reform pilot project. The bulletin reporter reporter Liu Jun knows, in July of this year, medicine of province corrected and decided the pilot hospital of 14 comprehensive reforms. It is reported, consider leaving synthetically, has increased the People's Hospital of hospital Changshu second at county level, in this way, there are 15 pilot hospitals in Jiangsu Province. The reporter knows, the river in Nanjing would rather be already decided as far back as April of this year in the district hospital. 15 hospitals are: Nanjing river would rather district hospital Yixing city first the People's Hospital Xuzhou city Sui would rather county people's hospital First the People's Hospital, Rugao of the People's Hospital in Wujiang of the People's Hospital in Jintan City Hospital east the People's Hospital, Taiwan of Xu Yi county of Huaian of county people's hospital of East China Sea of Lianyun Harbour Yizheng market Danyang City the People's Hospital the People's Hospital, Jurong of the People's Hospital Pacify the river city the People's Hospital of the People's Hospital Changshu second in the People's Hospital, Yang Zhong Public hospital reform pilot project, why not choose the large hospital reform, but choose the hospital at county level? The relevant person of Municipal Health Bureau in Nanjing claims, there are two consideration, at first, the public hospital reform is a very complicated problem, a lot of large-scale the first, second and third hospitals are under the jurisdiction of different departments, it is more to limit, and the internal system is comparatively complicated. "For example compensate, of some's large-scale public hospital reform, need the government to compensate more than one hundred million yuan, and the large hospital of tap, is up to more than 1 billion especially. And some public hospitals are in charge of belonging to the province, some are managed by the market, it is relatively great to operate the difficulty the reform, once does not change well, sequela is numerous, influence is greater. " And it is relatively simple for the hospital at county level to reform, easier to break through to some extent, easier to operate. On the other hand, place the medical reform of this year on the hospital at county level especially, because the public hospital at county level is a tap of the regional medical care, connect the ties of the large hospital in the city and medical health organ of basic unit, the problem of seeking medical advice that no matter see the doctor in solving countryside and county resident, or promote the public hospital reform to make breakthrough progress, have function of forming a connecting link. "The hospital at county level is a grade higher than the community health Center, the doctor's level, hardware condition are all so many, if can settle citizens' common disease, frequently-occurring disease well in the hospital at county level, it is very helpful that then difficult to see the doctor to relieving the large hospital. " Cancel the addition of medicines recently, the department of public health of Jiangsu Province has already issued " public hospital comprehensive reform pilot work instruction at county level of Jiangsu Province ", the hospital at county level of Jiangsu will reform maximum cancelling the addition of medicines a bit brighter in the future. In the instruction, have not required the hospital at county level to all use the basic medicine, but stipulate that allocates the basic medicine preferably, and use the basic medicine rationally as the first-selected medicine, raise the basic medicine constantly ' Edition at the basic level) Outfit proportion sum sale amount of money proportion. The relevant person introduces, in the fifties of last century, in with very difficult economy cases, for keep public the intersection of hospital and survival and development, country define public hospital can raise the price, provide medicines for masses after the 15%, have made the positive effect. But " mend medicine with medicine " The mechanism twists the behavior of using medicine of the hospital directly, cause " great prescription " , the outstanding problem of abusing antibiotic,etc.. Thus, this public hospital reform at county level of Jiangsu, cancels the addition of medicines, turn back " mend medicine with medicine " It is a key. "That is to say, after the public hospital cancels ' raises medicine with medicine ', the patient's expenses for medicine will be reduced by 15%. " After may set up the medicine thing service charge and cancel the addition of medicines ing, there is not a block in the hospital income, why compensate, let the hospital " live " Go down? The relevant person of department of public health of province introduces, according to " opinion ", the reform should change the public hospital at county level and compensate the channel. Explore and realize " Medicine is separated " Concrete for route,progressively compensating from service charge, medicines addition income and government be lasted service charge and governmented and be lasted two channeled three channel to be subsidized, change the situation relying on the income from sales of medicines to keep on the go. The relevant person analyzes, except that the governmental input is replenished, it may be through " set up medicine thing service charge " to compensate Come to go on. What is called medicine thing service charge, refer to patient's enjoying doctor's diagnosis and medicines to adjust etc. and serve the expenses paid. The expert thinks, cancel the medicines addition policy of the hospital, instead of collecting the medicine thing service charge to remedy the relevant cost, the direct economic benefits helping to cut off medical organization and medicines while selling are contacted. However, about setting up " medicine thing service charge " Also much dispute exists, the objection thinks, after cancelling the addition of medicines, collect again " The medicine thing service charge " ,This is " increasing the patient to bear in a disguised form" . Also experts will call upon " The thing fee of medicine includes in the basic medical insurance " ,It is unnecessary the patient foots a bill by oneself, it is expected to reduce and reform resistance. Advance other reforms of charging according to number, according to the stipulations of " opinion ", this time the hospital at county level of Jiangsu reforms, will also reform and improve medical treatment and ensure the means of payment. According to " the national the intersection of development and reform and the intersection of committee and the intersection of Ministry of Public Health and notice on launching according to the relevant issues of pilot project of reform of charge method of number " ' National Development and Reform Commission's price ( 2011) The 674th) Spirit, with the past 3 years (from 2008 to 2010) of locality Every number hospitalization cost mean value charges and consults the standard for number, push into the pilot hospital according to the reform of charging of number in an all-round way. Explore actively basic medical treatment ensures the way of paying of prepaying according to paying, total value of number of people etc. to reform, it accords with the expenses that medical treatment ensures the policy and the agreement stipulates to pay in full amount in time; Give full play to medical treatment and ensure the guide, restriction of the hospital of the means of payment and encourage function. Pass this reform, what will look like is it hospital future at county level of the pilot reform? The relevant person of department of public health of province introduces, through advancing the public hospital comprehensive reform pilot project at county level, make the intersection of county and the intersection of land and medical service system further improve, service ability is improved a lot, " mend medicine with medicine " The mechanism changes notably, the pilot work of the reform walks in the national forefront. The concrete goal is as follows: Set up and amplify the compensation mechanism of public hospital at county level, the finance at all levels meets requirements for national regulations to the input of the public hospital at county level, it is rational for medical treatment to ensure the system to pay method science, the medical service price basically reflects medical matters people Member's labor service value; All pilot project public hospitals at county level build up second first rate hospital higher than the national standard, some hospitals reach the tertiary second grade level, the ability to solve the clinical practical problem is strengthened notably, the going to a doctor rate is improved to more than 85%, basically realize serious disease does not go out of the county in the county town; One grade of public hospitals of Cheng County and medical health organ of basic unit link from head to foot to appear in an all-round way, the mechanism of division of labor and coordination of work, the basic unit examines, grades the medical treatment system for the first time and is implemented effectively; Medical expenses once with leaving hospital of clinic of public hospital at county level keep lower level, increasing degree is lower than the per capita disposable income or per capita net income increasing degree of urban and rural residents.


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