Jiangsu: It is not high and low to see the doctor The new rural cooperative medical service project remains to improve

Jiangsu: It is not high and low to see the doctor The new rural cooperative medical service project remains to improve
Jiangsu: It is not high and low to see the doctor The new rural cooperative medical service project remains to improve
Reporter county, municipal or district investigation find new rural the intersection of cooperative medical service and the the intersection of Huimin and project store some in remain improved place still in some Nan Su recently. One district director of health bureau in Wuxi introduced, the whole district participated in and " shut newly and agriculturally " last year Peasant combine to compensate more than 5000 people hospital treatmenting. Among them, accounts for 60% in the district or hospital treatment of township hospital, the ones that went to the above hospitals of market and market to see the doctor accounted for 40%. However, the compensation offered in hospital treatment of hospital of two grades only accounts for 37% of the total expenditure in the districts, townships, and it accounts for 63% to reach the compensation that the above hospitals of market and market see the doctor and offer. That is to say, the expenses that the hospital sees the doctor are much higher than that of the hospital in the district outside the district. "This is because treat in the district, the administration to the patient of the hospital, checking stricter system to assess, and reached the hospital at a higher level, the hygiene administrative department in the district can not be in charge of. " Have the people going to the large hospital all caught serious illness? No. The fact shows, the same disease, the hospital differ greatly outside the districts, townships. The municipal Wujin area relevant persons in charge of health bureau in Changzhou provide a group of data: 2007, district this have 953 join, shut peasant, move the intersection of appendicitis and operation, have 678 examples in whom township hospital move, per capita hospitalization cost is 2500 yuan; 224 district level hospitals, 4600 yuan for per person; 51 hospitals outside the district, 4900 yuan for per person. That is to say, see this kind of common disease, the expenses which the hospital produces go out of about one time of health clinics in towns and townships more outside the district. Common the intersection of disease and pneumonia, Wujin area have 557 example in hospital last year, each of health clinics in towns and townships expenses of 2200 yuan took place, the district level hospital is 6400 yuan, the hospital was up to 7300 yuan unexpectedly outside the district, it was more than of triple of the expenses of health clinics in towns and townships! "Because the expenses of the hospital are relatively high outside the district, larger pressure of a fund of the cooperative medical service that give. " This person in charge says, last year, the deficit of more than 3 million yuan appeared in the Wujin area cooperative medical service fund, deficit of this year will be more, say few that will reach 15 million yuan too. "Wujin area still fine, because through propagate extensively, 2007, 25% patient reach hospital treatment of the hospital outside the district only, the other places, about 40% more, the pressure that the cooperative medical service fund affords is larger, have to reduce and join and shut peasants' compensation proportion. " Someone thinks, the key of solving this problem is to bring the hospital outside the district into the examination system of the new rural cooperative medical service too. In fact, the hospital charges high outside the district, there is phenomenon of excessive medical treatment, there are rational compositions too. For example, the environment is better, medical personnel's level is higher that the large hospital is in hospital, the apparatus is relatively top-grade, this needs the patient to pay the corresponding expenses. So, only include the hospital outside the district in the examination system that the rural cooperative medical service compensates, can not change hospitalization cost on the high side the intersection of phenomenon and Wujin area the intersection of health bureau and following data that relevant person in charge offer show, patient " tall and low " There are profound reasons: Last year, the clinic patient accepting in the first class community clinic of the village was 1 million persons, reaching 3,400,000 persons of the district and medical organization of villages and towns. Is the clinic quantity born by the clinic at village level where quantity loud so small why is wide? "A problem exists here. " This person in charge says, " developing countries like Argentina, Peru, also do the similar cooperative medical service like ours. However, at their place, except emergency call, general disease is seen by the family doctor first, family doctor think turning into the intersection of community and hospital bad, watch turning into regional hospitalling bad and then. If change the place of examination without authorization, can't get and compensate by oneself. But we are not so, even a lot of people suffer from the small disease and run into even more advanced hospitals of villages and towns directly, because though we have system of changing the place of examination, it is difficult to carry out in place. " Why have system of changing the place of examination obviously but can not fulfill? Through understanding, the reporter finds there is good reason for it. First, the serious phenomenon of gap between generations exists in the clinic at village level, technical force is very weak. Because the medical worker of the first class clinic of the village has no unit to pay out wages for them, the collective in the village is basically not absorbed either, their income mainly relies on the operating profit. But medicines by the whole county ' Municipal or district) Purchase, unified price in unison, the profit rate is very low, the treatment of the clinic medical worker at village level has been just very low all the time, most graduates of university, junior college and special secondary school are unwilling to go to the clinic at village level to work. At present, in the first class clinic medical worker of village of Wujin area, only 10% of the people are graduates of university, junior college and special secondary school, the majority are original barefoot doctors. The weakness of technical force, cause peasant's even young disease to run into health clinics in towns and townships. "Support the clinic at village level, attract talents to go to the village clinic to work, really already extremely urgent, this needs government finance and collective resultant of forces of the village. " A person in charge of health bureau of this district says. Secondly compensate the system unreasonably. The reporter knows, most counties of our province are (municipal or district) now Stipulate, see the doctor in the clinic at village level, can obtain 10%-15% of the compensation and and if reach the health clinics in towns and townships in hospital, it is much higher to compensate the range, basically exceeds 50%. In this way, it is a general cold obviously, see the clinic in the village clinic, some water is hung, may need to cost more than 100 yuan, and reach the health clinics in towns and townships in hospital, because of compensating the proportion high, the patient will not foot a bill more either. This causes a strange phenomenon: Look in less than villages of small disease, and go to villages and towns even more advanced medical organization to see. And the health clinics in towns and townships are in order to increase the business income, the excessively medical phenomenon exists to a certain extent, thus lead to the fact the fund expenditure of the cooperative medical service increases, even the deficit appears. "Look actually from present operation, it is to raise the clinic of the first class clinic of the village and compensate the proportion to adjust the compensation policy, focal point, it is really too essential. " A person in charge of clinic at village level says. (Zhu XinFa)


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