Medical network - February 6 patients see a doctor expensive, irrational increase of medical expense and has a lot to do. Hubei taking public medical expenses control index method, reversed transmission public hospitals reduce health care costs, and will be charged with actual situation and hospital level of infrastructure investment, access to review such as hook, to control cost target of the top hospitals is preferred. For can not meet the cost target of hospitals, subtract or cancel the money.
"To see a doctor expensive", has always been the focus of media attention, also is common people complain about pain points.
Since October 2016, health and family planning commission of hubei province started on its website bulletin of the local department of 14 provincial hospital medical costs control indicators. Indicators, a total of 10 cover all medical expenses, outpatient and inpatient time medicine proportion, inspection and testing, health materials revenue accounted for the proportion of medical income, etc.
Health and family planning commission of hubei province party secretary zhang said that the purpose of the public is reversed transmission hospital reduce health care costs, and solve the problem of difficulty and high cost of treatment, strengthen the citizen health reform get feeling.
Control cost data of the public online, is not up to standard will subtract or cancel the money
"In the first half of 2016, our hospital outpatient expense is 271.44 yuan per capita, per capita hospitalization cost was 20556.81 yuan, compared with the same period in 2015, the outpatient service to reduce the 7.44 yuan, hospitalization cost is 513.94 yuan, but growth is reduced." Hubei province people's hospital, vice President of gao-hua wang told reporters.
"Medical expense control, is a worldwide problem. From the Angle of price, cost is always rising trend. Rose is also caused by several factors, such as medical technology continues to progress, constantly improve medical environment and so on." Gao-hua wang said, the control unreasonable medical expenses increased, the key is to promote reasonable treatment and reasonable charge.
The reporter understands, health and family planning commission of hubei province key monitoring indicators of medical expense control with 24 items, including 10 measures of for the public. "Select the 10 indicators of the public, because the data can directly reflect the cost, also easy to understand." Commissioner of health and family planning commission of hubei province medical administration medical tube hong-bo zhu is introduced. So far, health and family planning commission has already published two province, hubei province department of 14 provincial control fee index of the medical institution; Across the province, city, state, also put on their respective jurisdiction 2 above public hospital medical costs control indicators.
Zhang said that publicly accused of cost data in a row, can let people see understand hospitals ever to control the actual cost, also took to the track of benign competition between hospitals, have more power to JiangFei. "Publicity system, reversed transmission hospital USES the appropriate technology to control costs, only in this way, is the hospital survival." Wuhan city center guo-liang Yang, vice President of the hospital said.
After the fee index of the public, health family planning departments of provincial, city, state department also medical institutions to carry out the control special inspection and "look back".
"We will be charged fee goal implementation and public hospital infrastructure investment, access to public hospital level review, for examination and approval of new beds, equipment purchase, focus on learning (designed) construction investment, funding budget arrangement." Said hong-bo zhu, to control cost target of the top hospitals to be preferred, for short of control cost target of the hospital, all levels of the family planning administrative department of public health under the state council in conjunction with the change, finance and other departments subtract or cancel the money according to the situation.
Stomach trouble patient do brain CT, to control excessive medical treatment
"I once went to a hospital checking at the county level, found the hospital actually gave a stomach trouble critically ill patient brain CT. This is clearly excessive medical treatment." Zhang said that a stomach trouble patient, no matter how serious illness can have relationship with the brain. "By the public, let common people and the media supervision and public hospital medical behavior, reduce reversed transmission hospital ailment rectification, excessive, such as excessive medical examination behavior."
Published on the Internet at the same time, also in hubei province medical institutions to carry out the rectification of excessive medical treatment activity, to correct excessive examination, excessive use of medical services, the interests of the outstanding problems such as excessive treatment, regulating the behavior of medical institutions and medical personnel, strictly control the medical expense unreasonable growth. Said hong-bo zhu, rectification of the range is more than the province secondary and secondary medical institutions, public hospitals, private hospitals, medical institutions under the secondary reference implementation.
"In our hospital, the doctor performance to prescribing, check the project, but determined comprehensively according to the subject outpatient volume, hospitalization and surgery." Gao-hua wang, starting in 2015, the hospital to carry out the "rereading leaflet" exam. Each department to select 5 kinds of usage, the most commonly used drugs, the hospital according to the instruction, the questions in the doctor must take the test within 10 years. The move is to prevent the doctor prescribed drugs associated with disease not related or not, that is "excessive".
Distribution center in wuhan city hospital performance management methods in specific provision, drug income as the department of accounting income, medicine proportion shall not exceed the hospital's overall index. Hospital according to the discipline characteristic and historical factors, determine the medicine proportion fall in proportion, and decomposition to the department, asked all departments medicine proportion must decline than the previous year.
Guo-liang Yang, hospital clinical pharmacists for each quarter usage of the top 10 drugs to carry on the review, with abnormal fluctuations in special verification, use whether reasonable. The biggest drug to use, the hospital requirements in accordance with the previous quarter 60% of usage control; For 3 times, will be adjusted the procurement directory. "In the third quarter of 2016, we limit the 10 types of drugs."
At the technical level, the hospital has established the rational drug use electronic early warning management platform, the drug supply and marketing the whole monitoring. Guo-liang Yang said: "the doctor prescribed, the system will display a red yellow green three lights, once appear, the red light, the system can real-time blocking, the doctor is not a prescription, drug kinds ultra quantity can open; the system alarm, medicine department will follow up survey."
Supervision of hospital is also connected to the platform, real-time monitoring of the hospital medical behavior whether the data was improperly obtaining. According to introducing, this is done to "counter party", as a medical representative is mainly depends on all parties to send kickbacks to doctors.
Hubei synchronous establish accountability mechanism, strengthen the monitoring, sorting, and public medical expense, to control cost poor medical institutions and the existence of excessive medical behavior of medical staff, once found to be punish half year bonus; Once again find out clinical post, to punish a year bonus; The third time that handover discipline inspection departments. The existing management responsibility of leadership and department director, also give commandments separately according to the number of conversation, administration warned, punish bonus until removed.
Reduce the circulation and bulk purchase price reduction
"I hypertension for more than a decade, every day to eat blood pressure medication, now probably spend less than 120 dollars a month." Wuchang district liyuan community residents a mother-in-law said. This year, the abolition of all 36 public hospitals in wuhan drug addition, the drug sales, zero price difference all pharmaceutical drop of 15%.
"Cancel 15% bonus, is a double-edged sword." Guo-liang Yang introduces, at present under the condition of insufficient government input, cancel the bonus to cause the operation in some domestic hospitals. "At present, the urgent need for reform of medicine circulation field, solve the problem of reasonable pricing." Drugs from the factory to the hospital, he says, as many as four or five links between, by middlemen to make money, manufacturers complain that don't make money, patients complain of drug prices high, so the intermediate links, drug prices it is difficult to to a reasonable range.
In order to control drug prices artificially high, wuhan, xiangyang, ezhou pilot drug concentration belt quantity procurement, 54 specifications of drugs, the selection and the generic name of other drugs into bring along with all the purchasing drugs directory. Pilot to take advantage of bulk purchase, price volume, comprehensive evaluation, public bidding procurement, utmost lower drug prices. Hubei requirements, the pilot urban belt volume purchasing results of implementation, all at the provincial YaoXie centralized purchasing platform. The bidding enterprise shall be carried out in accordance with the requirements of "two votes" selection and distribution enterprise distribution.
"Recently met every quarter medicine directory drugs production, price increases." One industry source said, the medicine catalogue of drug prices low, good efficacy, but it is because the price is cheap, manufacturers to stop production, even if the production will rise in price. Moreover, some manufacturer don't accept bargaining, a "do you love do you want to" posture; Some foreign medicines, joint venture medicine small cut, but the clinical demand, inadequate domestic generics, efficacy is low.
"Different levels of hospitals, patients receiving, illness, fee standards is different also, don't make one size fits all, according to a standard evaluation." A hospital in wuhan admitted that health care reform to arouse the enthusiasm of the medical staff, medical staff treatment was carried out. "The government to increase investment, do more practical work, not to pass on to the hospital to bear the risks."
Zhang also said that the doctor is comprehensive, not behold a decline; Pure one reform, people have sense or not has improved significantly. Hubei linkage and comprehensive ShiCe will continue to adhere to the policy, through the reasonable adjustment of medical service prices, deepening the reform of public hospitals comprehensive, we will accelerate the establishment of a hierarchical diagnosis and treatment system, strengthening the medical service supervision measures, strictly control the medical expense unreasonable growth. |
