On July 5, the new policy of medicine separation was implemented nearly three months ago, and the municipal commission of health and family planning announced the implementation of the reform. The monitoring found that the total cost of medical institutions in Beijing rose by only 0.8 per cent since April. In the case of emergency medical treatment and hospital discharge, the total drug cost was decreased year on year, and the total drug cost of hospital emergency department of grade iii hospital fell 7.09%. At the same time, the proportion of medicine in the second and third level fell to 34.6% from 41.9% in the same period last year. Said before it is worth noting that for patients in big hospitals require cross section prescribing rejection problem, the city health development planning commission director LeiHaiChao revealed that Beijing will introduce appropriate of cross section of prescribing rules, and to ensure medication safety as the priority, on the basis of this is to find a balance and reasonable services for patients. Said the industry, and gradually let go across a prescription will not only facilitate the patients go to a doctor, also will further accelerate the classification and treatment pattern forming, especially more sinking prescription only to the basic-level hospitals, pharmacy of social security, etc.
Policy loosening
"Event, the city health development planning commission made it clear that will introduce appropriate of cross section of prescribing rules, and is released to the public the cross section of the control too strict prescription is expected to" loosening "signal, also shows the determination to fully reform of the current system." Industry experts say.
In fact, two months into the implementation of the new policy, some patients reported that they had been rejected for cross-section treatment at large hospitals. For example, one of the patients was prescribed high blood pressure and diabetes mellitus, which can be opened by a doctor, and the two departments of cardiology and endocrinology must be run after the reform. In response, the city health development planning commission, deputy director of the medical administration medical tube place becky clear explanation says, in accordance with the relevant provisions in this municipality, the doctor can't across large prescriptions, only allow across small prescriptions, "the doctor has a scope, clinical, oral, public health, and the four major areas of traditional Chinese medicine, can't cross each other. Clinical here are internal and external eye, ear, wife, son, or other big department, also cannot cross section. But would like to open points of high blood pressure medicine, such as diabetes patients, in principle is not breaking the rules". To this end, Beijing has issued a supplementary regulation on cross-section prescribing, which must meet several conditions, first of all, to treat the patient of his own family. The second is that the hospital system should be able to check the prescribing records of other specialists to prove that these drugs are indeed specialist and have no problem. Finally, the doctor should be able to judge the patient's condition. If these three conditions are met, the doctor can prescribe the same medicine according to the doctor's dosage and dosage form.
Business newspaper reporters find found in Beijing, in late April this year, city health development planning commission has issued the notice on further improving medical service supplement (hereinafter referred to as the "notice"), make clear a regulation, specialist physicians prescribe this professional disease diagnosis and treatment, should meet the following conditions: physician practice activities should be given priority to with this major disease, according to the illness needs to access other specialist drugs is complementary, and medical records; The prescription of other specialties should be part of the current treatment process of the disease, namely continuous treatment, without progress, no need to adjust the treatment plan, etc.
Risk avoidance
"There is a real risk of drug use in cross-section prescribing." The municipal health and family planning commission relevant officials said bluntly. Above the personage inside course of study says, in addition to cross section in the process of medicine release may involve all parties responsibility, the department of medical institutions are fine more and more, such as "good heart", may also for cross section prescribing "decoupling" has formed a certain obstacles.
Experts say that open cross section prescriptions for around is a very "subtle" reform, because this job involves multiple departments, regulatory up prone to wrangling, white space, and out of the question, medical institutions, it is difficult to delimit the responsibility of the competent department has been relatively slow to implement process. Told Beijing business newspaper reporters of the personage inside course of study, how to grasp the "cross section" of the span, is long term to the department in charge of quite a headache problem, so the parts would rather cautious when carrying out related work, eventually leading to a medicine even associated, commonly used to run multiple departments. With hospital ent center for the industry insiders said that, for instance, some big hospitals will refine to ear, nose, throat, head, neck, etc., this is what we hear a lot of "academy". Experts say the more specific the specialist, the more professional, more sophisticated, more targeted treatment that is responsible for the patient. But because of this, patients need to run multiple departments when they go to the hospital, and even when they are taking the medicine, they need to have many "specialists" prescribing them separately. Especially for some chronic diseases, perennial patients, because of the need to buy medicine to prescription drugs, it is necessary to find the doctor prescribe to buy, again and again to register fee would be a big economic burden.
Moreover, experts worry that the "separation of the mountains" issue will be highlighted by the further liberalisation of cross-section drugs. For diagnosis and treatment of different diseases, judgment, every professional "across the mountain", let across departments of specialized subject doctor prescribe medicine there is a certain risk, may don't know because of another disease, and prescribed drugs is not the most suitable for drugs, is not the most suit the medicine. Because even drugs that treat the same disease need to be refined.
"Is it more convenient for patients to prescribe drugs, or is it more professional and safe to use? We've had arguments before." City hospital authority for example pharmacist Liu Lihong always says, "some people with diabetes take some blood pressure drugs to control blood pressure for a long time, so he was at the diabetes, the doctor is can consider to give him some pressure at the same time, but must see the related medical records, not simply by patients with oral medicine, because patients to treatment or drugs are not very understanding, some medicines difference will be sent out a word."
Functional subsidence
In medical experts Zhao Heng view, in the case of satisfying certain conditions, gradually let go across a prescription is reasonable, but must conform to the clinical pathway, such as patients go to the hospital to see a cold, the doctor gave open throat, expectorant cure is reasonable, in order to further ease cold stomach upset some stomach medicine can also be caused by, but if the drug is too "crossover" have a problem.
"At the end of the day, let go of the cross section or to further speed up 'lateral court prescriptions are hierarchical medical reform, make 3 armour hospital, large medical institutions more fully bear the corresponding function." Zhao heng said.
Earlier this year, the Beijing hospital authority to disclose, although last year to Beijing municipal hospital of 22 patients with incurable diseases increased, common disease, frequently-occurring disease patients decreased, but to the big hospital the proportion of patients with simple prescription is still as high as 35%, led to a high quality medical resources waste, exacerbating the big d "registered" problems. Beijing tongrentang (group) co., LTD., chairman of MeiQun truth, also is in Beijing, the public suffer from chronic diseases, common diseases still the main way to get medicine for large medical institutions, the medical institutions in addition to provide services, also take a large part of the commonly used drug procurement and distribution functions.
Zhao Heng said, especially in patients with prescription needs focus if can reduce the patients with chronic diseases simply register for prescribing, run department frequency and frequency, can even more fully exert community medical institutions for medicine functions, 3 armour hospital advantages and resources can be more fully used, see a doctor difficult problem also is expected to get a degree of ease.
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