On July 1, July 4, the medical network of all urban public hospitals in our province was sold at a zero rate, while adjusting the price of some medical services. Reporters visited some hospitals in the province and learned that the people reflected the benefits of the New Deal. However, although the major hospitals have done some guidance and publicity work in the early days, there are still many citizens who have doubts.
To this end, shanxi evening news sorted out the hot issues of the people's attention, and invited relevant departments responsible for the solution.
On-site visit
The more expensive the drug, the more it saves
July 3 is the third day of the zero-percent drug use and the first normal working day of the hospitals.
At 10 am, the reporter came to the hospital, the outpatient hall was full of people. In taking the medicine window, the reporter interviewed more than 10 patients at random, and most people expressed their feelings about the price reduction.
Zhou, a provincial citizen who came to see the doctor because of his cervical discomfort, said: "no similar medicine has been bought before, no comparison."
Provincial capital citizens ms lu is a patients with high blood pressure, she tells a reporter, families, is she used a blood pressure medication, half a month ago, she bought a box is 56.9 yuan, now down to 52.95 yuan. "A box can save 3.95 yuan, 10 boxes is nearly 40 yuan, careful to calculate, but also can save a lot of." "But the registration fee has also gone up," Ms. Lu said. "in the past, my director's number was 10.5 yuan, now it's 25 yuan, so it doesn't seem to be much cheaper."
Later, the reporter interviewed the director of the pharmacy department of shan medical university, jin yue ping. She introduces, in the past, drug addition is 15%, November 1, mountain an one drug bonus will be cancelled by half, is decreased by 7.5%, and on the basis of the last year this time all the remaining 7.5% is cancelled.
"For some two dozen dollars, update to the citizens of the intuitive feelings may not be obvious, a box of medicine may be missing one or two or even a few cents, but for some chronic diseases patients, because all the year round, accumulate over a long period, can save a lot." In jin ping analysis, "judging from the current pricing, the more the more expensive medicine province. After proping, such as heart disease patients need to eat a year of wave vertical dimension, a box of this medicine before pricing is 128 yuan, the price is 119 yuan, more can save nearly $9, a week need to use two boxes, a year can save more than 900 pieces."
The price of medical services has been largely understood
Compared with the elimination of drugs, the people's feelings are more likely to be adjusted for the price of medical services.
At 4 PM, in the mountains an one general surgery ward, because the blood vessels of varicose veins in the hospital Mr. Jiang, he had just taken a day of listing, after careful comparison found: "the beds are up, the original is 16 yuan a day, now into 40 yuan; analyzes also rose, the original is 7 yuan, now into 20 yuan, expenses for medicine is cheaper than the original." Mr. Jiang calculated that on June 30, the five drugs he had been using totaled 896.32 yuan, while the same drugs were paid only 820.2 yuan, or 76.12 yuan, on July 3.
"In this way, compared with the daily increase in bed and medical expenses, the overall cost is less." Mr. Jiang said that reasonable price increases, he can understand.
Of course, Mr. Jiang is just one example. During the interview, the reporter learned that while the price of drugs was reduced, the medical service items that raised prices mainly included registration fees, visits and hospital fees. The reporter asked some of the outpatients at random, and the view on the improvement of the registration fee was different. Most people expressed understanding. "The doctors are really hard, too busy for the morning to drink, and often have to work overtime. After so many years, the registration fee has not changed, and they can't show their value." Liu said.
At 5 PM, the reporter learned from the provincial people's hospital, the hospital of mountain medicine, and the hospital of shan medical university that the complaints had not been received due to the price increases of some projects. "More than 3,000 outpatient patients in the morning, there was no one who was rioting, as usual, in order," xu minghui, director of the outpatient department of the provincial people's hospital, told reporters.
Policy interpretation
The original drug was added to all the patients and only 80% of the patients needed to pay the bill
"For the common people, what we see is probably the impact of price change on our own. In fact, the elimination of drug addition is the hallmark of public hospital reform." July 3, in an interview with reporters, provincial health economic restructuring office, deputy director of the state family planning commission jun-hua wu is introduced, the reform of public hospitals has lasted for many years, first started with public hospitals at the county level, in terms of the country, started in 2010. In 2012, we began to explore the early stages of the pilot cities for two consecutive years, and achieved full coverage in 2015. The reform of urban public hospitals was started in 2014, and taiyuan was the first pilot city. In 2015, it added the yuncheng city, and in 2016, changzhi, jinzhong and yangquan also started. According to the plan, 11 cities across the province will achieve full coverage this year.
"The elimination of drug addition means that the reform of urban public hospitals has been fully pushed away." 'from a large framework, the reform will focus on the management system, the operation mechanism and the medical service system,' Mr. Wu said. In terms of the reform and operation mechanism, the starting point is to break the mechanism of "taking medicine for medicine", but it involves a lot of links, and it is only one important link to eliminate the drug addition. In order to fundamentally change the current pattern, we must start with the production, circulation and use of drugs, as well as various government departments, such as NDRC, health and family planning commission and hospital. Therefore, in order to reduce the cost of medicine and medical consumables, and to reduce the benefit of the intermediate links, this year, our province will formulate a "two-ticket" implementation plan for drug procurement of public medical institutions.
"In accordance with national requirements, is fully implementing urban reform of public hospitals before the end of September, July 1, urban public hospitals in our province comprehensive cancel drug addition, this means that the pace of reform in our province than the national requirements for two months in advance." Wu said that in accordance with the plan, all public hospitals would eliminate the drug addition (except for the traditional Chinese medicine), and the general principle was "no reduction in hospital income and no increase in the common people's burden".
So, the hospital does not have the drug spread, so the reasonable income that reduces how should be solved? In principle, wu junhua introduced three ways to compensate: the medical service price adjustment compensation is 80%, the financial compensation is 15%, the hospital strengthens the accounting, and saves the operating cost of 5%. "Of course, this is just a guideline, and cities can also make adjustments in combination with the actual financial situation of the government to increase financial compensation." "In general, people are getting a lot of benefits," wu said. "the original drug was added to the patient's list, and the patient now needs to pay 80%."
In the interview, the reporter learned that the medical service adjustment that cancels the drug addition, the synchronous start, according to the requirement, the adjustment part will be covered by the regulation to cover the scope of insurance coverage. At the same time, will also be in total control medical insurance fund management mode, implement is given priority to with the macro-reforms, capitation payment, pay by bed, and other payment method of combining the compound payment method, gradually reduce pay according to the project.
Hot spot
The price of medical services such as diagnosis and treatment, surgery, nursing and beds will be improved reasonably
Why can't some medicine be bought in hospital? Are some medicine more expensive than drugstore? Why adjust the price of medical services... In the interview, many citizens still have questions about the New Deal. In this regard, the reporter interviewed the relevant leaders of the provincial health and family planning commission and individual hospitals to answer the hot issues concerned.
1. Why are some medicines not available in hospitals?
Mount a hospital pharmacy department director in jin ping an introduction, at present, the hospital all medicines are unified purchase by the government, all the medicines from the government procurement directory, some drugs do not necessarily in procurement catalog, so there will be a hospital can't buy.
Are some medicines more expensive than drugstores?
Jin yue ping said, the drugstore and hospital's purchase channel is not quite the same, it is understandable that the prices are different. After the implementation of the New Deal, in accordance with the requirements, in the procurement of drugs, although the government unified procurement, but the hospital can also combine the actual situation, and the drug dealer for a second bargaining. This means that even the same drugs could cost different hospitals in the future.
3. Why adjust the price of medical services?
Provincial health development planning commission economic restructuring office, deputy director of the jun-hua wu, overall, the main problems of the medical service price is the price comparison between project is not reasonable, price is low, diagnosis and treatment, nursing, surgery check treatment test price is on the high side; The nominal price of the medical service project is low, and the actual payment of the people is on the high side. Around for a long time, gradually increase the value of the part of medical personnel technical services project price, lower part of the project price higher, but the mechanism of "taking medicine cure" not fundamentally break, medical institutions, medical behavior is not standard, and the diagnosis and treatment level of medical insurance fund pays also increase hard factors, such as part of the medical service is difficult to adjust a reasonable price, the medical service price comparison relationship has not yet been fully straighten out. In addition, the medical service pricing is relatively single, medical service price management mode is given priority to with the project at present, although to a certain extent, to curb the independent projects, decomposition of medical institutions to collect fees in disorder, and so on and so forth, but for effective inhibition of medical institutions and doctors induction ability insufficient service demand, increased the unnecessary expenses.
4. How does it work in adjusting the price of medical services?
According to wu junhua, from the perspective of price adjustment, one is to further reform and improve the procurement of drugs and consumables to reduce the inflated prices. The second is to standardize the practice of doctor's diagnosis and treatment, use drugs and consumables reasonably, and reduce the number of drugs, especially the quantity of drugs with high price. Pricing from project point of view, to lower the price of large medical equipment check treatment, inspection, reasonable adjustment of ascension manifest the value of medical personnel technical services of medical service prices, especially in diagnosis and treatment of traditional Chinese medicine (TCM), surgery, nursing, beds, etc. Service project price. From the adjustment mechanism, one is to establish the dynamic adjustment mechanism based on the change of cost and income structure; Second, we need to establish a synergistic mechanism of price adjustment policy and medicare payment policy.
5. Why should I break the "medicine for medicine" mechanism?
Jun-hua wu, "to the medicine cure" subsidies for public hospital co., LTD. Is the planned economy period, allowing public hospitals on the basis of drug purchase price increase sales, to make up for a lack of government investment and hospital operating cost loss. This policy has played a positive role in ensuring the operation and development of public hospitals. But at this stage, the implementation of "medicine physician" policy produced some problems, due to the hospital, the doctor is closely related to the benefits and drug production and circulation enterprises, regulatory system defects and inadequate investment, public hospital drugs addition policy, under the market economy condition change and gradually evolved into a profit-seeking mechanism. This mechanism makes the deviation from the public welfare orbit in public hospitals to increase the burden of the people, hurt people's health, the corrosion of the health care team, strained doctor-patient relationship, damaged the image of the government, must be resolutely remove. Break the core of "taking medicine cure", is to cut off the hospitals and medical personnel to contact any economic benefits of the drug, is cut off benefit chain, regulating the behavior of diagnosis and treatment, control the unreasonable rise in medical costs, solve the decay in medicine cure, promote harmonious doctor-patient, the inevitable requirement of deepening reform, also is the people's keenly awaited, but also the real need of healthy development of the pharmaceutical industry. |
