Medical network on July 6 - July 4, health department, national development planning commission, the ministry of finance under the state council and other seven ministries jointly issued a notice, clear requirements directly under the national health development planning commission and the state bureau of traditional Chinese medicine and the budget management of colleges and universities affiliated hospital in 2017 September 30 must all take part in the public hospital reform of possession.
In county and city public hospitals, and military hospitals successively started after the comprehensive reform of public hospitals, in the top domestic public hospitals "national team" has finally launched the comprehensive reform in an all-round way. In addition, seven ministries have explicitly requested that the "national team" of public hospitals should play a demonstration role and become the "vanguard" of the reform.
At present, there are six hospitals in the state administration of TCM (TCM), including:
China academy of traditional Chinese medicine the gate hospital, Chinese academy of sciences wangjing hospital of traditional Chinese medicine, China academy of traditional Chinese medicine xiyuan hospital, China academy of traditional Chinese medicine ophthalmology hospital, Beijing university of Chinese medicine east hospital, Beijing university of Chinese medicine dongzhimen hospital.
The national health and family planning commission (NHFPC) has 44 hospitals, including:
Beijing hospital, the hospital, Chinese academy of medical sciences, Peking union medical college hospital, Chinese academy of medical sciences fuwai cardiovascular hospital, Chinese academy of medical sciences cancer hospital, Chinese academy of medical sciences, plastic surgery hospital, Chinese academy of medical sciences demartological hospital blood diseases hospital, Chinese academy of medical sciences, Peking University first hospital, Beijing university people's hospital, Peking University third hospital, Beijing university stomatological hospital, the sixth hospital of Beijing university, the first hospital of jilin university, jilin university, jilin university second hospital the fellowship hospital, jilin university stomatological hospital, zhongshan hospital affiliated to fudan university, fudan university, huashan hospital, pediatric hospital affiliated to fudan university, department of obstetrics and gynecology hospital affiliated to fudan university, fudan university, fudan university affiliated tumor hospital otolaryngology hospital affiliated second hospital, qilu hospital of shandong university, shandong university, huazhong university of science and technology, xiehe hospital affiliated to tongji medical college, huazhong university of science and technology, tongji hospital affiliated to tongji medical college, huazhong university of science and technology, liyuan hospital affiliated to tongji medical college, central south university xiangya hospital, central south university xiangya hospital, central south university xiangya research, first affiliated hospital of sun yat-sen university, sun yat-sen memorial hospital, sun yat-sen university, sun yat-sen university cancer prevention and control center, sun yat-sen university, zhongshan ophthalmic center, sun yat-sen university affiliated stomatological hospital, west China hospital of sichuan university, sichuan university, west China second hospital, sichuan university huaxi stomatological hospital, xi 'an jiaotong university medical school first affiliated hospital, xi 'an jiaotong university school of medicine, second affiliated hospital, xi 'an jiaotong university school of medicine affiliated stomatological hospital.
All 50 are major hospitals, such as grade iii, which are involved in health reform, which has a significant impact and a greater impact.
According to the notice, 50 major hospitals need to focus on some key reform tasks, including the purchase of high-value medical consumables in the area, and reduce the high price of consumables.
From the geographical position, 50 hospitals involved in provinces including: Beijing, tianjin blood diseases hospital, Chinese academy of medical sciences), skin diseases hospital, Chinese academy of medical sciences) of jiangsu province, jilin, Shanghai, shandong, hubei, hunan, guangdong, sichuan, shaanxi province. The high value consumables manufacturers in the industry need to pay attention to the specific issues that these large hospitals participate in the centralized procurement of high-value consumables.
In addition, the notice specifies that 50 major hospitals will also implement the medical service price reform policies of the territory, and the proportion of hospitals providing special medical services will not exceed 10% of all medical services.
The special medical treatment began in the 1990s, and was mainly used as the foreign guest and the high dry ward. Later, the status restriction was gradually eliminated. So far, the medical services in public hospitals can be classified as basic medical and special medical care, and the basic medical care will be covered by medical insurance. In the treatment of special medical treatment, there are a lot of high prices, imported pharmaceutical products, and beyond the basic medical scope of the examination, diagnosis and treatment programs.
It has been estimated that many hospitals make up more than 10 percent of total hospital revenue in terms of special medical care, especially in large cities and large hospitals. Correspondingly, the sale of some expensive, imported, and unconventional treatment programs in public hospitals also depends on the development of special medical care.
Seven ministerial posts require that 50 of the top hospitals in the country must strictly control the scale of medical services, which is not good for some industry players. High prices and imported products are becoming less and less viable in public hospitals, where private hospitals have to turn.
Annex: 50 hospitals need to highlight key reform tasks
(a) fully implemented before September 30, 2017, a comprehensive reform (except traditional Chinese medicine yinpian) bonus to cancel all drugs, break with medicine medical mechanism, establish maintenance public welfare, to mobilize enthusiasm and ensuring sustainable public hospital operation mechanism and decision-making, execution, supervision and coordination, the governance mechanism of checks and balances, promote each other, we will accelerate the establishment of a modern hospital management system.
(2) execute apanage medical service price reform policy earnestly, cooperate to adjust the structure of the medical service price, to improve the value of medical personnel technical services in the hospital medical service income of the total. In accordance with the function of "national team", we should carry out medical service projects that are suitable for the national team, and actively carry out new technologies and projects with high technical difficulties and high risks. To fulfill social responsibility to carry out basic medical services, strict enforcement of government pricing, orderly market regulation of outpatient medical services and other market competition more fully, stronger demand for personalized health care services, strictly control the scale of the special medical services, and provide the proportion of outpatient medical service does not exceed 10% of the total medical services.
(iii) actively participate in the construction of the graded diagnosis and treatment system and take the lead in the construction of the medical consortium and play a leading role. According to apanage the medical couplet body construction overall arrangement, joint secondary hospital, set up medical group of grassroots medical institutions, Shared with the talent, technical support, check the mutual recognition, prescription flow, service cohesion as a link, to the family doctor team to provide technical support and operational guidance, guide the high quality medical resources sinking, improving the capacity of grassroots medical services. We will encourage the establishment of a cooperative relationship between the trans-regional and a number of medical medias, and establish a high-level, complementary and complementary medical association, which will enhance the capacity of medical services in the region. We will encourage cooperation in specialized fields to form a specialized alliance across the region and enhance the ability to treat major diseases. We will encourage the provision of telemedicine services to grassroots, remote and less-developed areas, and improve the overall efficiency of quality medical resources and medical services. We will play a leading role in the health and poverty alleviation, the support of the group and the support of the group.
Dependency (4) take an active part in medicine, high value medical consumables centralized purchasing, hospital use of all drugs (not including Chinese medicine yinpian) should be through the earthly provincial drug centralized purchasing platform (provincial public resources trading platform) procurement. Encourage committee JuShu tube joint venture or a joint venture with local hospital hospital procurement group, giving full play to the advantages of bulk purchase, to carry out the belt quantity, with procurement budget, further squeeze drug supplies water price. Take the lead in the implementation of drug purchase "two votes", encouragement and drug manufacturers direct settlement drugs and drug production and distribution enterprise settlement distribution costs, and in strict accordance with the contract time payment drug payment for goods.
(5) actively participate in the reform of the mode of payment of medical insurance, and gradually reduce the amount of payment to be paid by the project, and expand the payment range by disease type and service unit. We will actively explore the payment reform of the related groups (DRGs) based on disease diagnosis, and do a good job in the standardization of basic work and clinical data. The clinical pathway management was advanced to improve the number of clinical pathway management cases, the rate of entry and completion rate. Actively participate in the online settlement of medical insurance.
(6) improve the hospital income distribution mechanism. According to the relevant policies and regulations of the central institution, it will improve the performance wage allocation method, reflect the differences in the position, balance the subject balance, and reflect the multi-lauderable and excellent performance. A sound system of internal performance appraisal, the outstanding performance of post responsibilities, workload, service quality, behavior standards, medical expenses, medical quality and safety control, personnel training, and the patient degree of satisfaction of medical ethics, such as index, the assessment results and the medical staff personal salary, job employment, job title promotion. It is strictly forbidden to issue revenue targets to departments and medical personnel, and personal compensation of medical personnel should not be linked to the income of drugs, sanitary materials, inspections and tests.
(7) take the lead in implementation of control public hospital medical expense unreasonable growth of several opinions (countries who restructuring hair [2015] no. 89), to regulate the behavior of medical personnel and treatment, strengthening hospital internal control system, and strictly control the scale of the hospital, reduce the drug supplies inflated prices, promote the reform of medical insurance payment methods, build the hierarchical diagnostic system, implementation of the national health promotion and health management, and other comprehensive measures to control the medical expense unreasonable growth. According to the principle of the local government, the management of the affiliated hospital is included in the control scope of medical expenses.
First, the establishment of a modern hospital management system. Formulate the articles of association of the hospital, to establish and perfect the system of hospital internal management organization, management, and rules of procedure, procedures, etc., regulating the internal governance structure and power operation rules, and improve the medical quality and safety, human resources, financial assets, performance appraisal, talents training, scientific research, logistics, information, such as internal management system, improve the level of hospital management standardization and refinement, scientific, reduce hospital operating costs. We will strictly implement the core system of medical quality and safety, and promote rational inspection, medication and treatment. In terms of position setting, income distribution, professional title evaluation, management and use, etc., make overall consideration for the establishment of internal and external personnel. Establish and improve comprehensive budget management, cost management, financial reporting, third-party audit and financial information disclosure system. Before the end of July, 2017, the local government will complete the work of the chief accountant. We will implement standardized training of resident doctors, standardized training of specialists and continue medical education system, strengthen the construction of clinical key specialties, disciplines and teaching bases, and do well in the training of medical students. We will strengthen standardization and standardization of hospital information systems, and take the lead in establishing unified information standards and interfaces to achieve connectivity.
(9) take the lead in implementing the plan of action for further improvement of medical services. The scientific implementation of the appointment and treatment, the realization of the time precise appointment, the implementation of the real-name appointment diagnosis and treatment. According to the patient's medical treatment, the patient should be able to allocate medical resources such as emergency hospital, hospital bed, pharmacy, etc., which can influence the bottleneck of the patient's medical treatment experience. To strengthen ambulatory surgery quality fine management, in order to explore some hospital services into medical services in the day, and optimize the medical service process, improve the efficiency of medical service, ease patients' hospital "and" operation difficult "problem. We will continue to improve the quality of medical care, and establish a multidisciplinary diagnosis and treatment model for severe and acute diseases, and strengthen the safety and privacy protection of patients. We will strengthen the construction of nursing teams, fully implement quality care and continuously improve nursing services. Strengthen drug administration, promote rational use of drugs. We will carry out information services such as consultation and delivery of medical information and the settlement of inter-patient consultation, and build a two-way referral information platform, which will play a leading role in the convenience of public medical treatment. |
