Dimethyl ** drug income accounted for 50% of the total

From February 1, 2013, Guangxi will officially launch the second batch of pilot county-level public hospitals for comprehensive reform pilot work. Based on the first batch of pilots in Xing'an and Yongfu, the city has added 10 counties as reform pilots to break the mechanism of “taking drugs to support medical care” as a breakthrough, cancel drug additions, and sell drugs at the purchase price. This means that all the county-level public hospitals in the city will come to an end by “taking drugs to support medical care”.

The 12 counties in the city bid farewell to “the use of medicine to support medical care” to make money by relying on medical technology in the

At present, with the deepening of the city's medical reform work, the reform of basic medical institutions has been successfully implemented. The state's basic medicine system has been implemented in all county-level public medical institutions in the city, and the masses have obtained more benefits in medical reform. However, public hospitals, especially county-level public hospitals, are the hardest “hard bones” in medical reform. Among them, "taking medicine to support medical treatment" is a deformed phenomenon. The eradication method is the "back to the doctor": medical staff do not rely on selling drugs, but rely on medical technology to make money.

According to the "Implementation Plan for the Pilot Work on Comprehensive Reform of the Second Batch of County-level Public Hospitals in the District" (hereinafter referred to as the "Protocol") issued by the Autonomous Region, the entire region will use the mechanism of "taking drugs to support medical care" as the key link to make overall plans. We will promote comprehensive reforms in the management system, compensation mechanism, personnel distribution, procurement mechanism, and price mechanism, and strive to increase the rate of visits within the county to around 90%, basically achieving the goal of “big illness without counties”.

Before the reform, the medicines sold by the hospital could be sold to patients on the basis of the purchase price by an increase of 15%. After the reform, all pilot public hospitals were required to cancel the drug addition. All medicines (excluding Chinese Herbal Medicines) were sold at the purchase price. After the sale was no longer possible, how would the hospital's income problem be solved?

The "Proposal" puts forward the principle of "returning to the doctor" so that medical personnel can obtain income through medical treatment. The hospital will thus reduce the amount of reasonable drug add-on revenues, and compensate them by adjusting the prices of medical technology services and arranging the county-level public hospital comprehensive reform subsidy funds, among which 80% will be adjusted for medical service price compensation and 20% will be for financial subsidy funds. The reporter saw from the “Programme” that after the start of the reform, the prices of medicines, medical treatment fees, and nursing fees for pilot-level public hospitals will be adjusted. There are a total of 47 items in this price adjustment item, of which 17 items have been reduced, and 30 items have been increased. The first is to adjust the price of some medical service items, and the price of 10 items of examination fees has been raised.

The doctors in the outpatient consultation fee were raised from 1 yuan/person to 3 yuan/person/time, the attending physician was increased from 2 yuan/person to 5 yuan/person, and the deputy chief physician was up to 3 yuan/person/time to 10 yuan/person/person. , experts from 8 yuan / person to 30 yuan / person. The price of 20 items for nursing care was increased by 90%, and the price of 17 items for large-scale equipment inspections was reduced by 5%. The adjusted medical service items are included in the payment scope of the medical insurance policy according to regulations, and the price increase part is paid according to the basic medical insurance policy. This will not increase the personal medical expenses burden of the insured personnel. On the contrary, the patient's cost burden will also be reduced.

Xing'an Yongfu took the lead in testing the hospital's healthy development

In September 2011, the Xing'an County People's Hospital and Yongfu County Traditional Chinese Medicine Hospital were included in the trials of the first batch of public hospitals in the region that were initiated by the Autonomous Region. Then, after these two county-level public hospitals first tried first, what was the overall effect and what benefits did the people receive?

According to the person in charge of the Chinese Medicine Hospital of Yongfu County, after one year of trials, the pilot reforms have shown initial results.

First of all, the problem of “difficulty in seeing a doctor and expensive to see a doctor” reflected by the people has been effectively alleviated. According to a set of data provided by the hospital, from January to November this year, the number of hospital outpatient visits reached 102,153, an increase of 20.96% year-on-year; the number of hospitalizations was 8,738, an increase of 56.76% year-on-year; the outpatient expenses were 63.2 yuan, and the discharged patients were paid 3,136 yuan. The increase in both patient outpatient and inpatient costs was effectively controlled within 10% of disposable income of urban residents and per capita net income of farmers.

Hospitals that had been worried about the phenomenon of “changing to death” did not happen. On the contrary, hospitals have tasted a lot of sweetness in the reform. From January to November, the outpatient service income of Yongfu County Chinese Medicine Hospital increased by 30.06% year-on-year, and that of hospitalization service increased by 51.90%.

The business income of the hospital showed a positive growth. After the medical reform, the per capita monthly income of medical personnel in the hospital increased by 25% compared with the same period of last year. The medical value reflecting the gold content was fully reflected, which greatly mobilized the enthusiasm of the employees. In addition, Yongfu County Chinese Hospital, in addition to the guidance of the price of the autonomous region to increase the 20 care fee items, 10 items of the examination fee is only adjusted according to the guide price of 73%, 17 large medical equipment inspection fees reduced to 50% of the original price The loss caused by the abolition of medicines in hospitals was not passed on to patients.

After Xing'an County People's Hospital simultaneously implemented zero-difference sales of drugs, cancellation of drug add-on, and medical insurance reimbursement policies, the hospital reduced the reasonable drug add-on income and compensated by adjusting the prices of medical technology services and arranging subsidies. This not only ensures the relief of the medical burden of the people, but also ensures that the hospital's reasonable income does not decrease.

Stepping into the Reform of Public Hospitals at the County Level in the "Sham Shui Po District" of Medical Reform

Compared with the reform of basic medical institutions, the reform of county-level public hospitals is more difficult and complex. After all, it is a new thing. In the interview, many of the heads of county-level public hospitals that were included in the second batch of reform pilots were inevitably worried.

In the county-level DM hospitals, the proportion of drug revenue to total income is usually close to 50%, accounting for almost half of the total. The elimination of drug additions means that many hospitals are suffering from injuries. This is for the county-level hospitals that rely more on medicines for their income, and the greatest concern after the elimination of drug additions is whether the compensation mechanism can keep up.

The relevant person in charge of the Xing'an County government said that in 2012, Xing'an County's annual drug plus-subsidy income was 4.69 million yuan, of which 3.75 million yuan was adjusted for service prices, and 940,000 yuan was allocated to district and county finances. At present, the county finance has pre-arranged 2 million yuan for the reform of county-level public hospitals. The increase in financial assistance has provided a strong financial guarantee for the smooth implementation of the county's health care reform.

“All municipalities and departments must strengthen the confidence in advancing the comprehensive reform of county-level public hospitals.” Vice-President Li Kang stated at the promotion meeting that it is necessary to highlight key points, seize the key, and accurately grasp the overall requirements of the comprehensive reform of county-level public hospitals. To adjust the prices of medical technology services, establish sustainable financial security mechanisms, steadily advance the reform of medical insurance payment methods, define the scale and function of hospitals, establish a vibrant county-level public hospital operation mechanism, and actively and steadily promote the second batch of county-level public hospitals. Comprehensive reform pilot work.

The person in charge of the Guilin Municipal Government also stated that after completing the reform of the two pilot counties, the city will fully roll out in Guilin. Guilin will boldly break through and continue to do a lot of fruitful work and beneficial explorations in personnel distribution system, performance work reforms, financial compensation, etc., and promote pilot projects for comprehensive reform of county-level public hospitals. Finally, the government, the people, and the hospital will be satisfied. Affordable.