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    Home > Active Ingredient News > Drugs Articles > Banning 21 kinds of auxiliary drugs from clinical pathway in Anhui Province

    Banning 21 kinds of auxiliary drugs from clinical pathway in Anhui Province

    • Last Update: 2016-01-05
    • Source: Internet
    • Author: User
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    Source: Yigu 2016-01-05 the first day of work in 2016, January 4 The notice on the establishment of clinical pathway management and guidance center of public hospitals at county level in Anhui Province was released on the official website of Anhui provincial health and Family Planning Commission on May 1, 2010 Among them, the most striking thing is to further clarify the auxiliary drugs used in the clinical treatment process, forbidding 21 kinds of drugs to be included in the clinical pathway form, which means that the medical insurance costs are controlled, On the basis of drug bidding, a new playing method has been added Especially since the basic drug catalog was established in the medical reform, auxiliary drugs have become the target of all provinces Different from the list of key monitoring and use previously, not being included in the clinical path means that these drugs have been completely expelled from the hospital market, which is for the drug companies and related generations who have made great efforts to research and develop and register Li Shang is undoubtedly a hurt blow In addition, in the formulation of the drug prohibition catalogue, Anhui provincial health and Family Planning Commission adopted the term "reference to the practice of brother provinces", which means that other provinces and cities can also refer to the practice of Anhui brothers for research and use Specific 21 kinds of drugs are: bone melon extract injection, calf serum deproteinized extract injection, bone melon polypeptide for injection, Safflor for injection, brain protein extract for injection, Gu Hong injection, RNA for injection Ⅱ , spleen Aminopeptide Oral freeze-dried powder, Trichosanthes injection, lentinan injection, compound coenzyme for injection, Brucea javanica oil injection, hepatohydrolytic peptide for injection, compound 3D B for injection , monosialtetrahexosylganglioside, calf blood protein extract, invert sugar electrolyte, Shenqifuzheng injection, cerebrosine peptide injection, sodium creatine phosphate for injection, alprostadil In order to further standardize clinical diagnosis and treatment behavior, improve medical quality, ensure medical safety and consolidate the reform achievements of county-level public hospitals in Anhui Province, the implementation plan of clinical pathway management of Yigu + county-level public hospitals in Anhui Province is in accordance with the notice on printing and distributing the action plan for further improving medical services (Guo Wei Yi Fa [2015] 2) issued by the national health and Family Planning Commission No.), Anhui Provincial People's government's pilot plan for deepening the comprehensive reform of the medical and health system (WZ [2015] No 16) and our committee's notice on doing a good job in the promotion of clinical pathway management of county-level public hospitals (wym [2015] No 512) and other relevant documents, combined with the actual situation of county-level public hospitals, formulate this implementation plan 1、 Target task Conscientiously implement the spirit of the relevant documents of the CPC Central Committee, the State Council, the provincial Party committee and the provincial government on deepening the reform of the medical and health system, according to the requirements of the national health and Family Planning Commission for clinical pathway management, and gradually establish a clinical pathway management and medical quality evaluation system and mechanism suitable for the actual situation of our province through the implementation of the clinical pathway management in the county-level public hospitals of the province, and constantly complete We will improve the mechanism for continuous improvement of medical services, control the unreasonable growth of medical expenses, and effectively improve the people's medical experience The specific objectives are as follows: (1) by the end of 2017, we will strive to achieve 70% of the discharged patients in county-level hospitals carrying out clinical pathway management (2) To control the unreasonable growth of the average cost of inpatient cases, the average cost of inpatient cases in county-level hospitals that carry out clinical pathway management has decreased compared with the same period of last year, or the growth rate does not exceed the CPI index of that year (3) The average length of stay of county-level hospitals implementing clinical pathway management was reduced compared with the same period of last year (4) Reduce the proportion of drugs By the end of 2017, the proportion of drugs in county-level public hospitals implementing clinical pathway management will be reduced to 30%, and the consumption of health materials per 100 yuan of medical income (excluding drug income) will be gradually reduced to less than 20 yuan (5) The use of antibacterial drugs meets the standards of the Ministry of health By the end of 2017, the utilization rate of antibacterial drugs for inpatients in county-level public hospitals carrying out clinical pathway management will not exceed 60%, the proportion of antibacterial drugs for outpatients will not exceed 20%, and the proportion of antibacterial drugs for emergency treatment will not exceed 40% The use intensity of antibiotics should be controlled below 40 DDDs per hundred person days (6) According to the requirements of the notice on the implementation and improvement of the guidance on centralized drug purchase in public hospitals (GBF [2015] No 7), the proportion of auxiliary drugs shall be strictly controlled, and the use amount shall be kept at a low level (7) To establish a single disease payment mechanism for clinical pathway diseases of new rural cooperative medical system (NRCMS), and include all the eligible clinical pathway management diseases into NRCMS according to disease payment (except trauma and childbirth), and implement a dynamic adjustment mechanism 2、 The implementation scope has been declared by the unit and reviewed by the health and family planning department A total of 75 county-level public hospitals in the province are listed in the implementation unit of clinical pathway management See Annex 2 for the specific list The health and family planning departments of each county (District) should actively guide the secondary and above hospitals within their jurisdiction to join the implementation unit of clinical pathway management, and gradually expand the scope of clinical pathway implementation 3、 Work measures (I) establishment and improvement of leadership and coordination organization The provincial health and family planning commission established a leading group for clinical pathway management promotion of provincial and county public hospitals with the main responsible person as the group leader, the responsible person in charge as the Deputy group leader and the main responsible person of relevant departments as the members The leading group office is located in the medical administration and medical management office of the Commission and undertakes the daily work of the leading group (see Annex 1) The leading group is responsible for formulating the promotion work plan and implementation plan of the whole province, studying and solving the outstanding problems in the clinical pathway management, and organizing the supervision of the clinical pathway management of the whole province Set up a provincial and county level public hospital clinical pathway management and guidance center, which is hung in Wuhu Second People's Hospital, and set up an expert management team to be responsible for clinical pathway business management, including publicity and training, technical guidance, dynamic tracking management, quality and effect monitoring and evaluation, etc 2 The municipal and county health and family planning administrative departments shall establish a leading group for clinical pathway promotion, determine special departments and personnel, be responsible for the organization, implementation, supervision and inspection of clinical pathway management of medical institutions within the jurisdiction, actively coordinate with relevant departments, and promote the work The municipal health and Family Planning Commission shall establish a clinical pathway management expert group to be responsible for the management of clinical pathway business in county-level public hospitals under its jurisdiction 3 The hospital that implements the clinical pathway management of county-level public hospital should establish the work system and coordination mechanism of the organization and leadership which is in the charge of the head of hospital and department The hospital establishes a leading group for clinical pathway management, which is mainly in charge of the group leader, to organize the formulation of specific work plans, implementation plans and relevant systems of the hospital, and organize the implementation The hospital should set up two-level special working organizations, which are hospital and department, define the special personnel, be responsible for the specific implementation of clinical pathway, and establish a regular reporting system At the same time, an expert committee is established to be responsible for formulating clinical pathway forms, organizing training, guiding and urging departments to carry out work, and regularly evaluating the progress, quality and benefit of clinical pathway implementation (2) In order to implement the clinical pathway management of county-level hospitals, our committee formulated the corresponding work promotion plan (see Annex 3) Every county-level public hospital should formulate detailed clinical pathway management work plan and strictly implement it every year The annual work plan shall include work content, responsibility division, implementation method, steps, guarantee, completion time limit, etc the annual clinical pathway management work plan shall be improved according to the completion of the previous year and existing problems, and the disease types of clinical pathway management shall be increased year by year to ensure the realization of the objective of clinical pathway disease management 1 Disease selection The hospital should carefully select no less than 50 representative diseases according to the annual distribution of disease types and the actual work of the hospital, as the disease types of clinical pathway management of the hospital, and further optimize the diagnosis and treatment process, make clear the inspection items and treatment drugs, and limit the use of consumables The selected diseases shall be reported to the administrative department of health and family planning at the corresponding level for the record 2 Form formulation According to the scientific demonstration of the selected diseases, a detailed clinical pathway form is formulated, specific work objectives and implementation steps are determined, strictly implemented, and diseases are continuously increased according to the actual situation 3 System upgrade Hospital should upgrade his system to support clinical pathway implementation, timely complete form entry and implementation debugging, and carry out trial operation of clinical pathway implementation as soon as possible (3) To establish the corresponding system to support clinical pathway management, county hospitals should establish and improve the rules and regulations of clinical pathway management, and realize institutionalized and refined management Specifically, it includes: establishing clinical pathway management system and assessment system, carrying out clinical pathway management and promotion work in strict accordance with various rules and regulations, regularly assessing departments and diseases carrying out clinical pathway management, ensuring the orderly development of clinical pathway work; cooperating with the new rural cooperative management department, establishing medical insurance payment and cost control system, reward and punishment system, and realizing clinical pathway management The medical staff are encouraged to pay for the single disease (4) Effective connection with the single disease payment of new rural cooperative medical system, effective implementation of clinical pathway management, trial implementation of single disease payment of new rural cooperative medical system, dynamic adjustment of single disease payment standard according to the proportion of patients visiting outside the same disease county and the proportion of increase and decrease of sub average cost, decrease of single disease payment standard and the proportion of patients visiting outside the county, and increase of sub average cost is lower than that of CPI in the same year The specific standards shall be formulated by the provincial agricultural cooperative office We should encourage regions with conditions to explore the reform of double quota payment for single disease, that is, fixed patients and agricultural cooperative payment quota In principle, the cost saved in the single disease payment shall be rewarded to the medical staff at a rate of no less than 60% (5) To strengthen the management of rational use of antibiotics, when formulating the clinical pathway form, it is necessary to meet the requirements of the guiding principles for clinical application of antibiotics (2015), control the unreasonable infusion, and prevent the use of antibiotics in patients with class I incision surgery from exceeding 30%, in principle, do not combine the prevention of the use of antibiotics Among them, in principle, patients with inguinal hernia repair (including patch repair), thyroid disease operation, breast disease operation, arthroscopic operation, carotid endarterectomy, skull tumor resection and vascular interventional diagnosis operation will not be prevented from using antibacterial drugs; in principle, the time for class I incision operation patients to prevent using antibacterial drugs is not more than 24 hours At the same time, strengthen the management of auxiliary drugs According to the practice of brother provinces and cities, the following 21 kinds of drugs cannot be included in the clinical pathway form, bone melon extract injection, calf serum deproteinized extract injection, bone melon polypeptide for injection, Safflor for injection, brain protein extract for injection, Gu Hong injection, RNA for injection II , spleen Aminopeptide Oral freeze-dried powder, Trichosanthes injection, lentinan injection, compound coenzyme for injection, Brucea javanica oil injection, hepatohydrolytic peptide for injection, compound 3D B for injection , monosialtetrahexosylganglioside, calf blood protein extract, invert sugar electrolyte, Shenqifuzheng injection, cerebrosine peptide injection, sodium creatine phosphate for injection, alprostadil (6) Further strengthen the clinical pathway management and supervision based on Information Technology(
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