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    Home > Active Ingredient News > Drugs Articles > Director of Guangzhou health and Family Planning Commission: the policy making of medical reform is more effective than the evaluation

    Director of Guangzhou health and Family Planning Commission: the policy making of medical reform is more effective than the evaluation

    • Last Update: 2015-03-16
    • Source: Internet
    • Author: User
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    Source: Yangcheng Evening News March 16, 2015 hospital compensation should not be the same last year, the state implemented the county-level public hospital reform pilot, and cancelled the drug mark up According to the requirements of the policy, after canceling the drug markup policy, the actual reduced income of county-level hospitals can be solved by adjusting the price of medical services such as surgery, financial investment, strengthening the accounting of hospitals and saving the operation cost According to Chen yini's investigation, there are still many problems to be solved: the calculation mechanism of financial compensation is unreasonable In the compensation method, after the government is required to share the drug markup, the hospital will reduce the total income by 20% At present, the base for calculating the hospital's income reduction is determined according to the previous three years, without considering the annual growth rate of the business volume of hospitals everywhere, resulting in less government compensation than the actual loss ——One size fits all compensation mechanism is unreasonable County level public hospitals include general hospitals and specialized hospitals such as traditional Chinese medicine and maternal and child health care, Chen said Before the reform, traditional Chinese medicine hospitals mainly used internal medicine patients, and the proportion of traditional Chinese medicine in income composition was higher than that of other hospitals, while MCH hospitals mainly used surgical technology treatment After the price adjustment of medical reform, traditional Chinese medicine hospitals with fewer operations are most affected In order to minimize the loss of income, some traditional Chinese medicine hospitals try to use more pieces of traditional Chinese medicine that are not affected by the "zero difference rate" of drugs, and some hospitals use more instruments and blood tests Chen yini believes that the current reform of public hospitals should be based on big data analysis, according to the annual operation of hospitals, develop dynamic compensation ratio, and set different financial subsidy standards for different hospitals One year after the pilot project, the state has expanded the pilot project of county-level public hospital reform It is necessary to achieve the goal of "more than 90% hospital visits within the county, and basically no serious illness out of the county" "To push forward this reform, supporting measures must keep pace." Chen yini said that on the one hand, the hospital should strengthen cost accounting, save operating costs, share 10% of zero margin compensation for drugs, and on the other hand, compensate for hospital losses by increasing the price of medical services such as surgery, "what will be the final result? The hospital is worried that the compensation can not make up for the loss of drug reduction, so it will increase the hospital income through over inspection and treatment, which will not decrease! "Chen yini believes that the health department should develop the medical behavior supervision system of public hospitals as soon as possible, and the main policies are mainly reflected in" three controls "- control of drug use catalogue (develop the county drug general control catalogue) , control the growth of medical expenses (implement the zero growth assessment of average medical expenses), control the use of antibiotics (limit the proportion of use), implement the prescription review system, standardize medical behaviors, and improve medical quality It is necessary to establish a supervision system for hospital medical behaviors and an internal performance evaluation system, and include key indicators such as strengthening cost accounting and saving operation costs into the evaluation system, which is linked with financial subsidies Chen yini found that in many local and county-level public hospitals, policy-making is more important than effectiveness evaluation when evaluating the effectiveness of medical reform, which obviously focuses on the step-by-step policy-making of medical reform, but the evaluation system of policy implementation effect is missing“ In this way, the pilot hospital of medical reform has been running for one year Although the grass-roots level has put forward various suggestions to correct the compensation mechanism, the local medical reform offices have no way to start because they do not have sufficient basis to make scientific decisions " There is no effective evaluation system, and there is no scientific evaluation opinion on whether the growth momentum of drug income has been curbed, whether the income of technical and labor services has been reasonably increased, whether the burden of all kinds of patients' medical treatment has been reduced, and whether the medical treatment rate of county-level public hospitals has gradually increased For this reason, Chen yini believes that the top-level design should be done as soon as possible and the effect of medical reform should be evaluated scientifically Through the regular analysis of residents' burden of medical treatment, including secondary average cost and individual payment, the paper evaluates whether the residents can enjoy the reform dividend after the reform; Through regular analysis of hospital operation, including key indicators such as hospital drug revenue and drug proportion, increase and decrease of hospital business and revenue, to assess whether to retain more patients to seek medical treatment in the county after the reform, and gradually achieve the final expected effect of medical reform of "serious illness does not leave the County" Building linkage data dynamic monitoring "at present, the operation mechanism of medical reform management institutions is not smooth!" Chen yini said that county-level medical reform offices, as the office of the county-level government leading group for medical reform, are mainly responsible for coordinating the key work of medical and health reform as a whole, and are temporary institutions Because the affiliation of medical reform office has experienced the change from the development and reform department to the health department, most of the medical reform offices of prefecture level cities are currently affiliated with the Health Bureau, some of the county-level medical reform offices are in the Health Bureau, some are still in the development and Reform Commission, which makes communication at the grass-roots level difficult and the efficiency greatly reduced Chen yini said that the reform of county-level public hospitals will change the original management system, need to improve the compensation mechanism, reform the personnel distribution system, and establish the corporate governance structure, which will touch the inherent policies and departmental interests The medical reform office set up in the health sector as a coordinating body is obviously not strong enough and difficult to coordinate She suggested that the dynamic monitoring mechanism of the linkage data between the municipal and county-level medical reform offices should be launched to fully control the situation of medical reform.
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