It's set! The 42 diseases in Fujian Province began to be paid for by disease

Medicine Network November 17th, November 16th, Fujian Provincial Health Insurance Bureau, the Joint Health and Health Commission hangs a notice - on the fifth batch of provincial public hospitals by disease to pay for the issue of the notice (hereinafter referred to as Notice) will once again pay by disease to the deep water area: wheezing, fractures, cough, kidney failure, heart failure, back pain, stroke, disease and other 42 kinds of pay-per-view reform in Fujian Province.
According to official data, these disease charges in the range of about 5000 to 10,000 yuan, they will be in the province's public hospitals and the 900th hospital, where the main diagnosis, the main operation in line with the basic medical insurance coverage and out-of-charge patients in hospital should be included in the scope of pay-per-disease.
It is understood that Fujian Province, in order to encourage and support the development of Traditional Chinese medicine, highlight the characteristics of Chinese medicine, play the role of pay-per-disease reform in promoting the coordinated development of Chinese and Western medicine, and continuously improve the charging policy for Chinese medicine services, the selection of 42 medical treatment programs mature, controllable quality, stable cost of common advantages of Chinese medicine to implement pay-per-view reform, as the fifth batch of public hospitals in the province.
It is worth noting that the payment policy for this batch of diseases shall be implemented in accordance with the provisions of the original Fujian Provincial Medical Insurance Office and the Provincial Health Planning Commission's Notice on the Charges and Payments of Provincial Public Hospitals on Disease-related Issues, that is, the medical insurance shall be settled in accordance with the charging standards of the disease, and the provincial-level medical insurance payment policy shall remain unchanged.
To this end, the Notice requires all units to strengthen the management of collection and payment by disease, to carry out quality control of Chinese medicine services, to implement detailed clinical pathways, to strengthen the management of collection and payment audit of diseases, and to further standardize the conduct of diagnosis and treatment.
provincial public hospitals should give full play to the role of information, the clinical path of Chinese medicine diseases into the information management, improve the chinese medicine disease cases home page information collection, improve the level of information management of Chinese medicine diseases.
At the same time, the provincial public hospitals should focus on Chinese medicine treatment, pay attention to the role of the advantages of Chinese medicine, year by year to improve the proportion of Chinese medicine treatment in Chinese medicine diseases, optimize the income structure of Chinese medicine, and constantly improve the overall proportion of Chinese medicine medical services.
literally, these diseases will be more inclined to the application of Chinese medicine.
To achieve the "patient side" of the collection and payment reform is understood that fujian four places (Xiamen, Ningde, Yantian, Longyan) was recently selected as the total regional points of the total budget and pay-per-view pilot cities.
fact, 22 county-level and above public hospitals in Sanming City, the star provinces of the health care payment reform, have been fully integrated into the C-DRG collection and payment management since January 1, 2018.
, the number of C-DRG disease groups in Sanming City reached 796 groups, covering 67% of discharged patients.
as the first "patient-side" collection reform, C-DRG pricing and payments in groups.
In Yuxi County, Sanming City, Yuxi County insured patients in Yuxi County General Hospital, Yuxi County Chinese Medicine Hospital, except for special circumstances, hospitalization costs cancel the starting line, the medical insurance fund according to the fixed reimbursement of 70% of the disease, 30% of the patient's own payment.
overall, the pay-per-view reform has established a "double standard" for hospital fees and medicare payments, which make patients aware of the burden of medical care.
is also the most important, but also to stimulate the hospital to control the cost of endo-driven.
so many parts of the country are also learning from Sanming's approach.
, the number of diseases paid for by disease in Fujian Province has reached more than 700.
2019, Xiamen City, on the basis of the zero basic budget for health insurance, fully implemented the "point method under the total budget" payment system reform.
year, the city's total cost of health care increased from an average of 15.93 percent before the reform to 13 percent, hospitalization costs decreased by nearly 10 percentage points year-on-year.
, of course, such reforms are only a way to go.
Due to the lack of standardized and standardized governance of china's current data, there are large differences between existing medical data and medical practice, there are certain innate deficiencies, from this point of view, based on big data disease score payment, there are also large fluctuations, deviate from the clinical reality of the possibility and risk, but also need to pilot verification process.
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