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    Home > Active Ingredient News > Drugs Articles > Sanming mayor: the interest chain of drug circulation is the biggest obstacle to medical reform! It is suggested that the state use these five methods to rectify

    Sanming mayor: the interest chain of drug circulation is the biggest obstacle to medical reform! It is suggested that the state use these five methods to rectify

    • Last Update: 2017-07-10
    • Source: Internet
    • Author: User
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    Source: learning times 2017-07-10 at present, China's medical reform has entered a deep-water area and a critical period Although some local medical reform has achieved some results and accumulated some experience and practices, there are still many links that need to establish and improve relevant policies and systems at the national level, so as to promote the comprehensive deepening and implementation of medical reform To standardize the supervision of drug approval, production and circulation The drug problem is the root of all problems in the field of medicine and health, and the interest chain of drug circulation is the biggest obstacle to promote the medical reform At present, the cost of drug consumables in medical institutions accounts for more than 60% of the total medical expenses Due to the high price of drugs, the quantity and price of drugs are wasted, and the medical waste is serious In order to succeed in medical reform, we must first curb the waste of drugs, start with drug approval, production, circulation and use, and eradicate the interest chain Therefore, it is suggested to carry out comprehensive rectification at the national level: first, to rectify the drug names, dosage forms, specifications and disorderly prices, to clean up the drug number, to standardize and standardize the names, dosage forms and specifications, to further standardize the national drug registration behavior, and to strictly approve the admission of new drugs; The second is to mark the price of drugs The State Food and drug administration requires pharmaceutical enterprises to mark the ex factory price of drugs (the port price of imported drugs) on the minimum package in the GMP certification regulations The third is to strictly implement the "two vote system" for drugs and consumables used in public hospitals that are purchased through centralized bidding; Fourth, large equipment, imported drugs and high-value consumables shall be negotiated and priced by the state; fifth, a unified "healthy China" information service platform shall be established nationwide We will publicize information on drugs, consumables, equipment prices, medical services, etc nationwide, and realize information interconnection between relevant departments, and strengthen supervision by means of information technology for the whole society to inquire, use and supervise Establish a more scientific and reasonable medical insurance management and operation system At present, 50% - 70% of the medical service income of public hospitals in China depends on the settlement and payment of medical insurance, and the proportion of people's medical payment is also determined by the medical insurance policy In fact, medical insurance plays a key role in the social medical service chain of "government public hospitals patients", and the scientific management and operation of medical insurance play a crucial role in the medical reform Use However, at present, the medical insurance management and operation system is not perfect, and there are still some problems, such as the nonstandard medical insurance catalogue, the multi management of medical insurance, the low utilization rate of funds, and the difficulty in the operation of medical insurance funds Therefore, it is suggested that we should learn from the practice of Sanming medical insurance system reform and improve the medical insurance management system in order to give full play to the joint efforts of medical insurance and medical services and maximize the health benefits of the common people First, we should rationalize the "Three Guarantees in one" management system from the national level, integrate the "Three Guarantees" according to the concept of great health and great health, clarify the combination of drug procurement department and the "Three Guarantees", adopt the third-party management, implement the integrated management, promote urban and rural equity, and improve the use efficiency of medical insurance fund; Second, according to the clinical needs, revise the three medical insurance drug catalogues Under the supervision and participation of the discipline inspection and supervision department, the relevant departments will remove the varieties that are squeezed into the medical insurance reimbursement catalogue by improper means in a closed and authoritative way We will optimize policies to promote innovation in the management system of public hospitals At present, the vast majority of public hospitals in China rely on drug price differentials for survival and development It is understood that more than 50% - 70% of the annual income and expenditure balance of a tertiary hospital depends on drug price differentials In 2017, the national public hospitals should realize the zero price difference of drugs in an all-round way, which means that after breaking the decades old management system of "supporting doctors with drugs", the Chinese public hospitals should establish a new management system as soon as possible to achieve the new goal of normal operation and balance relying on medical services and financial subsidies This involves two key links: medical service price and financial security First, the price of medical services At present, the price of medical services in China far deviates from the general pricing principles of value and social services It is difficult for public hospitals to get compensation from the price and maintain their own operating costs through their own medical services Therefore, it is suggested that after cost calculation and social price comparison, corresponding policies should be issued to clarify the charging standards of all kinds of hospitals, so as to promote the steady increase of medical service prices in public hospitals Second, financial security To speed up the establishment of a new management system in public hospitals, public medical investment funds at all levels of finance must be in place Therefore, it is suggested that the government should issue policies and regulations to improve the sharing mechanism of all levels of Finance in medical investment, so as to ensure that the regional public medical investment funds in the middle and lower reaches of fiscal revenue are fully guaranteed We will improve the incentive policies for grassroots health workers The public welfare of public hospitals can hardly be achieved only by large-scale top three hospitals Now large-scale public hospitals have a strong "siphon effect", which not only siphons the excellent doctors of the lower level hospitals, but also siphons the patients up, which will cause the large-scale public hospitals to become stronger and more crowded, while the grass-roots medical and health service system is weaker and weaker, thus further aggravating the lack of medical and health service system The question of balance The key to solve this problem lies in hierarchical diagnosis and treatment The grass-roots health personnel are the most basic "gatekeepers" in hierarchical diagnosis and treatment With the further promotion of hierarchical diagnosis and treatment system, the role of grass-roots health personnel will be more prominent However, at present, there is no real environment that encourages grass-roots health personnel to work safely and be willing to stay at the grass-roots level General practitioners and specialized doctors in grass-roots medical institutions It is common that it is difficult to introduce and retain Therefore, it is suggested that the government should establish a policy mechanism to attract excellent doctors and graduates to work at the grass-roots level by strengthening the up-down linkage between the grass-roots medical and health institutions and hospitals, and improving the treatment of grass-roots health personnel We will accelerate the development of medical consortia in public hospitals To promote the development of public hospitals into medical consortia group is conducive to the realization of the up and down connection of hospital medical resources, cost reduction and brand competitiveness It is regarded as one of the effective ways to promote the reform of public hospitals at this stage, and it is also a strong starting point for promoting the construction of medical consortia as specified in the 2017 government work report of the State Council But at present, there are no corresponding laws and policies to provide legal protection and supervision for the development of public hospital collectivization, most of which are established under the new policy of medical reform and the support of the government Therefore, it is suggested that the national level should formulate and promulgate relevant policies and regulations as soon as possible according to the current situation, promote the construction and development of the Hospital Medical Association into the legal track, build a standardized, institutionalized and legalized macro-control system, study and issue relevant supporting policies, set up industrial development funds, and ensure the orderly management, scientific operation and steady development of the Hospital Medical Association.
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