echemi logo
Product
  • Product
  • Supplier
  • Inquiry
    Home > Medical News > Medical World News > Should pharmaceutical companies be alarmed by the arrival of DRGs from pilot to full simulation operation?

    Should pharmaceutical companies be alarmed by the arrival of DRGs from pilot to full simulation operation?

    • Last Update: 2020-02-12
    • Source: Internet
    • Author: User
    Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com
    With the reform of medical insurance payment system in full swing and the reform of disease collection and payment system in advance, DRGs, a "foreign monk", has gradually found its most suitable position on the road of medical reform with Chinese characteristics As DRGs is gradually launched from the pilot, the impact it brings is not only the payment reform of medical institutions, but also the reshuffle of the whole medical industry Just entering 2020, the national health and Health Commission dropped a "bomb": on January 3, 2020, the national health and Health Commission medical administration released the notice on printing and distributing the clinical pathway of diseases (2019 version) According to the notice, according to the clinical practice and combined with the medical progress, the national health and Health Commission has organized the revision of the clinical pathway of 19 subjects related to diseases, forming 224 clinical pathways of diseases (2019 version) In response, on October 16, 2019, the National Medical Security Bureau officially issued the notice on printing and distributing the technical specifications and grouping schemes of DRG paid country pilot, which contains two important standards, namely, the technical specifications for DRG grouping and payment of national medical security and the grouping scheme of national medical security DRG (chs-drg) This also means that at present, the core standard of DRG has been issued, which is equivalent to completing the top-level design and basic construction From local pilot to top-level design, DRGs has a long and tortuous road From the research of DRGs started in 1988 to the establishment of the super Medical Insurance Bureau in 2018, DRGs finally joined the ranks of the medical reform army under the influence of various factors such as game and complex design In the previous pilot schemes, medical insurance payment and hospital performance evaluation have become the most common two directions in the selection mode However, due to the game between the parties, these two directions which restrict each other extend a variety of modes but cannot be widely promoted With the implementation of chs-drg in China, DRG has entered the high-speed road In the aspect of drug selection, whether the clinical pathway is involved, whether the clinical promotion and acceptance of the product are high, and whether the cost performance of the product affect the use of the drug With the reform of medical insurance payment system in full swing and the reform of disease collection and payment system in advance, DRGs, a "foreign monk", has gradually found its most suitable position on the road of medical reform with Chinese characteristics As DRGs is gradually launched from the pilot, the impact it brings is not only the payment reform of medical institutions, but also the reshuffle of the whole medical industry "(in the whole province), we will comprehensively implement the total budget management, pay for inpatient medical services according to the" disease group points method ", gradually implement the bed per day payment for long-term and chronic inpatient medical services, and explore the combination of outpatient medical services and family doctor signing services, and implement the lump sum payment by head." On the morning of July 17, 2019, at the press conference on the reform of basic medical insurance payment mode of county medical communities in Zhejiang Province, "opinions on promoting the reform of basic medical insurance payment mode of county medical communities in Zhejiang Province" officially appeared in the public eye According to Yang Ye, director of Zhejiang Medical Insurance Bureau, the payment method of "disease group points" is one of DRGs payment methods According to the notice on the list of pilot cities of DRGs payment countries by disease diagnosis issued earlier, Jinhua has been determined to be one of the first 30 pilot cities of DRGs payment countries According to the requirements, the pilot cities will ensure the simulated operation in 2020 and start the actual payment in 2021 Shortly after the reform of payment method was initiated, the draft for comment of the Interim Measures for DRGs point based payment of hospitalization expenses of basic medical insurance in Zhejiang Province was released quickly This also means that Zhejiang will become the first province to fully implement DRGs point based payment in the field of medical insurance payment This is less than half a year before Jinhua City became the first pilot city of 30 DRG payment countries It's no surprise that Zhejiang became the first province to eat crab Jinhua City launched DRGs payment reform pilot in 2016 In July 2016, Jinhua City "packaged" all diseases into 595 paid disease groups according to the case data of more than 210000 inpatients in the first 18 months of 42 designated medical institutions in the city The disease group price was formed by the cost level of the disease group, the cost level of each hospital and the budget of the medical insurance expenditure fund in that year This dynamic price formation mechanism was later promoted“ Disease group points method As the core link in the medical reform, it is not easy to realize the reform of medical insurance fund payment from extensive to accurate According to official data, from July 2016 to June 2017, DRGs pilot operation for one year, the annual hospitalization expenses of all medical personnel were reduced by 170 yuan, and the burden of the masses was reduced by 23.7 million yuan The growth rate of self financing medical expenses of patients was changed from 2% in 2015 to 0.7% in 2016, and the cash burden of the masses was reduced by 10.02 million yuan Compared with the original payment system, the medical institutions achieved efficiency and cost savings 3 More than 8 million yuan; the growth rate of actual fund expenditure is 7.1%, which is 0.4 percentage points lower than the budget growth rate, which is nearly 50% lower than the growth rate of about 14% in the previous three years in our city, and the pilot medical institutions can share 3.11 million yuan of retained income of fund balance according to regulations No wonder there is a saying in the "medical reform circle" that "one year's experiment in other places is not as good as one year's hard work in Jinhua" From local pilot exploration to national strategy of top-level design, DRGs has been groping for nearly 40 years in China Moreover, for the pilot DRGs, Jinhua is not the first city to "eat crabs" Since the DRGs reform was launched in Beijing around 2006, different models have been developed across the country From pilot scale-up to provincial promotion, it is enough to show that Jinhua's DRGs are undoubtedly successful But the DRGs, whether bj-drgs in Beijing or Shenkang DRGs in Shanghai, have not been widely promoted Choosing which model is the most critical and difficult step.
    This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.

    Contact Us

    The source of this page with content of products and services is from Internet, which doesn't represent ECHEMI's opinion. If you have any queries, please write to service@echemi.com. It will be replied within 5 days.

    Moreover, if you find any instances of plagiarism from the page, please send email to service@echemi.com with relevant evidence.