With the gradual introduction of DRG prescription drugs how to do clinical academic promotion?

The pace of medical reform is getting closer and closer, and the week-long DRG pilot negotiations have just landedIn addition to the "4 plus 7" and banded procurement, the key point driving the reform of DRG payment - the health insurance business coding standards in 2019 to complete the top-level design and drug, consumables and other information standardization workThe National Medical Insurance Diagnosis-Related Sub-Group (CHS-DRG), developed by experts organized by the National Health Insurance Administration, will launch a simulation test in 2020, with 30 pilot cities and provinces in Zhejiang Province operating;the reshuffled super-health-care agency has moved quickly, producing efficiently and with a vigorous style of reformClinical behavior in the future is more standardized and transparentFor pharmaceutical enterprises, the need to pay more attention to the clinical use of drugs in hospitaland and doctors diagnostic decision-making behavior, from the original focus on prescription rights to pay attention to the right to diagnosis, hospital-side promotion and marketing will rely more on the medical team of pharmaceutical enterprises to respond professionally01
THEDRG IMPLEMENTATION STATUS QUO:TOP-LEVEL DESIGN GRADUALLY IMPROVED, THE PILOT CITY BECAME THE FOCUS OF-IN RECENT YEARS, CHINA'S TOTAL HEALTH CARE COSTS CONTINUE TO CLIMB, AND THE GROWTH RATE OF HEALTH CARE EXPENDITURE IS SIGNIFICANTLY HIGHER THAN THE GROWTH RATE OF HEALTH INSURANCE INCOME PHENOMENON, MAKING THE HEALTH INSURANCE FUND FACE THE RISK OF DEFICITThe "over-diagnosis" caused by the payment method of pay-per-item health care is considered to be one of the main reasons for the unreasonable increase in medical expensesDRG, the more advanced international method of payment for health care, will be doctors' prescription behavior into cost control, thereby improving the unreasonable growth of medical costs, to ease the pressure on health care expenditure, the government has high hopesWhat is drG?DRG, full name: Diagnosis Related Groups, Chinese name: Disease Diagnosis-related grouprefers to the clinical process and resource consumption of patients similar to a group, unified pricing and management based on gender, age, disease diagnosis, complications, disease severity and other factorsin layman's terms, it's paying for the diseasethe National Health Insurance Administration completed the top-level design and standardization of information such as medicines and consumables in 2019, started simulation testing in 2020, 30 pilot cities in 30 countries and the whole province of Zhejiang Province, and took the lead in initiating and completing the first negotiation of DRG weight rate in 30 pilot cities of DRG payment mode reformThe DRG pay reform plan will be fully operational by 202102
THE CHANGES AND TRENDS OF THE DR
G PILOT HOSPITALS:RATIONAL USE OF DRUGS, PATIENT-CENTERED TREATMENT QUALITY WILL BECOME THE CORE OF THE COMPETITION-THE PAYMENT PRINCIPLE BASED ON DRG, ONCE THE COST OF THE DISEASE GROUP EXCEEDS THE COST, DIRECTLY AFFECTS THE PERFORMANCE OF CLINICIANS, INDIRECTLY AFFECTS THE CLINICIANS AND CLINICAL DEPARTMENTS OF ALL RELEVANT INDICATORS OF THE RANKING, CORRESPONDING TO THE CLINICAL WILL HAVE THE ACTIVE RATIONAL DRUG CONTROL SOURCE POWERUnder DRG reasonable drug control, clinician acceptance is higher
clinicians often say: clinical work is actually very complex, constantly changing, the complexity of clinical work can not be solved by formula, this should consider the actual situation of patientsThe current prescription review and rational drug control is difficult to solve the above-mentioned clinician feedback problem, but the implementation of DRG can be a perfect solution to the above-mentioned problems, according to the specific situation of each DRG disease group for specific analysis, give different reasonable drug control programsThe implementation of DRG payment reforms, which shift clinicians' prescription behavior from "big prescriptions" to cost control, can effectively reduce unnecessary waste of medical resourcesAt the same time, the National Health Insurance Administration, through the analysis of the expected behavior of clinicians to circumvent the influence of DRG policy, has established a more perfect system of supervision and evaluation indicators in CHS-DRGs and its technical specifications and grouping programs, and has carried out comprehensive control sanatorage from the aspects of organization management and system construction, patient quality, medical service capacity, medical behavior, medical quality, resource efficiency, cost control and patient satisfaction, in order to regulate the prescription behavior of doctors after the DRG payment reformHowever, from the experience of other international and regional DRGimplementations, it is difficult for clinicians to completely circumvent the practice of breaking down hospitalization, transferring patients to outpatient clinics, selecting patients, undertreatment, high coding, etc Pre- and post-hospital examination, drug use transfer to outpatient clinic, etc in order to reduce the cost of treatment during hospitalization, or become the implementation of DRG policy to face regulatory difficulties patient-centered to improve the quality of diagnosis and treatment, to create a small and medium-sized hospital word-of-mouth differentiation
under the influence of DRG policy, in addition to the change in payment methods, the total amount of health insurance advance payment may be different than before The hospital calculates the cost of hospitalization for each type of hospitalization by predicting the number and number of inpatients in the following year, so as to report the total cost of hospitalization for the current year, but when the medical insurance settlement is settled, the total medical insurance for the current year will be adjusted to determine the total medical insurance for the current year in the disease grouping and pricing, each provincial health insurance unit can adjust and differentiate the management points in the light of the situation of the province Article 10 of Chapter 4 of the Regulations on the Payment of DRGs for The Hospital Expenses of Basic Medical Insurance in Zhejiang Province and Hangzhou City clearly stipulates: "The unified DRG points and difference coefficients of the provincial and Hangzhou municipalities in Zhejiang Province, and DRGs with little difference in costs, may be gradually eliminated and the coefficients of difference stowfrom can be phased out to achieve the same price as the same disease." "
the general trend of total health insurance and the same price of the same disease, which can be adjusted by weighting, drives the provincial and municipal hospitals to pursue the High Case Combination Index (CMI) to reduce financial pressure under the same resource series, and gradually sink the corresponding "sick group" patients with the same disease in the choice of non-provincial large hospitals, because there is no difference in treatment programs, the quality of service and treatment efficacy of different hospitals will affect the results of the results Whether it is possible to attract more patients after sinking to choose this hospital, the hospital itself needs to patient-centered to improve the quality of diagnosis and treatment, to build a professional reputation For pharmaceutical enterprises, to help hospital clinicians to prescribe more in line with the real needs of patients, more in line with the pharmaceutical economics of drug choices, the hospital's help is really visible 03
THE IMPACT OF CONCLUSIONDRG ON THE CLINICAL PROMOTION STRATEGY OF PRESCRIPTION DRUGS: THE KEY TO IS THE CLINICIAN'S DIAGNOSTIC DECISION-MAKING - SINGLE PATIENT HOSPITAL-END PROFIT - THE PAYMENT STANDARD OF THE DRG GROUP OF THE INSURED PERSONS IN HOSPITAL - THE COST OF DIAGNOSIS AND TREATMENT OF THE INSURED PERSONS DURING THE HOSPITAL COMPARED TO THE SIMPLE DRUG PRICE, THE HOSPITAL WILL COMPREHENSIVE LYING THE WHOLE PROCESS OF CLINICAL DIAGNOSIS AND TREATMENT, WITH REFERENCE TO THE EVALUATION OF PHARMACOECONOMICS TO SELECT THE CORRESPONDING DRUGS, IN ORDER TO BALANCE THE QUALITY OF MEDICAL SERVICES AND THE COST OF MEDICAL TREATMENT OF THE INSURED PERSONS AT THE SAME TIME Low-cost but low-rated drugs that are evaluated by pharmacoeconomics will be phased out when they switch from increasing revenue to increasing costs single patient health insurance fund DRG should pay the hospital expenses ( (the resident of the DRG group of the insured person payment standard - full out-of-pocket expenses - first out-of-pocket expenses - start-up line) " policy provisions of the fund payment ratio the income obtained by a single patient in the hospital is not directly affected by the medical insurance list and drug selection, however, the insured person has the right to refuse out-of-pocket drugs, making the clinician's choice of drugs limited Whether there are alternative drugs in the health insurance list, whether doctors have the ability to persuade patients to accept out-of-pocket drugs will indirectly affect the cost of hospital care, but also affect the health insurance list and the sale of drugs inside and outside the drug how to promote prescription drugs in the face of clinician prescription dilemmas? pay attention to the details of diagnostic examination: the doctor's clinical diagnosis is divided into six steps: consultation, examination of diagnosis, treatment options, brand selection, dosage, compliance The implementation of DRG is fully affected by the three core links: treatment options, brand selection, dosage, these three links due to the optimization of the path of the disease group, the establishment of the standard disposal procedures of the disease group, a single impact on a clinician's prescription rights gradually smaller, we have to move forward to our concerns, pay more attention to patient seeking treatment and examination of diagnosis links use "professional scholarship" to influence prescription thinking: for each clinician, the specific signs and symptoms of the patient, a disease in the beginning of treatment and later treatment process of drug choice, each doctor in the prescription will be more or less personalized differences This is based on past treatment experience, external influences and academic guidelines value-driven academic marketing can improve doctors' association with disease and drug choices In this kind of academic marketing promotion, enterprises can help doctors correctly identify patient types, focus on the doctor to convey specific symptoms and indicators (consensus, guidelines, thematic academic meetings), the transmission of domestic and foreign literature selection and other content of academic value, to provide routine diagnosis and treatment or expert consensus, so that they understand the treatment plan, case sharing and so on The gradual introduction of DRGs is a challenge and an opportunity for pharmaceutical marketing, with players who are ahead of the game and the transition to be the leading winners on the track In line with the trend of change, the transformation of value-driven medical marketing has become unstoppable