Medical network May 5 - for the sake of that drugs can really play a role of the clinical research and development design, with the most appropriate quantity can cure patients, so as to maximize reduce the patients' medical consumption, to reduce and relieve their "expensive", reasonable compression medicine accounted for as a major measure for health reform. However, for a variety of reasons, the proportion of medicine in many medical institutions, although falling, failed to cooperate with the elimination of medicine to reduce the patient's goal. 

 

North a county hospital in 2015-2016 and the first quarter of 2017 accounted for, has been controlled between 23% - 20%, in the eight months of medicine proportion was 19.89%, 80% gross margin! It's unbelievable. 

 

So, what is it that makes it so low? To author and responsible for the business management, drug procurement, performance appraisal, and other important related department heads and staff in contact, the results showed that: 

 

First, government subsidies are not in place. Hospital, the hospital is a provincial counties in government financial difficulties, according to analyse the financial section chief, since 2015 the hospital drug shortage of zero tariffs as the county government financial aid has been now pay 20% of the should fill, there are still 10 million yuan subsidy arrears. Dean made a special trip for this several times to the county finance "dun", no clear answer, finally county leaders made it clear "no matter what way you use to press the medicine proportion, on behalf of the government share the melancholy" "benefits no longer consider, if not for the government to concern, consider your position". Results, including other county hospital all dare not to the county finance to drugs zero premium subsidies, but had to pour all my strength on malicious pressing of tricks, trying to malicious pressure medicine proportion. 

 

First, the use of pharmaceutical procurement. Has five iron wrist: one is not buying imported, originality and ordinary high prices, the second is resolutely put an end to the use of adjuvant, three is to encourage guide allows patients to a pharmacy to buy medicine, four is hospitalized patients discharged with medicine can't more than three days, five is malicious pressure resistant to use. 

 

3, cancel outpatient infusion fluid. Other patients will not be admitted to the clinic unless the emergency treatment requires the transfer of fluids. The hospital has set up a supervisory team to conduct prescription and medical records every day at the outpatient pharmacy and emergency department, and find an out-patient treatment fluid and a fine of 500 yuan for the prescription doctor. Weekly meetings will be criticized for long-term monitoring. 

 

Iv. Strictly regulate the use of antimicrobial agents. Interpretation training to floor doctor of antimicrobial agents, the antibacterial drugs clinical practice guidelines (2015 edition) ", to carry out the "perioperative infection prevention strategy" training, in the form of MDT interpretation 2015 CHINET data and share medical records, medical personnel can master basic knowledge of the antimicrobial application, at the same time, strengthen information controls. The first three doctors, who are more resistant to the drug than the top three, have canceled a one-month bonus for two consecutive public doctors. After more than three times in the year, the Chinese government will talk and consider resigning. 

 

The average, special section has specific index limits. For special departments such as pediatrics, internal medicine, formulate special standard medicine proportion index, but the department must be lower than the secondary general hospital medicine proportion index (40%), and surgery, gynecology, ophthalmology, Chinese medicine rehabilitation wards and other departments in principle under 20%. For every one percentage point, the division of the division of the director of the department declined by 0.1. It is also a necessary indicator for the study of the department, the annual evaluation of the individual, and the promotion and promotion. 

 

The outpatient pharmacy is almost a decoration. The ward guarantees the basic medicine, and the shortage of medicine in the outpatient pharmacy is normal. For half a year in 2016, there are only 60 kinds of TCM pills in addition to Chinese medicine, and all of them are medicine for low price packaging. Prescriptions for traditional Chinese medicine account for only 12 per cent of the 1, 800 outpatient prescriptions. 

 

Although medicine accounted for under the lower, more patients in hospital can turn rates continue to increase, once rising to 18% at the end of 2016 farmers (new), hospitalization days did not see obvious reduction, per capita consumption in hospital from 3300 yuan in 2014 to April 2017, 4020 yuan, annual income rose from 2010 in 64 million to $1.83 in 2016, rose 3 times. According to the people at the hospital, the hospital had an overdraft of more than 4.8 million yuan in the first quarter of this year. The dean is very anxious but helpless! 

 

The deepening medical and health system reform in 2016 work ", according to the national medicine proportion fell to 40% from 46.33% in 2010, a government-run medical institution revenue growth fell to 18.97% from 18.97% in 2010. 

 

As you can see, the vast majority of public hospitals in the country have a steady decline in the proportion of medicines, and incomes are slowly rising. But if the drug zero premium subsidy mechanism is not perfect, channels do not get through, at the end of September the national medicine for medical public hospital, the medical service price adjustment and government financial aid is not in place, only by myself in my thrift medical institutions to reduce health care costs, impossible to guarantee normal operation of public hospitals. At the same time, also cannot reform of public hospital property, the tube they should be separated and dean, and so on, then, the public hospital dean is possible, also will consider using for personal fame and gain and loss of duties and powers of the similar distortion of this hospital practice to malicious pressing accounted for, regardless of the nature of medical treatment and hospital, so patient treatment should use the medicine didn't bought into the purchase, use, or lobbyists, this not only can't according to the clinical pathway to the real purpose, also contain great medicine, medical security, lose the real meaning of health care. 

 

Therefore, the abolition of all public hospitals across the country medicine for medical before 5 months, the government should be conscientious, full, timely pay the medical institutions drug zero premium subsidies, including drug after zero price subsidies. The government should reform the top designers design as soon as possible to develop a detailed necessary to cancel the medicine for the medical subsidy mechanism and plan, to speed up the pace of the medical service price adjustment, increase the intensity of salary system reform, rational increasing staff income, improve their work enthusiasm, can no longer own hospital alone with these ugly and mutation is to cancel the medicine for the medical check, government leaders can't even use "post deployment of appointment" pressuring the public hospital deans let them wantonly, arbitrary down medicine proportion. 

 

Otherwise, the deformation of such drugs accounted for, although the government financial pressure is reduced, but the patient's "expensive" will remain the same or more heavy, cancel the medicine for the medical of hope and purpose, is undoubtedly an dream!