Medical network May 17 - a less developed province in economy, economic indicators for many years in gansu province is lower than the national average, but average hospitalization and inpatient spending three years in a row to maintain the lowest; It did not include 11 comprehensive health care pilot provinces, but innovative initiatives on top of the national level... The health reform, which has traditionally been characterised by traditional Chinese medicine, is not that simple. 

 

On April 10th, the ministry of health and social security of qingyang city, gansu province was formally established. The health care integration breakthrough action, let a national guard the investigation of the reform for the planning commission of gansu experts shine at the moment, and hand over "adjust measures to local conditions" type of gansu health questionnaire, or reform template will become the central and western regions. 

 

The division of division of division of division of division of division of division of division of disease + health insurance lever to lever to move a classification of medical treatment 

 

With "health leveraged" reversed transmission hierarchical diagnosis, through differential fees and expenses standard, guide the patients according to their condition priorities, between shunt in basic-level hospitals and large hospital, most areas to promote grading diagnosis and fall to the ground, and who in gansu province development planning commission director burman that health is leverage, but not all of them. 

 

Gansu province passed "the division of division of division of division of division of division of division of division of division of labor of disease of disease of disease and the lever of health insurance", push open the urban and rural people's level of the treatment of the treatment in the whole country, guide the patient orderly medical treatment. 

 

The "division of division of division of division of division of division of division of division of division of division of labor", it is to mean the provincial and municipal level (3 level) hospital to be responsible for the treatment of 50 + n kinds of difficult and dangerous disease and the work of teaching, scientific research and so on; County district (level 2) hospitals in 250 + n kind of common disease, frequently-occurring disease diagnosis and treatment of the towns and townships (level 1) responsible for the public health services and basic medical services in the region, to carry out 50 + n kinds of general treatment of the disease. 

 

In order to give play to the role of leverage health leverage, gansu province, "for the treatment of patients with simple, no complicated complications, and so on and so forth directly to the provincial hospital, reduce or no expense reimbursement ratio". "If the patient should be in the county, he would be reimbursed for 50%." Guo yufen, for example, said, "for example, the case of appendicitis, for example, is 2,000 yuan in the country, 5,000 yuan in the county, only 50 percent of the 2,000 yuan." At the same time, the patient who has been transferred to a medical institution will be deducted from a certain amount of health care costs. The disease that is contracted by the inferior hospital at the superior hospital also will deduct certain health insurance fund. 

 

"No reimbursement" both "buckle hospital money", "forced" to patients in hospitals at the county and township, burman think grading diagnosis and treatment policy appears to be "too far", gansu province, but in fact they rhyme. Diseases of the basic medical institutions, and through the "new farmers and platform for screening and determine after expert assessment. Since after the signing of the agreement, if have no ability to make a diagnosis and give treatment the disease at the grass-roots level is not the signing of the agreement." Guo further explained that the classification of the diagnosis and treatment of the disease is carried out by dynamic management, by the time limit to the number of cases of diagnosis and treatment, and the ability of the grass-roots initiative to improve the service ability. "The following year assessment, grassroots medical institutions to increase in the number of diseases, raising more than 10 diseases at the county level, township ascend above 5 a number of diseases, to make a diagnosis and give treatment ability to the signing of the agreement, and the corresponding adjustment health policy." 

 

In addition, the new order is being gradually established in gansu province, which will use the fund as leverage to promote the sinking of quality medical resources. According to the data, the diagnosis rate was 15.45 percent in 2016, down 9.63 percent year on year in 2013. The actual compensation ratio for hospitalized patients was 66.7 percent, up 8.34 percentage points from 58.36 percent in 2013. 

 

The policy formulation and the main body of the administration will be separated from the national health insurance 

 

The reform of the health care system in fujian province has long been seen as one of the highest in the country. The provincial health insurance regulatory commission, which was set up in 2016, brought together the functions of health care in various departments and carried out the "triple medical" linkage. But Chinese health economic association deputy secretary-general, the researcher should Jane thinks, "health committee of fujian province unit is still not fully settled, and throughout the province, gansu province to determine the health policy formulation and orgnaization of the main body of the separation of such a system adjustment is the first in the country." 

 

We have learned, in gansu province have already completed the integration of provincial medical insurance system of the responsibilities involved in urban and rural residents, the establishments of adjustment work, led by the provincial health office, departments and so on in conjunction with the club, the fiscal policy, people club department responsible for fund management and orgnaization of business, and the social enterprise administration to establish urban and rural residents in gansu province medical insurance agency, mainly to undertake urban and rural residents of urban and rural residents medical insurance, serious illness insurance policy executive orgnaization of service of implement and management. "This is a substantial step in the integration of the health care system." "Said dai tao, deputy director of the national health and family planning commission. 

 

And set up positive organizational system at the county level, the municipal government of qingyang city urban and rural residents health security bureau directly under the city, residents will town worker medical insurance, medical insurance, maternity insurance, new agriculture, medicine, purchasing, management of medical service price, medical insurance fund, civil affairs, medical treatment, such as birth fund budget responsibility shall be integrated. , one should think Jane, qingyang health care integration mode ", at least in the lower administrative coordination cost will be displayed on the edge ", and will help promote and deepen the "3 d linkage". 

 

Gansu province actively explores the combination of health poverty alleviation and health care policies in addressing major disease patients and those who are suffering from difficulties. Since April 1, 2017, on the basis of the original policy, gansu province, costs and expenses, and increased the major disease patients "provincial hospitals for 50 refractory disease, all patients to first pay after see the doctor," burman said, for urban and rural residents personal own compliance medical cost of more than 30000 yuan of above parts (including 30000 yuan), serious illness insurance again segmented reimbursement in proportion, "minimum expenses by more than 80%, the highest reimburses 98%, no caps on." 

 

More practice and precise help to the grassroots new ideas 

 

The present situation of economic and social development determines the basic reality problem of quality medical deficiency in gansu province. How to effectively improve service ability at the grassroots level for gansu province financial strength is not strong, "throw money" is obviously not a solution to the problem, doctors more practice and one-on-one help become gansu province development planning commission of their thinking. 

 

"Our institutes of 10 families and gansu province people's hospital, director of the division director is a collaborative working relationship, any problems in the clinical between them can be on the phone." Yuzhong county peace center hospital medical department director of something that was introduced, in addition to the provincial people's hospital as a cooperative unit to provide technical support, the second people's hospital of lanzhou city and more practice in the institutes of physicians. 

 

Benefit from more practice to support, gansu province, "provincial experts down to the county, the county experts work down to the township level, go down later to compensate, fee and operation have compensation." Burman explained, "such as an expert in the provincial hospital get 6 yuan fee, to the county hospitals can get 30 yuan, and in the county-level hospitals to carry out the surgery will get 1500 ~ 2000 yuan compensation, compensation from the surplus funds for health care hospitals at the county level in accordance with the provisions, pay." 

 

In the case of primary care, medical care can also buy telemedicine services. In yuzhong county peace central hospitals, for example, when a beyond the disease patients of institutes of diagnosis and treatment ability, to the provincial people's hospital appointment remote medical service institutes will, "55 yuan/m fee shall be borne by capital of balance of hospital care." According to berling, more than one year since the launch of the remote medical collaboration, the total has been carried out 10 times. Similarly, maternity and child care self-raised funds established in gansu province, gansu province maternal and child health remote network service system ", in addition to carry out the remote expectations rescue guidance and complicated cases of consultation, also remote training for grassroots medical institutions in 2016 64, accumulative total training 7438. 

 

However, according to the research, zhuang ning, deputy director of the national health and family planning commission, said the application of medical informatization and telemedicine in gansu province was "not good enough". "Gansu province winding more than 1600 kilometers, Beijing to lanzhou linear distance is more than 1300 kilometers, if we don't introduce modern means to make the best of health resources play a biggest role, expand the scope of coverage radius and radiation, the common people in" and "expensive" and "difficult" also increases the risk on the basis of a doctor, so on the strong base to put information on good."