Medical network May 17 - "this year's health reform tasks has been clear about the two time points, one is in July 31 of this year, all the cities must be out of the city comprehensive implementation of the reform of public hospital; the second is September 30, all across the country, urban public hospitals will cancel the drug addition (except traditional Chinese medicine yinpian)." On May 11, the national health and family planning commission held a special press conference on the task of deepening health reform in 2017, said the director of the state council's health care law, director liang wannian. 

 

We will review the management of modern hospitals, the management of modern hospitals, the protection of health insurance, the supply of medicines, and the comprehensive supervision... Of the 56 tasks of the five institutions, the most notable is the elimination of all drugs. 2017 is the year when the work is done to implement the reform of the law. What happens if the drug is added to the public, and does the common people enjoy a fair medical and health service? 

 

The "cage change bird" is worth borrowing 

 

"Reform of public hospitals need 3 d linkage: health care, medicine and health care to linkage, is the core of a task is to break with medicine medical mechanism, establish a new public hospital operation mechanism, a new mechanism called maintenance public welfare, to mobilize enthusiasm, ensuring the sustainable." Liang Wannian said. 

 

In addition, the most critical point in the treatment of medicine is to eliminate the addition of drugs. There are now three main compensation channels in public hospitals, namely government subsidies, medical service charges and drug addition. The reform is to remove the third compensation channel from three channels to two channels. In this regard, liang thinks that the idea of the cage exchange in sanming, fujian province is worth thinking about and borrowing. 

 

The first step is to remove the drug and increase the cost of the health service. "If there is no room for space, it will increase the burden of medical care for the common people." Mr. Liang said that in the past, the economy has been able to make changes in the circulation area through the introduction of two bills, high water consumption and water consumption. In addition, through reasonable regulation of the treatment of hospital, can save money for health insurance. 

 

Make room for the structure. "One of the main reasons doctors have unreasonable practices is that the price system for health care is not justified and does not reflect the value of health workers' services." Liang said that the key to the adjustment is to increase the cost of medical services that reflect the value of medical staff. 

 

"A sign of a very core, now the income structure of public hospital, the medicines and chemical reagents, supplies the materialized mainly income accounted for about 60%, 70%, truly reflect the labor value of technology of medical income is about 30%. Through this reform, can make drugs and consumables than drop to less than 50% of overall income." Liang Wannian said. 

 

Liang wannian, reforms of the early now area, such as fujian sanming drug proportion has been below 30%, reflecting the labor price income proportion by the past around 30% to 50% or even 60% now. Structure adjust, the hospital total value increase, can, in turn, to establish salary system in accordance with industry characteristics and job characteristics, to fully arouse the enthusiasm of the medical staff, so it really made it through the reform, make the operation of the hospital was not affected, make sustainable medical insurance fund, make people whole medical burden does not increase, and hospital into benign orbit. 

 

The price of sunshine is to be made reasonable 

 

"To the common people commonly used to reduce blood sugar medicine 'check, China as an example, the original policy restrictions could not enter sales of medical institutions at the grassroots level after the implementation sunlight procurement, patients can be in front of grassroots medical institutions to see a doctor and get medicine. At the same time, people also enjoy of drug prices is favorable, such as China, check the decline reached 8.9%, 20 pieces is 23.13 yuan." "Said changyi, director of the south mill community health service in chaoyang district, Beijing. 

 

More than 30 days ago, the city of Beijing began to implement the "comprehensive reform implementation plan" in the city of more than 3,600 public medical institutions. "This is a great thing for grassroots health services." Chang Yi said, medical reform, community and large hospital can be unified on purchasing varieties, communities can purchase to the big hospital all medicines, coupled with the early stage of the human social security bureau of Beijing have big hospitals and community health care for common good policy, greatly promote the Beijing grading diagnosis and treatment work of the ground. 

 

Information: visit the nursing department of new bridge hospital, third military medical university. Chen was taken 

 

Indeed, the grassroots medical institutions and secondary and tertiary hospitals purchasing platform of unity, upper and lower linkage, is implements the grass-roots medical institutions is consistent with secondary and tertiary hospitals purchasing catalogue, laid the basis for the classification system, convenient for patients go to a doctor and get medicine. 

 

This is just a microcosm of many health reform efforts. According to the Beijing municipal health development planning commission, the Beijing medicine apart since around the implementation of comprehensive reform, more than 3600 service of medical institutions by orderly, drug sunlight procurement platform order cumulative amount is 5.1 billion yuan, the cumulative savings of about 420 million yuan, 8.2% savings. 

 

The monitoring showed that the total number of emergency visits to the three tertiary hospitals decreased by 15.1% over the period of a month, and the total number of hospital visits in secondary hospitals decreased by 7.2%. The number of first-grade hospitals and community service centers was increased by 3.4 percent, and some common diseases were gradually diverted to the primary medical institutions. 

 

"By sunlight procurement, implementation of hierarchical diagnosis and treatment, let people to see the doctor at home, no longer have to pile big hospitals, this and an important content of the reform." Liang Wannian said. 

 

The reform of the compensation system for medical staff needs to keep up 

 

"Medicine for the medical" for "technology for medical", this is the ultimate goal of cancel the drug addition, and ease the difficulty and high cost of people to see the doctor the key to the problem. At the same time, the reform of the compensation system for medical staff is a natural problem. 

 

", it is necessary to do a good job in the pilot documents have clear requirements in the comprehensive reform pilot provinces and other other provinces have to pay for a certain number of city selected respectively reform pilot." Liang Wannian is introduced, such as 11 comprehensive reform pilot provinces, each province to choose three city, other provinces except Tibet, each province to choose a city, the system of public hospital compensation reform, to explore the experience. Then, through a year or so of trial, the experience in the pilot area is summarized in time, and the guiding document of the remuneration system for medical and health industry is set up. 

 

Specifically, Liang Wannian said the salary system reform of the key contents are as follows: to optimize the structure of public hospital compensation, how to according to the situation of different public hospitals, including in the case of a public hospital internal different jobs, effectively according to the function orientation and responsibility requirements, establish a scientific and reasonable salary structure, it is pilot areas to explore. 

 

Second, it is important to determine the compensation level of public hospitals. Now, the public hospital compensation levels for approval in accordance with the unified general institution is to do, but said the health care industry, has the talent training cycle is long, large labor intensity, high professional risk, need to lifelong learning. "To do this, you need to have breakthrough in the pilot areas, reasonable compensation for public hospital level. Go up, the total income is more scientific and reasonable structure, incentive compensation system for medical personnel also came out." Liang Wannian said. 

 

In addition, "local public hospitals can be encouraged to explore the reform of the President's annual salary." Mr. Liang said that the dean represents the government to administer the hospital, and that the pay is directly disbursed by the government and has nothing to do with hospital revenue. But the government to the dean to carry on the strict examination, the assessment results to and approved by the hospital total compensation levels, use this mechanism to let dean back to him on behalf of the government to manage the role of the hospital. There are also some places for medical staff, such as the city of sanming in fujian province. These areas also encourage pilot areas to explore experience in a variety of ways. 

 

Finally, it is the implementation of public hospital's allocation of autonomy. Mr Leung points out that the amount of pay, once defined, will be allocated, and how it will be skewed towards front-line personnel. How to embody the workload, work quality and people's satisfaction, how to completely cut off directly contacted with the medical staff and drug, check the revenue problem, need to give full autonomy, public hospital by public hospital performance distribution measures according to the circumstance, should avoid "Commons".