Sanming medical reform experience: how to crack the "expensive to see a doctor" is done?
Xinhua News Agency, Fuzhou, November 17-title: Sanming Medical Reform: how to crack the "expensive to see a doctor"?
Xinhua News Agency reporters Xiang Jiaying and Guo Xun
As one of the key issues in the protection of people's livelihood, the reform of the health care system has attracted much attention. The fourth Plenary session of the 19th CPC Central Committee pointed out that it is necessary to improve the national basic public service system in the following aspects: education for the young, education for learning, income from work, medical care for the sick, security for the elderly, housing for the elderly, support for the weak, and so on. The reporter recently learned that Sanming City continues to implement the spirit of the fourth Plenary session of the CPC Central Committee, effectively shifts the focus of medical and health work, sinks medical and health resources, and provides the masses with safe, effective, convenient, and inexpensive public health and basic medical services. Significantly improve the difficulty of seeing a doctor and the expensive situation of seeing a doctor.
Youxi is the experimental field and forerunner of Sanming medical reform. Since 2012, the local government has gradually pushed forward the comprehensive reform of county-level public hospitals. "our hospital is now one of the cheapest hospitals in the country." Yang Xiaoleng, secretary of the party committee of Youxi County General Hospital, said.
According to the 2018 Statistical Bulletin on the Development of Health Care in China by the Health and Health Commission, the average outpatient expenses of public hospitals above the second level in 2018 are 204.3 yuan, and the per capita hospitalization expenses are 6002.2 yuan. According to Yang Xiaoleng, the cost of Youxi County Public Hospital is 141.52 yuan and 4302.62 yuan respectively.
He said: as a pilot project of county medical reform, the experience of Youxi County is to start with medicine, promote the "linkage of the three medical treatments" in medical care and medical insurance, and gradually solve the problem of "expensive to see a doctor."
"the government has curbed the false high prices of drugs and consumables by implementing zero price difference sales of drugs and consumables and joint purchase of drugs and consumables. Within the hospital, through the control of unreasonable medical expenses, rational use of drugs, reasonable examination and reasonable treatment, the quantity and price of drugs and consumables can be reduced at the same time. " Yang Xiaoleng said.
In the past, the "big prescription" has been criticized by the people. In view of this, Youxi County strengthened the supervision of outpatient and hospitalization expenses, established the database of medical insurance doctors, and implemented the code management of medical insurance doctors. Implement the classification management system of antimicrobials, the hospital announced the top 10 antimicrobial dosage rules and prescribing doctors every month. The management of infusion was strengthened and 53 kinds of diseases without infusion were determined.
Wang Wei, a citizen of Sanming who has suffered from myocardial infarction, said that after the health care reform, medical services were better and prices were cheaper. "in 2014, I implanted the first heart stent, when the imported stent was 28000 yuan and the domestic stent was more than 10, 000 yuan. Last year, because of heart failure, two more stents were implanted. The price of imports has dropped to 16000 yuan, and the price of domestic products has dropped to more than 8000 yuan. " Prices of commonly used drugs, such as aspirin, which used to be 30 yuan a box, are now 7 yuan a box, and Polyvir tablets have dropped from 18 yuan to 13.1 yuan, Wang Wei said.
Cao Zuji, another villager from Yuchi Village in Xicheng Town, Youxi County, said he enjoyed county-level diagnosis and treatment services at his own expense of 5 yuan according to township standards.
Hu Yongxing, president of Youxi County General Hospital, said that since the medical reform, Youxi County has dynamically adjusted the prices of more than 5000 medical services six times, further optimized the hospital income structure, and increased the proportion of medical income. The price water extruded from drugs and consumables is partly beneficial to the people and the other part is transformed into medical income, which is used to improve the salary and treatment of medical staff. The health insurance fund is used to subtract the expenditure on drugs and consumables and add to the expenditure on hospital medical services.
Youxi medical reform is the epitome of Sanming medical reform. Sanming City continues to supplement the shortcomings of medical resources, promote hierarchical diagnosis and treatment, reduce the circulation cost of drug consumables, and standardize medical behavior, which not only solves the problem of "difficult to see a doctor" and "expensive to see a doctor", but also maintains the balance of medical insurance fund. Data show that after the reform, from 2012 to 2018, Sanming urban workers medical insurance in the case of rising dependency ratio year by year, the annual final balance (including the balance of the previous year) are about 10 million yuan, significantly higher than before.
At present, Sanming medical reform has entered the stage of "taking health as the center", from "treating existing diseases" to "treating no diseases", and the control of chronic diseases has been continuously strengthened. Youxi County General Hospital set up a national health management department, township health centers set up a national health management station to jointly promote public health. At present, the consultation rate in Youxi County is 90.8%, and the consultation rate at the grass-roots level is 60.78%.
It is reported that the State Council leading Group on deepening the Reform of the Medical and Health system recently issued a "Circular on further popularizing the experience of deepening the Reform of the Medical and Health system in Fujian Province and Sanming City." In order to give full play to the demonstration, breakthrough and driving role of the experience of medical reform in Fujian Province and Sanming City, and promote the in-depth development of national medical reform.