Introduction: on April 8, 2017 Beijing health care reform was officially launched, more than 3,600 medical institutions canceled the drug markup, the much criticized ? Drugs to support doctors? became history,? Separation of medicine? The time has come. At the same time, the registration fee, diagnosis and treatment fees are completely canceled, the collection of medical service fees.
One of the core elements of the health care reform in Beijing is the abolition of registration fees, consultation fees, the establishment of medical service fees. According to the fee standard, the Air Force General Hospital, a tertiary hospital, for example, the general outpatient medical service fee of 50 yuan, 60 yuan for deputy chief physicians, 80 yuan for chief physicians, 100 yuan for renowned experts, emergency medical service fee of 70 yuan, inpatient medical service fee of 100 yuan / bed day. And previously, the hospital's general outpatient general registration fee is 5 yuan.
The reporter found that, although the medical service fee than the past registration fee seems to have increased a lot, but from the general outpatient to the well-known experts, medical service fee medical insurance reimbursement amount is 40 yuan, the out-of-pocket amount is only 10 yuan.
The reform, much attention is paid to all public hospitals to cancel all drugs (excluding traditional Chinese medicine drinks) markup, all drugs to implement zero-difference rate sales. Since then, the drug to support the medical, hospital drug markup of 15% for sales, which is an important compensation channel and source of income for public medical institutions. After the medical reform, Beijing will organize the implementation of drug sunshine procurement, to all drug manufacturers open drug quality information, dynamic linkage with the manufacturers, the same specification of drugs, the national provincial centralized procurement of drugs, the lowest bid price, and in the sunshine procurement platform to be announced.
Reporters in the outpatient hall of the Air Force General Hospital in the independent registration query machine to see, medical service fees and 435 medical services and thousands of drugs have been fully imported into the medical institutions information system, can be self-service query. Allergic rhinitis patients, Mr. Chen said, their long-term use of montelukast sodium chewable tablets, ? Today opened two boxes, the price is 28.86 yuan a box, 20% cheaper than before.? It is reported that after the abolition of the drug markup, the overall price of drugs fell by 20%.
435 price adjustments Total patient costs do not increase
According to the health department's calculations, the overall outpatient medical costs have decreased this time, and inpatient medical costs have risen slightly. Through the health sector of the 405 types of static measurements show that after the reform, the average outpatient sub average cost reduction of 5.11%, inpatient costs per case an average increase of 2.53%. The total amount of medical costs remain basically balanced, and the overall cost burden on patients has not increased.
The implementation of this healthcare reform program will have no impact on the reimbursement process of the insured. The Beijing Municipal People's Government is still implementing the relevant provisions of the real-time settlement for card-carrying medical treatment when the participants in the fixed-point medical institutions.
Guangdong
Beijing took the lead in launching a comprehensive health care reform, Guangdong is also fast. According to the March 29th provincial government officially issued the "Guangdong Province to deepen the comprehensive reform of the medical and health system implementation program", the first half of this year, the province's comprehensive reform of public hospitals, the introduction of the relevant programs around the city, the province's public hospitals in July before the full abolition of drugs (except for traditional Chinese medicine drinks).
At the end of March this year, the national health care reform work video and telephone conference arranged for the deployment of the important policies of pharmaceutical reform, including the industry's most concerned about the two-ticket system, separate medicine, health insurance payment system reform. At present, the state has formulated 11 pilot provinces for medical reform, and Guangdong Province is not included in the pilot province. The state requires that `prefecture-level and above cities that have not yet implemented the reform of abolishing the drug markup, before the end of July to introduce an implementation plan, before September 30 to fully promote the comprehensive reform of public hospitals, and make sure to fully abolish the drug markup. This means that after October 1, all public hospitals across the country to cancel the drug markup.
It is reported that the province of Zhuhai, Zhongshan, Dongguan three cities are listed as the comprehensive reform of public hospitals national contact pilot city. The relevant person in charge of the Provincial Health Planning Commission said that the pace of health care reform in Guangdong will not lag behind in any way. According to the end of March, the latest "Guangdong Province to deepen the comprehensive reform of the medical and health system implementation program", the first half of this year, the province's comprehensive reform of urban public hospitals comprehensively, the introduction of the relevant implementation program in various municipalities, the province's public hospitals before July to abolish the full range of medicines (except for traditional Chinese medicine and tablets) 15 percent markup.
? Guangdong strive to 2018 medical cost increase of no more than 9%, secondary and the following public medical institutions per capita outpatient cost growth rate, per capita hospitalization cost growth rate of no more than 9%; three public medical institutions per capita outpatient cost growth rate, per capita hospitalization cost growth rate of no more than 7%; personal health expenditure accounted for a proportion of the total cost of health to reduce to less than 27%.? The provincial health commission said.
Voices from all sides
Wu Shaolin, a hospital management expert and executive vice president of the Provincial Physicians Association, said, ? I asked someone to repair the air conditioning, the workers came less than five minutes, add a snow seed, charge a service fee of 60 yuan, which is the market price.? But public hospitals are different, it also bears a very important basic public **** medical and health services function, which determines our public hospitals, can not be like the United States to fully implement the market price.
Wu Shaolin pointed out that the abolition of the drug markup is no problem, but the government's subsidies to the public **** health care functions should follow, otherwise it may lead to hospitals to compress the supply of public **** health care, increasing ? Diversified demand? of? individual consumption? part of the provision.
Zero-percentage increase is not a problem Government subsidies should be in place
Zhongshan People's Hospital Director Yuan Yong introduced, Zhongshan City, from December 1 last year, the implementation of zero-percentage increase in drugs, in addition to the abolition of the increase in the cost of medical consumables, large-scale medical equipment, check the project price down 10%, test down 6%. From the outpatient observation, chronic patients get the benefit is obvious.
Yuan Yong believes that the realization of an effective ? The three medical linkage?
Yuan Yong believes that the realization of effective ? Now the abolition of drug markups, medicine and health insurance should also work together. In terms of medicine, the national implementation of? The two-ticket system (which means that drugs are sold from the manufacturer to the customer) has been implemented nationwide. (refers to the drugs from the production enterprise to the circulation enterprise to open an invoice, the circulation enterprise to the medical institutions to open an invoice), help to reduce the circulation of drugs, reduce the burden of the masses of drugs.
? The three medical linkage? is the key
In response to the abolition of the drug markup, senior hospital management experts, provincial physician association president Lin Shuguang said, ? Theoretically, patients will feel the cost of drugs cheaper down, but I personally more concerned about the drug bank construction is ready? There may be a clear trend towards the socialization of pharmacies after the zero-price-added drugs. He called, as soon as possible to start solving can completely replace the hospital pharmacy drug library construction, preferably group social pharmacy, in the form of central station depot, centralized to reduce the cost of drug transportation, storage, storage, loss, etc., so that the drug is more secure, but also can be really cheap.
Are you ready for drug depot construction?
Rong Limin, president of the Third Hospital Affiliated to Sun Yat-sen University, said the operation of the hospital should not be affected by the abolition of the drug markup,? I think to be calm.? As a public hospital, he said, the greater concern is not economic benefits. Patient satisfaction, medical quality, technical level is the main consideration index, do a good job in these areas, business will naturally continue to rise.
? Hospitals should definitely be strictly enforced in accordance with the national healthcare reform policy. Rong Limin revealed that last month the hospital in the hospital related meetings have been clearly proposed through the refined, scientific management to improve the operational efficiency of the hospital, including the rational allocation of human resources and the full use of human resources, as well as scientific research, talents, the construction of disciplines, in order to enhance the level of medical services to provide long-term support.
Economic efficiency is the main consideration of non-public hospitals
Guangdong status
Guangdong drugs in recent years has realized the sunshine procurement, the province's electronic trading platform for pharmaceuticals bidding transactions in the centralized purchasing management principles, allowing the commissioning of the bargaining, the independent joint bargaining, the bidding to follow the procurement, the inter-regional joint purchasing and specialty hospitals joint purchasing. The company's website has been updated with the latest information on the company's website.
In terms of health insurance reform, Guangdong intends to implement a composite payment method reform that combines multiple payment methods, such as per-patient payment, per-person payment, per-bed-day payment, and total prepayment, and encourages the implementation of the payment method according to the group of disease diagnosis-related payment. In the hierarchical diagnosis and treatment, not only the contracted family doctor can prescribe long-term medicines for chronic diseases, the province will also promote primary health care institutions to carry out rehabilitation comprehensive evaluation and other 20 medical rehabilitation projects included in the scope of payment of medical insurance; to comply with the provisions of the referral of hospitalized patients can be calculated consecutively starting line.