Why should we pay attention to the quality of medical services? Zhu Qingsheng said that the quality of medical services is the main criterion for the masses to evaluate health work, and the masses' recognition of the reform is mainly reflected in the quality and cost of medical services. Only by satisfying the people at this point can the reform go further. The most important thing in the development of medical institutions is connotation, and the quality of medical service is the core of connotation development. At the same time, improving the quality of medical services can reduce disputes and accidents and establish a good industry image.
Improving the quality of medical service is the starting point of this year's "year of changing work style". The National Conference on Medical Administration requires health administrative departments, hospital administrators and medical staff to do seven things well: change old ideas and put "patient-centered" into practice; On the one hand, strictly implement the existing rules and regulations and technical specifications, on the other hand, introduce advanced concepts and methods from all over the world, such as risk management, evidence-based medicine and total quality management. , and create your own system; Establish and improve the medical quality management mechanism in the legal person structure of medical institutions, and combine it with the reform of personnel distribution system; Strengthen the training of medical personnel, and establish an examination and elimination system; Increase the scope and intensity of medical service information disclosure; Cost control, rational drug use and joint inspection; Strengthen professional ethics education and improve the internal supervision and social supervision system.
Explore new ways to solve the problem of "difficult and expensive medical treatment" for grassroots people.
"Difficult and expensive medical treatment" has been a hot and difficult issue strongly reflected by the society for many years, and it is also a major topic in medical reform research. Different industries and different people have different understandings and views on this topic involving people's livelihood, which also leads to different theoretical research and public opinion debates. There are two arguments: who should be responsible for the problem of "difficult and expensive medical treatment"? Second, how should medical care run?
Can people feel that seeing a doctor is "not difficult" and "not expensive"? Below, the author makes some superficial discussions on this topic of people's livelihood through some experiences and feelings of working in primary hospitals, as well as interviews with relevant people in related industries and departments, hoping to help alleviate the "difficult and expensive medical treatment" of grassroots people, alleviate the increasingly tense relationship between doctors and patients, and build a harmonious and healthy society.
First, an analysis of the reasons why grassroots people are "difficult and expensive to see a doctor"
(1) The main manifestations of the difficulty and expensive medical treatment of grassroots people.
The "difficulty in seeing a doctor" lies in: (1) It takes too long to see a doctor, especially for farmers in remote mountain villages. (2) The technical strength of medical institutions is weak and it is difficult to meet the medical needs. Such as poor medical staff, poor diagnostic equipment, poor facilities, unclear diagnosis and poor treatment effect. (3) The service of medical institutions is not in place. For example, the layout of hospital departments is unreasonable, the procedures are complicated, and a few medical staff have a weak sense of service, so it is difficult to get in and their faces are ugly. (4) Large hospitals are overcrowded, and there are "difficulties" in registering, taking medicine and waiting in long queues.
Expensive medical treatment: (1) Expensive medicine (2) Expensive examination (3) Expensive special treatment equipment (4) Excessive treatment, resulting in unreasonable expenses.
(B) Analysis of the reasons for "difficult and expensive medical treatment"
Based on the current situation of hospitals and some mechanisms of medical operation, it is not difficult to analyze the reasons for "difficult and expensive medical treatment":
(1) The geographical environment of village-level medical institutions is limited, and the allocation of village-level medical institutions by the health administrative department is not in place, which leads to many farmers seeking medical treatment in the difficulty of getting in and out.
(2) On the one hand, the government's insufficient investment in health has affected the renovation and improvement of hospital facilities, the purchase of equipment, the training of talents and the development of technical projects, resulting in poor medical treatment capacity of hospitals and affecting the efficiency and speed of people's medical treatment; On the other hand, the hospital's own management level is limited, and it is unable to solve the economic investment of self-development, which affects the medical service ability.
(3) Hospital management is not in place, the internal restraint mechanism is not perfect, and the quality of individual medical staff is poor, which makes it difficult for people to see a doctor.
(4) The price of sanitary materials is artificially high, the management in the field of drug circulation is not standardized, the circulation link is too heavy, and the price reduction of drugs has not made a substantial breakthrough, which has aggravated the degree of "expensive medical treatment".
(5) After the promulgation of the new Regulations on Handling Medical Accidents, the handling of medical accidents is "inverted proof". For the purpose of self-prevention, doctors over-examine during diagnosis and treatment, which increases the medical burden of patients.
(6) With the development of medical science and technology, the continuous use of new technologies, new drugs, new instruments and new materials, and the progress of diagnosis and treatment methods, patients enjoy safe, accurate and fast diagnosis and treatment services, and their expenses increase accordingly.
(7) Hospitals exist and develop in the economic environment of rising prices. The increase of medical and health expenses is the inevitable result of medical science and technology progress and social and economic development, and it is inevitable to increase within a certain range.
(8) In order to survive and develop, the hospital pursues its own economic benefits unilaterally, and departments or doctors take overtreatment behavior to complete the target tasks and improve the benefit salary, which increases the burden on patients.
(9) Individual doctors' professional ethics are corrupted, and they only prescribe large prescriptions in order to pursue kickbacks and commissions; Individual doctors have poor basic theory and low level of diagnosis and treatment, and only know to check with large equipment or check randomly; In order to vent their dissatisfaction, individual doctors bring their emotions into medical work, take it out on patients or "kill them".
(3) Who is to blame for the problem of "difficult and expensive medical treatment"
According to the analysis of the above reasons, it is not difficult for us to understand that the problem of "difficult and expensive medical treatment" is a comprehensive problem and cannot be simply attributed to a certain industry or department. It is a problem chain, involving the examination and approval and pricing of drug prices and special medical devices by the price department, the circulation supervision of drugs and medical devices by the drug supervision department, the government's investment, the supervision and law enforcement by the health administrative department, the internal management of the hospital, the management ability and quality of the dean, and doctors. However, we should clearly see that the key link of medical expenses is the hospital, and the hospital should be the "goalkeeper" of medical expenses. The lack of social responsibility and professional ethics in hospitals will lead to the aggravation of the problem of "difficult and expensive medical treatment" It is the current medical operation mechanism that hospitals order food and others (patients, governments and units) pay the bill. In addition to some subjective and objective reasons, doctors, hospitals, drug dealers and pharmaceutical factories have a large number of disorderly ordering, ordering, selling vegetables, selling vegetables and cooking. Therefore, how to explore the new operating system and mechanism of "three medical services" (medical care, medical insurance and medicine) is the most important work and core measure to solve the problem of "difficult and expensive medical treatment" for the masses. On the other hand, we should abandon the view that it is difficult and expensive for the masses to see a doctor, and think that the current government investment is insufficient, so long as the government increases investment, the problem will be solved. Actually, it's not. It is very important to fundamentally solve the problem of "difficult and expensive medical treatment", but another problem that cannot be ignored is how to maximize the waste and loss of medical and health resources, revitalize a large number of existing idle resources, and standardize and improve the utilization efficiency of existing resources.