The high cost of medical consumables has always been an important reason why people are "expensive to see a doctor" and a "hard bone" in the process of medical reform. From 20 12, Ningbo, Zhejiang province took the lead in implementing the procurement reform of medical consumables, which greatly reduced the price of medical consumables, and was called "Ningbo rule" by the medical community.
The so-called "material cost" refers to the cost of medical consumables, which was once the "big head" of people's medical expenses. According to a statistical data of Ningbo Municipal Health Planning Commission, there were three general hospitals in Ningbo in 20 10.
From 2065438 to 2002, medical expenses increased at an average annual rate of 20%, of which the increase of consumables was as high as 3 1. 1%, accounting for 22% to 30% of the total expenditure of all inpatients and surgical patients.
40% to 60% In 2065438+02, the annual purchase volume of medical consumables in these three hospitals reached 662.7 million yuan.
Hu Jianhua, inspector of Ningbo Health Planning Commission, who has been in charge of medical discipline inspection for a long time, said that the inflated price of medical consumables increased the burden on patients, increased the pressure of medical insurance, and even fostered corruption, which affected the image of hospitals and doctors.
"Some corporate public relations can basically guarantee huge profits as long as they win the department director. This has become a clear rule rather than a hidden rule. " Some doctors said.
In order to solve this problem, Ningbo began to attack the virtual high of consumables from 20 12, that is, centralized procurement of medical consumables, taking the whole Ningbo market as a "bargaining chip", conducting bidding negotiations with suppliers of consumables, and ensuring high-quality and low-price transactions through complete system design.
The first difficulty in purchasing medical consumables is "human feelings". On the one hand, the Ningbo Municipal Health Planning Commission publicly promised not to accept "intercession", on the other hand, it set a "threshold" in the system.
The first hurdle is computer "screening": the computer scores the qualification elements of suppliers and determines the shortlist according to the scores from high to low. This practice effectively avoids the interference of human factors in the process of supplier shortlisting. "If there is a criminal record such as bribery, one vote will be rejected." Hu Jianhua said.
How to control the quality? Ningbo has set up a second hurdle: brands are "selected" by experts. On the day of selection, the supervision department randomly selected 25 experts from major hospitals, and each expert independently voted for qualified consumable brands, and selected the shortlisted brands for price negotiation according to the number of votes.
"This practice not only meets the clinical needs, but also avoids a few doctors having the final say." Xiao Jinshan, former party secretary of Ningbo Lihuili Hospital, said.
After the first two quality checks, the last one is the price check: centralized bidding, whoever has the lowest price will win the bid. Hu Jianhua said that the bidding site is "multi-round quotation, one by one elimination, on-site announcement", and the whole process is open, so it is not tricky.
For example, conical instruments are the most important consumables in lumbar surgery. Before centralized procurement, the price of each set was 22,000 yuan. After several rounds of quotation and elimination, a company quoted 6450 yuan to clinch a deal. But negotiators still feel a little inappropriate.
"The market volume is relatively large, and we think the two companies are more suitable. In case the winning bidder cannot supply the goods under special circumstances, it will not be out of stock. " Hu Jianhua said that the second lowest offer at that time was 8800 yuan, while Ningbo Medicine.
A principle of centralized procurement of consumables is that the difference in transaction price of the same product is generally within 5%. So the negotiators started a tug-of-war negotiation with the second company for three days and two nights. In the end, both companies traded at 6450 yuan.
The centralized procurement of medical consumables has achieved remarkable results. Up to now, Ningbo has purchased 18 1436 kinds of medical consumables, and the average price has dropped by 43. 15%. By the end of July this year, medical expenses had been saved by 902 million yuan.
While the price of medical consumables has dropped, the consumption of consumables has also dropped significantly. The comparative data before and after the centralized procurement by Ningbo Municipal Health Planning Commission showed that the consumption of hemostatic materials per operation in major hospitals in Ningbo decreased by 46.22% on average, and the expenditure per operation decreased from 4 17. 19 yuan before the centralized procurement to 17 1.42 yuan after the centralized procurement.
Centralized procurement of medical consumables has also broken the irreplaceable status quo of imported products. According to statistics, 5 1% of the 404 products purchased by the third batch of medical consumables in Ningbo are domestic products.
The centralized procurement of medical consumables in Ningbo benefited patients and effectively controlled the medical insurance costs. According to the statistics of Ningbo social security department, medical institutions in Ningbo have implemented effective measures to control fees.
The annual growth rate of medical expenses for industrial and medical insurance decreased from 65,438+05.3% in 2065,438+02 to 5.2% in 2065,438+05. In order to encourage hospitals to reduce fees and control fees, the social security department rewarded relevant hospitals, and the cost of consumables was well controlled.
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