In the future, you can also choose a "package" to see a doctor! The newest addition to the list is the new "package" of medical services, which will allow you to get the most out of your medical care!
In the past, when you went to the hospital, you were always a little worried about how much money you would spend, how much you would have to pay for more tests, and how much you would have to pay for more medicines or consumables.
No need to worry about that! Recently, Guangxi, Zhejiang, Sichuan, Henan and other provinces intensively issued a notice to expand the scope of collection and payment by disease. According to incomplete statistics, nearly two-thirds of the country's provinces have implemented or are piloting the implementation of the charge by disease.
Experts, each province about more than a hundred kinds of diseases, is charged by disease, that is, "packaged charges".
That is to say, all the costs incurred by the patient medical treatment, a one-time "package" to pay. The company's website is a great place to find out more about the company's services, and to learn more about the company's products and services!
After the reform of the health insurance how to pay, see the doctor can not spend less money?
Can you actually improve the efficiency of the fund by charging according to the type of disease, and eliminate the excessive medical treatment of both doctors and patients?
What does it mean to be charged by the type of disease?
By the disease charges, that is, from the patient's admission to the hospital, according to the disease treatment management process to receive standardized diagnosis and treatment, to achieve clinical efficacy standards after discharge, the entire process of diagnosis, treatment, surgery and other costs, are a one-time package charges.
The hospital charges according to this standard, the medical insurance fund and the insured patients pay according to the prescribed proportion.
In fact, according to the type of charge is not a new thing, many years ago, some hospitals for some diagnosis and treatment process is relatively fixed diseases have been implemented according to the type of charge, but, at that time, called the "packaged treatment", such as for cesarean section, appendicitis and other diseases. In foreign countries, the practice of charging by type of disease has also proved to be able to reduce the overall cost of medical care.
An example: Guangxi lumbar intervertebral disc removal treatment, the maximum price of 15,000 yuan
Guangxi Health Planning Commission and other departments to jointly implement the trial by the type of charge, the 127 types of diagnosis and treatment, diagnosis, and other costs incurred by the respective packages, the implementation of the maximum price, to control the unreasonable rise in medical costs.
It is understood that this provision is mainly implemented in the second and third-level public medical institutions in Guangxi, involving the nervous system, respiratory system, digestive system, traditional Chinese medicine and other 19 clinical specialties, 127 types of diseases.
The charges of the third-level public medical institutions, for example,
Lumbar disc herniation for lumbar disc removal treatment, the maximum limit of 15,000 yuan;
The maximum limit of postoperative adjuvant treatment for colon cancer is 13,680 yuan;
The maximum charges of the second-level public medical institutions are based on the benchmark of the third-level public medical institutions, with a downward fluctuation of 5 percent.
The Circular also stipulates that in these medical categories covered, hospitals shall not charge other fees except for the cost of blood transfusion (including blood costs), patients discharged from hospitals with medicines, and hospital bed fees in excess of the standard ordinary bed fee, which can be charged separately.
If a patient enrolled in basic medical insurance has serious complications during treatment, etc., and is withdrawn from the clinical pathway with the consent of the patient (or family member) and the approval of the social insurance agency, the diagnosis and treatment fees will be calculated separately.
Medical costs, to be reduced?
The purpose of charging by disease is to control costs. The total cost of hospitalization of patients, including diagnosis, treatment, surgery and other costs, mainly by the bed and nursing costs, inspection and testing costs, drugs and consumables costs, doctor's fees and surgical fees and other components. Among them, bed and nursing fees and doctors' consultation and operation fees are relatively fixed, and are likely to rise with the deepening of health care reform.
So, charging by type of disease mainly targets the cost of examination and testing, drugs and consumables. The aim of controlling medical costs is achieved by reducing excessive examination and test costs and unnecessary drug and consumable costs.
In the current medical environment, doctors are most afraid of missed diagnoses, and improving examinations and tests is an important aspect of reducing missed diagnoses. This part of the cost can only be reduced in some hospitals have the possibility, for some large hospitals, examination and testing is very formal, especially after the recent years under the clinical path standardization of hospitals, examination and testing have a clear norms, examination and testing of the cost of the decline in space is actually not much.
Of course, some hospitals have the phenomenon of excessive examination and testing, and charging by type of disease will obviously compress the cost of examination and testing.
The cost of medicines is a relatively large part of a patient's hospitalization expenses. Due to the system, hospitals generally have the phenomenon of supporting doctors with medicines and compensating doctors with medicines. With the implementation of zero-percentage markup on medicines, the overall decline in the cost of medicines is also a general trend. The cost of consumables, on the other hand, accounts for a large part of the total hospitalization cost for many patients, especially surgical patients. By charging on a case-by-case basis, these two costs are also expected to come down.
"Charging by type of disease is beneficial to patients, can reduce the burden of patients to see the doctor, while the cost of treatment can also be predicted in advance." Shandong has piloted a public hospital by disease charges, a doctor said, to acute simple appendicitis, for example, before the Jinan public tertiary hospitals in the treatment of more than 12,000 yuan below the fluctuation of the fee, while the charge by the type of disease is reduced to 10,000 yuan.
"Under this packaged charging method, the drugs, medical consumables and inspection and testing used by patients become the cost of diagnosis and treatment services, rather than a means for hospitals to gain revenue." Shenzhen Nanshan District People's Hospital network technology section director Zhu Yusong said. This collection and payment method will force hospitals to reduce the cost of services, standardize medical services and optimize the cost structure, so as to achieve the goal of curbing the rise in medical costs.
At present, the provinces launched a "packaged" package to see the doctor cover more than a hundred kinds of diseases, and most of them are common diseases.
Expert interpretation: so medical reform, can inhibit excessive medical
Financial commentator: standardization is to a certain extent can indeed go to reduce the problem of excessive medical care, because in the treatment process, there are many places are not black and white, and even a lot of choice.
For example, the same efficacy of the drug, imported drugs and domestic drugs have a lot of difference, or the use of medical materials, or other accessories, then this time in the absence of constraints, the doctor and the patient is more willing to us with the best of the best treatment, the best way of treatment, then this time it may be the overall cost of the rise more.
So for the patient, for some people, he may see this disease, say treatment of an appendicitis he may be 10,000 yuan down, may be up to 15,000 yuan, for the patient then, he may have to pay more for this cost, then for our health insurance fund then also paid more for this cost, but in the process, the hospital and the doctor may be a kind of individual in some of these hospitals to produce this kind of cost, but in the process, the hospital and the doctor may be a kind of individual in some of these hospitals to produce this kind of cost. The hospitals may have a kind of individual hospitals to produce such a kind of drive, so he solved this problem.
The report of the 19th National Congress pointed out that the deepening of the reform of the medical and health system and the comprehensive establishment of a basic medical and health system with Chinese characteristics, a medical insurance system and a high-quality and efficient medical and health service system.
For a long time, most of the medical insurance has been implemented on a per-service payment basis, and the payment method is a post-payment system, where patients are reported according to the fee bill.
This payment method tends to cause over-treatment, stimulating hospitals to introduce cutting-edge diagnostic and therapeutic equipment and promote high-priced drugs, making it difficult to control medical costs and overburdening the health insurance fund. And with the approach of an aging society, collecting less and spending more will become the new normal for the health insurance fund. For the health insurance sector, cost control has become a necessary path to health care reform.