Why should we grasp the quality of medical services? Zhu Qingsheng said that the quality of medical services is the main measurement mark of the public's evaluation of health work, the public's recognition of the reform is mainly reflected in the quality and cost of medical services. Only when the people are satisfied on this point can the reform go deeper. The development of medical institutions is mainly about connotation, and the quality of medical services is the core of connotation development. At the same time, improve the quality of medical services can reduce disputes and accidents, establish a good image of the industry.
Improving the quality of medical services is the entry point for this year's "Year of Changing Style". The national medical work conference requires health administrative departments, hospital administrators and medical staff to do seven things: change the old concept, the "patient-centered" to the letter; on the one hand, the strict implementation of existing regulations and technical specifications, on the other hand, the introduction of the world's advanced ideas and methods, such as risk management, evidence-based medicine, total quality management, etc., to create their own systems. On the other hand, it introduces advanced ideas and methods from all over the world, such as risk management, evidence-based medicine, total quality management, etc., and creates its own system; establishes and improves the mechanism of reflecting medical quality management in the corporate structure of medical institutions, and combines it with the reform of the personnel distribution system; strengthens the training of medical personnel, and establishes a system of assessment and elimination; increases the scope and intensity of the disclosure of information on medical services; controls the costs, and rationalizes the use of medicines and the sharing of examinations; strengthens the education of professional ethics, and improves the system of internal and social supervision.
Explore new ways to solve the grassroots masses "difficult to see the doctor, expensive" problem
"Difficult to see the doctor, expensive" has been a strong social reflection of the hotspot, difficult problems, but also a major topic of health care reform research. On this topic involving people's livelihood, different industries and different groups of people have different understandings of different views, which also produces different theoretical research and public opinion debate. The focus of the debate are two: one is to produce "difficult to see the doctor, see the doctor expensive" problem in the end to whom to blame? Secondly, the medical operation in the end how to be
Can let the masses think that it is not difficult to see a doctor, "not expensive"? Below, the author through their own work in the grass-roots hospitals, some of the experience and feelings of the relevant industry sectors of the relevant population survey interviews, the livelihood of the topic to do some shallow discussion, and expect to alleviate the grass-roots people "difficult to see a doctor, see a doctor expensive", alleviate the increasingly tense relationship between doctors and patients and the construction of a harmonious health has certain benefits.
I, grass-roots people, "difficult to see the doctor to see the doctor expensive" cause analysis
(a) the grass-roots people difficult to see the doctor, the main performance of expensive
"Difficult to see the doctor" difficult to: (1) long distance, inconvenience, especially for some remote mountain villages, the doctor is not convenient. Especially for some farmers in remote mountain villages. (2) The technical strength of medical institutions is weak, it is difficult to meet the medical needs. For example, the medical staff's business is poor, the diagnostic equipment is poor, the facilities are simple, the diagnosis is unclear, and the treatment effect is poor. (3) The services of medical institutions are not in place, such as the unreasonable layout of the hospital's departmental settings, complex procedures, a few medical staff with a weak sense of service, the existence of the door is difficult to enter, difficult to see. (4) large hospitals are overcrowded, registration, medicine, waiting for a long queue exists "difficult to wait" difficult.
"Expensive" in: (1) expensive drugs (2) expensive examination fees (3) some special treatment equipment expensive (4) excessive treatment, minor illnesses, delayed treatment to produce unreasonable costs.
(2) "difficult to see the doctor, see the doctor" cause analysis
Through some of the hospital's current situation, combined with some of the mechanism of medical operation, it is not difficult to analyze, "difficult to see the doctor, see the doctor," the causes are:
(1) the village medical institutions geographic restrictions and health administrative departments of the village medical institutions configuration is not in place to lead to a number of farmers to seek medical treatment "difficult to travel".
(2) on the one hand, the government's lack of investment in health, affecting the hospital's facilities to update and improve the purchase of equipment, training of personnel, the development of technical projects, resulting in the hospital's poor medical treatment capacity, affecting the masses to seek medical treatment efficiently; on the other hand, the hospital's own limited level of operation, unable to solve the self-development of the economic inputs, affecting the ability to provide medical services.
(3) The hospital management is not in place, the internal restraint mechanism is not complete and ineffective, the quality of individual medical staff is poor, resulting in the masses to see a doctor.
(4) the price of health materials is too high, the management of the circulation of medicines is not standardized, the circulation of the layers of the code, the price of medicines has not made a substantial breakthrough, aggravating the degree of "expensive medical care".
(5) After the introduction of the new "Regulations on the Treatment of Medical Accidents", the implementation of the "reversal of proof" in the treatment of medical malpractice, out of their own preventive purposes, doctors in the process of diagnosis and treatment of excessive examination, increasing the patient's burden of medical care.
(6) The development of medical science and technology, new technologies, new medicines, new instruments and new materials are constantly being used, the progress of diagnosis and treatment means that patients enjoy safe, accurate and fast diagnosis and treatment services at the same time, the cost of expenditure increased accordingly.
(7) hospitals are in the rising prices of the city's economic environment, survival and development, health care costs are the inevitable result of medical and scientific progress and socio-economic development, within a certain range of growth is unavoidable.
(8) hospitals in order to survive and develop one-sided pursuit of their own economic benefits, departments or doctors in order to complete the target task, improve the effectiveness of the salary, to take excessive treatment behavior, increasing the burden on patients.
(9) individual doctors professional moral corruption, only to pursue kickbacks, commission, large prescriptions indiscriminate prescribing; individual doctors basic theory is poor, low level of diagnosis and treatment, only know with the help of large-scale equipment inspection or abusive inspection; individual doctors in order to release the heart of the dissatisfaction, the emotions brought to the work of medical care, anger in the patient to vent their anger or "cruel slaughter".
(C) "difficult to see the doctor, expensive" problem in the end to whom the blame
Based on the above analysis of the causes, it is not difficult to understand, "difficult to see the doctor, expensive" problem is a kind of comprehensive problem, can not be attributed to a single industry, a department, it is a problem of a chain of issues, the problem is not the same as that of the other side, the problem is not a problem of the other side, it is a problem of the other side. It is a chain of problems that involves the price department's approval and pricing of medicines and special medical devices, the drug administration department's supervision of the circulation of medicines and medical devices, the government's investment, the health administration department's supervision and law enforcement, the internal operation and management of the hospitals, the manager's managerial ability and quality, and the doctor's professional morality and quality of practice. Solving any of these problems alone will not completely solve the problem of "difficult and expensive to see a doctor". However, we should be sober to see that the key link in the generation of medical costs is the hospital, the hospital should be the "gatekeeper" of medical costs, the lack of social responsibility and professional ethics of the hospital will lead to "difficult to see a doctor, expensive to see a doctor," the problem of aggravation of the heating. It is the current hospital "à la carte" others (patients, government, units) "pay the bill" of the medical operation mechanism, coupled with certain subjective and objective reasons, which led to doctors, hospitals, drug companies, pharmaceutical companies, a number of chaotic "à la carte ", messy "buy food," more "order food", more "sell food", messy "sell food ", messy "do" dish phenomenon, which also led to people on their verbal attacks. Therefore, how to explore the new "three doctors" (medical, health insurance, medicine) operating system and mechanism is the most important work, is to solve the masses "difficult to see a doctor, expensive" core initiatives. On the other hand, we should abandon the view that the masses "difficult to see a doctor, expensive" is the current government investment is insufficient, as long as the government to increase investment in the problem will be solved. In fact, it is not, how to fundamentally solve the masses, "difficult to see a doctor, expensive" government investment is certainly very important, but can not be ignored another problem is how to maximize the exhaustion of medical and health resources waste and loss, revitalization of a large number of existing unused resources,