Beijing of Xinhua News Agency on November 23 report (reporter Jiang Guocheng) the country develops and reform committee, Ministry of Public Health and manpower resource and social security ministry are released 23 days jointly " reform medicines and chemical reagents and the opinion that medical services the price to form a mechanism " , advanced the near future that medical price reforms and long-term goal. To 2011, order of value of market of our country medicine should improve stage by stage, drug price tends reasonable, medical services price structure sex to contradict to alleviate apparently; To 2020, medical price can change of cost of service of production of objective and seasonable report and market supply and demand. " opinion " clear, the government makes drug price want to abide by " supply and demand of compensation cost, reasonable profit, report " basic principle, at the same time level of consideration socioeconomy development, masses bears ability, medicines and chemical reagents is clinical the element such as value; Strengthen the management that sums price action to current link further, reduce a government to coach current price difference leads valence medicines and chemical reagents stage by stage level, maintain reasonable price difference or rate of exchange concern between medicines and chemical reagents; The government makes primary medical services the price, want to be on basis of cost of reasonable compensation medical establishment, according to deduct finance allowance, medical establishment to sell medicines and chemical reagents and medical apparatus and instruments (bad news material) check and ratify of price difference accrual. " opinion " put forward, in reasonable make drug retail and directive price while, want according to " medicine is apart " requirement, reform medical establishment compensates a mechanism, cancel medical establishment to sell addition of medicines and chemical reagents stage by stage. Public hospital cancels income of the reductive after addition of medicines and chemical reagents, can pass increase finance allowance, improve medical services price and establish " medical issue serves cost " the measure such as the project has necessary compensation; Want to reform medical services to serve price pattern further, accelerate solve medical services to serve contradiction of price structure sex, raise the medical services that reflects technology and service value to serve the price, reduce large and medical equipment supervision and remedial value; Strengthen pair of management that are worth price of medical apparatus and instruments high, lead the price reasonable form.
Case of Xi‘an market price supervises examination bureau to begin from now, will begin by a definite date the medicines and chemical reagents of 4 months and examination of focal point of price of medical services, depreciate to what the government sets medicines and chemical reagents does not depreciate to reach the designated position, change medicines and chemical reagents is packed covert rise in price wait for behavior,
These units accept an inspection The limits that checks this is business of drug production, sale (contain " 3 endowment " enterprise) , medical establishment (contain external paid the medical establishment such as the army of the service, armed police, run by the local people seeks profits gender medical establishment) , disease precaution controls center, blood orgnaization of representative of invite public bidding of station, medicines and chemical reagents and other, and the section that concerns with medicines and chemical reagents and medical services and collect fees unit. The price that main examination produces since July 1, 2007 and collect fees behavior, the examination that violates act to great value but on restrospect to one year. Drug price checks what In drug price respect, whether is the medicines and chemical reagents that regulation of main examination government depreciates carried out by the regulation reach the designated position, have without defer what depreciate or do not depreciate by formulary extent, random avoids national price runs policy need not or use a government less to depreciate of medicines and chemical reagents; Whether is price medicines and chemical reagents carried out by valorize to the government, have fix a price without exceed one‘s authority, whether to put in the breakthrough to top retail price is sold or change drug name, norms and pack covert rise in price; The drug that medical establishment sells, arrange on the foundation that whether purchases value actually in medicines and chemical reagents add evaluate, of medicines and chemical reagents add valence rate actually to whether be by formulary control 15% (prepared herbal medicine in small pieces ready of decoction adds Chinese traditional medicine valence is led 25% ) less than, the rake-off outside having valence waits covert the behavior that raises the rate that increase price. Medical services the price to check what Price field serves in medical services, whether does main examination collect fees by formulary project and standard, have without improve grade or the standard collects fees, decompose collect fees the project repeats collect fees and collect fees only do not serve or of little service; Whether is the one-time medical and wholesome data that medical establishment uses put in above to collect fees behavior; Medical whether is the medical apparatus and instruments that value of equipment supervision services, medical establishment sells carried out according to price level of the regulation etc.
The examination ends to the end of November, came to was direct examination and key examination in October in August period, was processing period in November, to service of medicines and chemical reagents, medical services all sorts of chaos add valence, chaos to collect fees behavior prices branch investigates gravity.
China will boost national level actively this year public hospital reform is pilot, undertake public hospital compensates mechanism reform, fulfil a government to throw policy, adjust medical services to serve the price, cancel addition of medicines and chemical reagents stage by stage. When news of national Ministry of Public Health does to disclose this one information today, say, as one of points that countrywide sanitation works this year, encourage each district what public hospital reform begins formal diversity is own and pilot, make, implement public hospital setting and development program, optimize composition of public hospital construction; Exploration perfects public hospital to run system, improvement strengthens public hospital processing; Drive a hospital to run system of mechanism and human affairs, income allocation to reform, strengthen post performance assessment, exploration carries out post performance pay to make; Begin a doctor many a little bit hold course of study and clinical method are pilot; Exploration single defect is planted quality management, advance apply " electronic anamnesis is basic and normative " . In the meantime, encourage, support and guide social capital to hold be not public hospital, accelerate form diversity to handle cure situation. Ministry of Public Health expresses, coach those who strengthen pair of pilot policy, technology and groom, dog cheek by jowl pilot job makes progress, begin survey superintend and director to guide investigate with base line, had done evaluate preparation; Research establishs standard of public hospital staff, strict control is large and medical plant layout, encourage build in all share, raise wholesome resource to use efficiency. In addition, still set research center of national district medical services, build medical services quality government control, evaluation and supervisory system and it is core with commonweal sex, it is a center with the patient, it is oriented public hospital to superintend a system with performance, improve medical services quality in the round, ensure medical services safety. Specific content includes: -- system of go on a tour of inspection of perfect and large hospital, evaluation of evaluation of the hospital that start is pilot, normative medical establishment hold trade act, strengthen medical services advertisement to superintend; Perfect system of doctor qualification exam, strengthen a doctor hold trade act management; -- advance make an appointment diagnosis and services, open further on the weekend outpatient service, extend time of outpatient service registration, adopt a variety of civilian, benefit civilian measure, optimize flow, convenient patient go to a doctor. -- normative hospital complains management, drive build people of medical services dispute to mediate system of system and insurance of medical services liability. -- advance reasonable with medicine, carry out " national prescription collect " , perfect prescription comments on a system, strengthen reasonable monitor with medicine, normative antibacterial clinical application runs thing. -- deepen clinical foundation to nurse quality management, rise nurse working level, fulfil collect the orgnaization that offer blood to set a program, perfect doctor takes an examination of nucleus and medical personnel medical ethics to test a system regularly. (Reporter Ceng Liming)
In extensive network Beijing on October 10 message (reporter Liu Tiansai) from cure of Ministry of Public Health politics department learned a few days ago, this department near future will be in hospital of Beijing University people to wait begin optimize a service flow, reasonable use medical services resource pilot job. Pilot and main include two parts content: It is door emergency call the settle accounts after making a diagnosis and give services first; 2 it is resource of integrated section office and patient demand, change a space with time.
Zhao Minggang of politics department vice director says doctor of Ministry of Public Health, in the past, patient of outpatient service, emergency call sees a doctor, project of every diagnosis and services wants fee of capture of one by one, increased to queue up to expect time. Expend personnel as a result of capture queueing up at the same time overmuch, affected order of hospital door emergency call. He says, pilot " door emergency call the settle accounts after making a diagnosis and give services first " , want technological process of readjust outpatient service, emergency call seeing a doctor, on the base that in crowd of examine of face each other, emergency call seeing a doctor means paying fee has classified, according to different crowd specific case study differs mechanism paying fee, the diagnosis and services that draws lessons from cash pledge of prepay of patient of be in hospital serves mode, simplify flow of patient door, emergency call seeing a doctor.
Jiao Yahui of deputy director general of office of government of politics department medical services tells cure of Ministry of Public Health the reporter, execute " the settle accounts after making a diagnosis and give services first " , the hospital can is opposite cash pledge of every patient collection, install independent information identification code. Every accept the patient to make a diagnosis and give services, information system is met deduct relevant expense automatically from inside cash pledge.
"Change a space with time " , it is to show in the light of job of medical services of different section office medical services of actual condition, patient needs resource of medical services of sue for peace to use a case, make overall plans to medical services resource from time, space and manpower resource, science is allocated. Zhao Minggang says, at present outpatient service person is a lot of hospitals completely in the morning suffer from, surgery demands exceeds supply, rate of consulting room, surgery empty buy is higher afternoon. Accordingly, want reasonable arrangement the diagnosis and services of different section office works, raise hospital outpatient service, emergency call, surgery to wait use efficiency.
Wang Sha of dean of hospital of Beijing University people introduces, at present this courtyard is debugging information system, right the outpatient service of different section office, different crowd second all charge undertakes calculating, predict pilot job can spread out before the end of the year.
In electric Ministry of Public Health allotted new network a few days ago on January 24 " the announcement that about print and distribute medical servicesd superintendency job point 2009 " , to a few jobs 2009, undertook deploy.
The announcement says, of the party seventeen put forward clearly greatly, hold to common medical services property of healthful society commonweal. Push public hospital reform, strengthen medical services to superintend, it is one of key jobs that deepen reform of medical sanitation system. Basis 2008 the State Council " 3 calm " regulation, ministry of Public Health established medical services to serve superintendency department () of department of abbreviation cure canal, the superintendency that assumes service of medical establishment medical services works, build medical establishment medical services to quality is evaluated and control a system, the organization begins medical services to quality, safe, service, finance affairs is supervised and be evaluated wait for the job, build the public hospital that is core with commonweal sex soundly to superintend a system, assume advance public hospital to manage system to reform the job.
Working conference pointed out countrywide sanitation 2009, advance public hospital reform is pilot, strengthen medical services to the service manages and be superintended, the hospital is established to superintend an orgnaization in wholesome service, build the public hospital performance that is core with commonweal sex to evaluate administrative system and safety of medical services quality to evaluate a system. Fulfil to be carried out in the round countrywide sanitation worked 2009 conference spirit, directive each district does medical services of good medical establishment to serve superintendency job, begin hospital government system reform is pilot, maintain the commonweal quality of public hospital, now will medical services superintended working point print and distribute to give you 2009, tie place please the work is real, perfect origanization construction, formulate job is arranged, fulfil each deploy. Ask your hall bureau medical services superintended working arrangement to sign up for my ministry medical services to serve superintendency department 2009.
Medical servicesd superintendency job point 2009
2009 is Ministry of Public Health establishs medical services to serve superintendency department, strengthen medical services to serve the first year of superintendency job in the round, also be medical sanitation a year when system reform deepens in the round. Various and wholesome service wants to be mixed theoretically with Deng Xiaoping " 3 delegates " serious thought is guidance, carry out deep implement scientific progress concept, closely around key of wholesome 2009 job, build the public hospital that is core with commonweal sex soundly to superintend a system, build medical establishment medical services to quality is evaluated and control a system, the organization begins medical services to quality, safe, service, finance affairs is supervised and be evaluated wait for the job, advance public hospital to manage system to reform the job.
One, strengthen medical services to serve superintendency orgnaization and team construction
Establish responsible medical services to serve superintendency special orgnaization, cogent the superintendency that strengthens services of pair of medical establishment medical services, safeguard the commonweal sex of public hospital, it is to insist to be with the person this, solve people to see a doctor the need of problem of go to a doctor, it is to deepen medical sanitation facilities of sanitation of system reform, stimulative medical services coordinates the important step that can develop continuously in the round. Various and wholesome service should understand the value that medical services enhances to serve superintendency job below current condition, arduous sex and long-term sex deeply, according to the actual condition of this unit, union deepens reform of medical sanitation system, build perfect medical services to serve superintendency orgnaization, provide necessary personnel power, straighten working relationship, make clear goal assignment, fulfil post responsibility, begin the work actively.
2, research builds a hospital to evaluate a system
(One) various and wholesome service should be summed up deep " it is a center with the patient, give priority to a problem in order to improve medical services quality " the hospital manages year of activity experience, publicize advanced type, popularize good experience, expand to consolidate and enlarge mobile achievement, stimulative medical establishment strengthens management, improve efficiency, improvement serves, control cost.
(2) research builds quality of medical establishment medical services, safe, service and performance to evaluate a system. Accelerate hospital management to evaluate systematic construction, normative hospital evaluation evaluates the work. Exploration establishs the lasting effect mechanism of hospital management.
(3) the evaluation that the organization begins medical services quality, safe, service, financial management is checked and superintend the job. The hospital that start evaluates pilot job and individual examination to evaluate the work. The organization begins work of go on a tour of inspection of large and public hospital. Strengthen the guidance that builds to morality of medical personnel profession.
(4) begin application of service of primary to public medical establishment medical services, basic medicines, medical services to serve rights and interests of fair, patient to safeguard, the evaluation of manpower resource management and integrated performance.
3, strengthen safety of medical services quality to superintend
(One) drive build country, province, city (the ground) safety of quality of 3 class medical services controls evaluation system. Begin specialized subject of national level medicine to accuse to evaluate a center character pilot job. The fundamental link that directive medical establishment serves around diagnosis and services, make plan of medical services improvement in quality, begin quality to assess an evaluation, raise medical services to serve quality.
(2) research builds early warning system of risk of national medical services. Classification, classification launchs medical services venture the collection of pertinent information, collect, analysis works. Organization, directive medical establishment and medical personnel are adopted in time deal with measure puts forward to improve and be on guard proposal, cogent safeguard medical services is safe.
(3) undesirable incident information collects perfect medicines and chemical reagents, medical apparatus and instruments, analysis and mechanism of processing of cautionary, lash-up and system. According to the property of undesirable incident, limits and serious degree, classification statified take effective measures, reduce pair of medical services safety and the patient‘s healthy adverse effect.
(4) increase pair of medical services advertising to superintend strength, strengthen all sorts of pair of media to release medical services advertising to monitor, investigate gravely lawfully break the law violate compasses release medical establishment of medical services advertising.
(5) the desired result management that strengthens pair of medical establishment and hold trade act is superintended, the doctor with the uniform standard that start checks the work regularly, begin pair of medical establishment and public health worker lawfully hold of course of study supervise and check.
(6) the good experience that processing of systematic summary unskillful and faulty medical or surgical services works, explore the mechanism of tripartite mediate of dispute of doctors and patients. The standard that fortifies pair of patient complaint handling and superintendency job, boost insurance of medical services liability, compose establishs relationship of harmonious doctors and patients.
4, begin a hospital to move superintend
(One) research makes a hospital run superintendency system frame. Draft a hospital to move those who superintend is medium long-term work program. Research is made in the light of different system of ownership, different level, different area hospital government policy is mixed moving mechanism.
(2) coordinate reform of medical sanitation system, strengthen a hospital to run superintendency job. Enlarge a patient to see a doctor make an appointment service, promotion hospital runs advanced practice of management and experience.
(3) begin a hospital to run special superintendency job. Strengthen safety of pair of medical establishment equipment, establishment to use what ensure a condition with logistics service to superintend. Aggrandizement carries out circumstance of discipline of finance and economics to medical establishment superintend.
Rep. Ron Paul meets a medical marijuana patient--Nov. 9 2007
Open win the first, talk about the problem that oneself understand system of more Chinese medical services.
Before reforming and opening, chinese sanitation and health are regarded to be a kind of cause that provides welfare of the whole people, as the arrival of times of reforming and opening, socialist market economy, safeguard of this kind of welfare begins to transfer to social security, conventional medical services defends make trouble course of study to cannot have gotten used to the need that society of current our country admits, "Commercialize " or " welfare is changed " the controversy lasts up to now. No matter be to commercialize system or welfare to change system, the current situation that we see is: In 30 years when go in reforming and opening on one hand, chinese economy lasts level of fast growth, per capita rises substantially; On the other hand, scope of number of the sicken rate of countrywide urban and rural dweller, sicken is increasing; On one hand the investment that governmental year after year is increasing medical services to protect make trouble industry, on the other hand, "Have economic requirement see a doctor difficult, do not have economic condition see a doctor expensive " the outstanding issue that becomes current medical services to serve a field.
Create the source of above phenomenon, come from the problem at medical services system, and the outstanding performance of a variety of system issues, it is the directional mistake that the government throws: Major government investment is cast to medical services an orgnaization, and safeguard system is in medical services to serve a process to buy sheet for medical services again.
The process of healthy state and composition are: Healthy - inferior healthy - disease, and the corresponding countermeasure that controls this one process is precaution - healthy interpose - cure. Medical services is one of healthy payoff only, another payoff still included precaution, health care, education, environment, social security to wait a moment. Before this, the last segment that the much that governmental finance throws threw healthy state -- medical services an orgnaization, should undertake in upper reaches originally " scanty " , turn into to be in actually downstream " " , as a result expression is major countryman from " health " enter directly " disease state " , all sorts of chronic illnesses are sent high, and orgnaization of downstream medical services can‘ts bear heavy burden, because prevent investment and medical services investment to reflect the investment on healthy result,comparing is 1: 8, spend 1 yuan of money to throw precaution to be able to save the remedial cost of 8 yuan of money namely, the government appears in the investment of segment of medical services very little, when pressure of orgnaization of medical services is enormous, the investment that the government increases pair of medical services to serve again... made an investment so - the service is differred as a result - again devoted vicious circle.
Another feature of malady of system of Chinese medical services, namely " for medical services process buys sheet " . Below existing medical services system and system of medical services safeguard, formed what be dominant with clinical medical services to be " service process buys sheet " the current situation, basically pay cure to serve the expense of process happening namely, this also makes medical services system inside " baleful and revulsive " , " excessive service " system sex inducement. Finance can passive be patient allowance or " buy sheet " , form the finance that treats for the patient to guarantee a system, investment is very huge, but still cannot satisfy social requirement, thereby aggravate the vicious circle that governmental investment increases ceaselessly, it is dereliction of duty of medical services corruption, medical services, service poor, medicine and phenomenon of too advanced society offerred diagnostic fare " system opportunity " .
The result link up with that drive of medical services market, system should improve with health, is not with medical services process photograph is contacted. System of current medical services sanitation is heavy " the individual is clinical cure " , " buy sheet to serve a process " , light " healthy result is improved " , " healthy precaution result is incentive " , the promotion of the development that expression prevents medicine for negligence and healthy safeguard consciousness and fulfil, implementation is health and cannot consume in preventing a process " buy sheet for healthy result " .
Governmental investment should change key devote to communal and wholesome system, should pay close attention to precautionary medicine development and construction of healthy safeguard system and socialization application, attention relieves the communal product that service function gives priority to with healthy safeguard, medical services, still have a share clinical medicine development and " primary medical services is ensured " the half communal product that serves an orgnaization. And with clinical the product of half communal, half competition with cure (like civilian battalion hospital) with complete competition " personal product " (serve an orgnaization like health management, check-up, health care) relevant industry, should use the power of the market, outside capital, unlock completely, "Its society of the society does " , the benign loop that drives medical services market develops.
Become community oneselfInspect a patient to be a family member
-- Chinese in the 2nd people of city hospital " baby-sitter type " service of community medical services suffers praise
Before before long, be located in word of ongoing journey assorted Chinese in the 2nd people of city service center of sanitation of community of hospital advancement region is on duty the nurse receives sanitation of key medical services suddenly to serve a target -- break down for a long time the dweller of Huang Jiatang village in the bed phone of Home Liu Ling, saying is the body feels unwell. After be informed a circumstance, immediately of this center Doctor Zhang Jiming guides a nurse to be driven toward Home Liu Ling, fail for much viscera function via diagnosing diagnose, turn its very quickly examine has services to the hospital. From examine to when sending toward hospital around to use mere 15 minutes, seasonable keep within limits the patient‘s illness is exasperate.
"Ailment enters a hospital into community, a serious illness " the criterion that is community sanitation service. Work at sanitation of community medical services to serve better, this courtyard is service center of two community sanitation (station) deployed B to exceed, the equipment such as appearance of custody of report of electrocardiogram machine, heart, the setting observes sickbed 9 pieces, begin service of all-around medical services, rehabilitation, satisfied the Medical Protection need of community dweller greatly. Favorable environment seeing a doctor, perfect medical services establishment, low drug price, left good impression to community dweller.
On August 13 morning, the reporter is carrying fine drizzle seek by inquiry on the head open takes a route afore east paragraph the courtyard of assorted word crossing belongs to community sanitation service center, just stepped into the door to encounter director of central the first month to smile head on greet sb. Enter a center, the reporter sees, inside house 4 sit the patient that examine doctor is seeing a doctor to come round is making an inspection seriously, the patient that queues up from the back sits trimly over to await. Be in neat anew " healthy home " before the colour television that there are 42 inches on mural wall, the ground of patient in spirits that hitting an a bit watchs Olympic Games match, two cure protect what personnel stands to just looking attentively at a patient each to drop bottle... , the first time contact, dribs and drabs left deep impression to the reporter.
Community sanitation serves the main component that is urban sanitation job, it is the fundamental link that realizes everybody to enjoy hygiene target. " the directive opinion that the State Council serves about developing urban community sanitation " middle finger gives community sanitation to serve is wait to serve a target for the key with woman, children, old people, chronic person, disabled, impoverished dweller, with active service, come to serve give priority to. Chinese in hospital of the 2nd people carries out city seriously the opinion spirit that implements city of medium, province to serve about community sanitation, in community service center (station) advocate among construction " riant service, patient is consummate " community sanitation serves a concept, be welcomed goodly by place administer dweller. Last year a of in the winter in the morning, live in east community of alley of tower of east of Shanhaiguan Chen Hui honest old people stagger alone the service center of sanitation of ongoing journey community that walks into this courtyard courtyard to belong to, before after nurse beyond emerald green Ling sees, going up instantly, support sb with hand she, after the patient‘s condition that knows this old person in the inquiry needs, help him up to the doctor slowly before. Understanding has not had breakfast to a respectful form of address for an old person, central cure protects personnel to buy mug-up and congee to him inside the snack bar of the doorway again. After been diagnose, because do not have the company of family, director of the first month fears day of Leng Lu is slippery fall old person, barred for him a taxi remanded her, the person of old native place that after the event is informed a circumstance still hit a phone to convey on a special trip deeply gratitude.
The duty place that examine of fixed make one‘s rounds is community sanitation service needs, also be city service center of sanitation of community of hospital of the 2nd people (station) since building insist for a long time to be civilian the one big characteristic of the service. Service center of sanitation of this courtyard community (station) street of road of Ma Chi of road, ongoing to the people of place administer journey, Xing Hanlu, belfry, drink, Jiang Tan, scenery road, Zhongshan in all 8 community, about 50 thousand person built a company to go one by one library of dweller health record. Undertake examine of make one‘s rounds every months to community dweller regularly, especially a few aged body weaks that have diabetic, coronary heart disease, high blood pressure and the patient that cannot ambulate due to illness undertake coming to check and be treated every week, if the drug that takes for a long time is taken, need a phone only, community sanitation service center (station) with respect to meeting clique the person sends medicine to come. Live in Chinese in city highway bureau on the west hind courtyard of city family member Chen Xiaolin‘s aunt of 78 years old, contract coronary heart disease old. Because family busies all the day,work, old person act is difficult. To this, service center of sanitation of ongoing journey community Director Meng Lijun arranges Yu Cuiling of this center nurse to come regularly examine of make one‘s rounds one, take wants drug, observe in time to the illness and take effective measures, should have Liu aunt " baby-sitter " cure is protected, excited grandma busy vertical stroke has thumb. To save expenditure, advocate managing consciousness, community service center (station) cure protects examine of personnel make one‘s rounds is to use pedestrian travel to go, no matter blow,rain, the old old man of long-term to the much name inside community sicken holds to medical services to take care of from beginning to end.
The service center of sanitation of ongoing journey community that hospital of the 2nd people sets city and service station of sanitation of Zhongshan street community are held to from beginning to end " patient consummate, credit the first, excellent service, clean-fingered practise medicine " community medical services a concept, the community sanitation center that riant service, warmth sees a doctor (station) the impression that left profundity to a lot of patients. To this, the reporter visited a few dwellers of people region community, belfry community, mention city service center of sanitation of community of hospital of the 2nd people (station) medical services, everybody praises in succession say: "Service station of sanitation of community medical services not only all ready, cure protects facility personnel enthusiasm is considerate, still insist to undertake medical services dog to a few long-term and ill patients examination cure, it is simply ‘ baby-sitter type ‘ family doctor! It is simply ‘ baby-sitter type ‘ family doctor!!
