Medical network - on February 21, recently, the human resources and social security ministry, the ministry of finance, the state health and family planning commission, the state administration of traditional Chinese medicine issued by the "about salary system reform of public hospitals will be carried out pilot work guidance", improve public hospital compensation system, arouse the enthusiasm of medical staff, initiative and creativity.
Increasing the income of doctors will lead to rising medical costs? How break "medicine for the medical security increase revenue for the doctor? Doctors can pay ease, obstetrics, pediatrics emergency shortage of "doctor"? According to the focus problem, "xinhua viewpoint" reporter interviewed a number of industry experts.
A: increasing the income of doctors will lead to rising medical costs?
According to the guidelines, Shanghai, jiangsu, zhejiang, anhui, fujian, hunan, chongqing, sichuan, shaanxi, qinghai, ningxia and other 11 comprehensive reform pilot province choose three cities (state, area), other provinces except Tibet each choose a public hospital comprehensive reform pilot cities to pilot.
The reporter understands, at present, Shanghai, hunan, sichuan and other places have a corresponding reform measures, improve the diagnosis and treatment cost, encourage work more, some hospital doctor income increased.
"Guidelines encourage work more, superior blue-chip reward, it is more fair and reasonable income distribution way, will improve the doctor's work enthusiasm." Xindu district of chengdu second people's hospital doctor said LeiZeFei, beginning in 2015, the chengdu district on hospital internal income distribution mechanism to break the past "Commons" mode, implement the performance appraisal way to work more.
District in the second people's hospital rehabilitation of Chen Bangzhong, said before the section of the income distribution have a "seal top line", "line", doing much more also won't take a penny, now have no this layer "ceiling", everyone be mobilize enthusiasm, average revenue department staff is raised, before he himself than reform increased by more than 1000 yuan a month.
Children critical care medicine branch committee, director of the guangdong province medical association has its yi believes that health care workers pay is not satisfactory, mainly the intensity of labor and technical content are not reasonable respect. Now the price of the system, the registration fee is still on the low side, the doctor technology labor value failed to reflect, to gradually transition in the future.
Shanghai municipal development and reform commission recently issued the notice on adjusting part of the price of medical service in the city, since February 15, the appropriate adjustment of outpatient medical service price inspecting fee etc. The reporter learns from some medical institutions, began a new charge standard. Changzheng hospital, for example, will the registration fee from each 18 yuan of average outpatient service promoted to 22 yuan, deputy director of the physician expert outpatient service the registration fee from $24 to $30, promoted to chief physician from 31 yuan RMB 38.
Has broken the yi believes that "Commons", work more, it is imperative to improve labor technology reward. But to what degree, the cost by the hospital, individuals, etc. How to reasonably share the medical insurance fund, need careful study.
Increasing the income of doctors means rising medical costs? Interview to understand, some places in the compensation reform practice, does not increase the patient's medical out-of-pocket spending. In 2015, according to data, xindu district of chengdu second people's hospital medical staff average wages a 13% increase in 2012; And its "medicine proportion" has dropped 6.87% in 2012. Antibacterial drug procurement prices fell by 56% on average, a total of a 15.27 million - yuan drug benefit; Outpatient and hospitalized patients all costs 131.17 yuan and 5557.89 yuan respectively, both lower than average district public hospitals of chengdu.
Some local adjust medical costs into the scope of coverage, not to bring extra burden to patients. In the presence of pediatricians income low, guangdong in the first half of 2017 to enhance children under the age of six related medical service price, no more than 30%. Health and family planning commission of guangdong province, said huang fei, deputy director of premium projects include public hospitals for children under 6 years of age and clinical diagnosis, general operation and clinical surgery such as basic medical treatment service project. After the adjustment of medical expenses in accordance with the provisions incorporated into the scope of coverage.
Focus 2: break "medicine for the medical" how to improve the doctor income security?
Guidance is clear, it is strictly prohibited to revenue target required by the department and the medical staff, medical staff personal compensation shall not with drugs, health materials, inspection, testing and other business income.
Sichuan province people's hospital uropoiesis surgical department director wang said: "not to prescription, as a doctor examination to income indicators, through the performance appraisal and distribution system, encourage surgeons do big and difficult to conquer incurable diseases through diagnosis, surgery, physicians can truly reflect the value of the doctor."
Health and family planning commission of Shanghai health care do relevant personage says, compensation is a key link in the process of health care reform. Shanghai is to perfect the municipal hospital medical staff performance salary scheme, through the salary system reform to prevent the distortion of the medical behavior.
After break "medicine for the medical" mechanism, the hospital income gap will be how to compensate? The reporter understands in an interview in guangdong and other places, public hospitals due to the cancellation of drug addition to reduce the reasonable income, adjust according to the medical service price 80% 80% of compensation and special financial compensation, the principle of hospital self digestion of 10% to compensate.
Ai-qin li, vice President of the children's hospital of hunan province said that the "medicine" instead involve multiple interests adjustment, social phenomena, must insist on health care, medical treatment, medicine, "3 d linkage", to avoid the embarrassment of "solo dash, attend".
Some public hospitals, drug income starts after change, may affect the doctor treatment. Ai-qin li said that after the implementation of drug "zero price difference", the hospital drug revenues and some hospitals in respect to government subsidies, need to take money out "absorb" the hospital drugs "zero price difference" after the loss of income, to improve the doctor treatment is difficult.
Suggestions to China, vice President of the people's hospital of hunan province, the establishment of financial input and improve the long-term mechanism, improve the treatment of medical staff, regulating the behavior of medical personnel, improve the salary expenditure proportion of public hospital spending, guarantee the medical staff wages.
Focal point three: reform can ease the pediatrics, emergency department, grassroots "doctor shortage"?
Opinion request, to the people's need and professional talent shortage of professional tilt, reflected the knowledge, technology, service, management, and other elements of value, avoid the pot.
The reform can alleviate a lot of the hospital, first aid, anaesthesia, pathology, pediatrics obstetrics doctor shortage problem?
It is reported, current, the pediatrician gap of about 2000 people in guangdong province, but the major of guangdong medical college training of pediatric graduate less than 50 people a year. Some in the industry, the medicine for the medical system, pediatric is one of the lowest income department. Children less dosage, according to the course, the dose of 10 to 15 children, only the equivalent of one adult dose.
Commissioner of health and family planning commission of sichuan province maternal and child health, han mei told reporters, treatment of pediatric medical personnel at the grass-roots level is lower and the lack of appropriate incentives, many people prefer to go to large hospital administrative department, also not willing to bear the children's medical service at the local level. You also need to increase, especially in remote areas at the grass-roots level pediatrician in the treatment of tilt, attract more pediatrician at base.
The reporter understands, Shanghai in the new round of reform of public hospitals to implement internal reform of the income distribution system, according to the working load, the medical quality, patient satisfaction, cost control, cost control, work difficulty level, and clinical research of medical ethics teaching "eight elements" for distribution. In Shanghai ruijin hospital, xinhua hospital, such as comprehensive hospital, a pediatrician income has with other department doctor basically unchanged.
Some experts think that pediatric doctor shortages such as need to increase supply from the source design. Sichuan province people's hospital pediatric surgical director of the cultural thought, the guidance can be partly reversed transmission across to speed up the cultivation of the pediatrician. In addition, still unknown to the cultivation of the unpopular department doctor set up a complete set of incentive mechanism, straighten out the hospital pediatric interest distribution system, ensure the talent shortage of professional doctor income level, to let more people really want to in pediatrics, fundamentally break the pediatric shortage of "doctor".
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