Medical network on March 22 - under the policies of "encirclement and suppression", this year the day of the public hospitals may be more sad.
In policy documents issued by the moment, as the snowflake health reform in China has been gradually into the deep waters, many experts have claimed, in 2017, is China's health care reform make substantive progress, and under the policies of "encirclement and suppression", this year the day of the public hospitals may be more sad.
A, cancel the drug addition: public hospital get into trouble
In recently, the CPPCC press conference Wang Hesheng, director of the reform of the state council office made it clear that this year will be fully opened the comprehensive reform of public hospitals, drug addition all cancelled. According to incomplete statistics, this year is expected to once again save the drug costs RMB 60 billion - 70 billion.
That is to say, the public hospitals to cut down the cost of more than 600 drugs this year, a large number of capital city hospital, as well as a prefecture-level city of large hospital, will become 2017 drugs zero bonus to reform the object!
Zero bonus will bring what kind of impact to public hospital? Is also on this year's two sessions, a former nantong university affiliated hospital, deputy director of the National People's Congress to represent Liu Fan admitted that in affiliated hospital of nantong university, for example, for example, after the implementation of drug "zero price difference", the hospital drug revenues, part of the hospital subsidies did not reach the designated position, need to take money out "absorb" the hospital drugs "zero price difference" after the loss of income.
"As a output value of more than 20 $3 armour hospital, drug zero price difference after reduce the gap in 150 million net profit, the losses of the gap is 60 million, through various channels to compensate 20 million, (left) from?" Because after zero bonus compensation does not reach the designated position, there are 40 million gap. Liu Fan truth, in this case, to care for a raise is difficult.
Visible, if the compensation mechanism does not reach the designated position, in 2017 abolish all drug addition, or there will be many more large public hospitals in trouble.
Hierarchical diagnosis: a large public hospital day to the past!
There is one word more fire in 2016, is the "d", refers to the county medical services "community". With hierarchical diagnosis and treatment of propulsion, before leaving the hospital instantly became the bestselling despises the county hospital.
Health development planning commission of guangdong province inspector @ new wave wave of Colombia - liao said, big hospital, it is imperative to shrink, the first national increase financial input to the county hospital, county hospital continuously expand and improve diagnosis and treatment, the hospitals will be broken.
According to the national development and reform commission's latest clearly in the "national health security engineering construction plan", 2017, the arrangements of the central budget no longer support the construction of township hospitals and village clinics project investment. So money is mainly to who? Or county hospital!
Not only that, the country to the grading diagnosis and an incredible goal, only in 2017, the county JiuZhenLv inside will increase to 90%, the basic elements of a serious illness county.
And grassroots drug sustained release, but also a direct impact on MenZhenLiang big hospital. If one is not out of the county, a serious illness with a chronic illness to buy medicine did not go to large hospital, big hospital days can good?
It is understood that some municipalities directly under the national famous 3 armour hospital the medical departments number of patients decreased nearly a quarter than the same period last year, around the start and the secondary hospital guide patients to cooperation.
Third, the most profitable "independent" clinical laboratory, image division faces!
Countries clearly put forward hierarchical diagnostic files, will integrate regional medical resource sharing. Integration of the second class above hospital existing inspection, disinfection supply center, such as resources, open to the grassroots medical institutions and chronic medical institutions. Explore set up independent regional medical test mechanism, pathology, diagnosis, medical imaging inspection agencies supply mechanism and blood purification, disinfection, realize regional resources sharing. Strengthen medical quality control, to promote peer between medical institutions and medical agencies and independent inspection institution between the mutual recognition of test results.
Visible, medical imaging, medical inspection, pathology, hemodialysis, nursing department to a third party is the trend of The Times. Zhejiang is more than the tonglu county hospitals have taken place in clinical laboratory by a third party to explore.
As is known to all, clinical laboratory, image are the main point of profit hospital, predictable these third-party department will continue to advance in the next few years, public hospitals so that lead to loss of income as you can imagine.
Four, charged fee: according to the incoming macro-reforms era!
Dean of Shanghai health care of the first penetration and the original Duan Tao once said, in accordance with project fee payment mode, the medical expense control is difficult, hospital especially third public hospitals has become bigger and stronger ideas and impulse. So in the past decade, three public hospital is the development and expansion of crazy, can run thousands of beds, income is often a few dozen million.
However, this is not to continue!
In January 2017, the national development and reform commission, planning commission, the people club department jointly issued the notice about push press disease charging work, deployed across the all-round press disease fee reform work.
"Notice" published in 320 planted catalog, many for the specification for clinical pathway, treatment effect is a common disease and frequently encountered disease in clear, and secondary and clear regulations all public hospitals above to select a certain number of disease to implement press disease to collect fees, city public hospital comprehensive reform pilot area before the end of 2017 the disease is paid by the disease to no less than 100. Around and asked, to further expand the number of diseases is paid by the disease.
File and even said that to build a medical institutions according to the disease to charge the inspection rewards and punishment system, will be effected according to the disease to charge into the public medical institution performance evaluation system, strengthen the supervision and evaluation and incentive constraints; All localities and departments to strengthen organizational leadership in the process of reform, vigorously promotes the policy implementation, to ensure the reform obtains the actual effect.
Today, several places across the country had been issued in macro-reforms file, press disease to pay will be pushed in the national mandatory. According to the project payment time coming to an end. That is to say, how to control the medical expense scheme has been clear, and is gradually implemented.
In the manifold new wave, under the trend of charged fees, large hospitals hit even more so. The homogeneity of medicines and chemical reagents, consumable zero bonus, technology, make income space is becoming smaller and smaller.
Five, the doctor regional registration: more professional legal, hospital may not be able to tube!
In early 2017, health development planning commission have blockbuster released a new version of the physician's practice registration management method ", "regulations on detailed rules for the implementation of medical institution", in which the physician practice registration measures for the administration of the physician's practice places from the past "medical treatment, prevention or health care" changed to "medical treatment, prevention or health care is located at the provincial level or at the county level administrative division", practicing doctors registered location as the provincial administrative divisions, assistant practicing doctors' place of registration for the administrative divisions at the county level, to achieve "a register, regional" effectively. And the implementing rules for the regulation of medical institutions in the delete on-the-job medical personnel shall not set up clinics. Two documents are started on April 1, 2017.
In fact, the country has been encouraging the doctors have been advancing and more practice is subject to various difficulties and creation of the two files for the doctor went out of the public hospitals, more practice provides of protection of the laws, policies, legal formalities as long as a doctor, public hospital does not deserve to be stopped.
More practice legal means? Before some doctors to patients, doctors could be guide to the hospital more practice. Therefore, whether the average patient or the special medical care, public hospitals will be faced with patients follow doctor loss situation.
6, social d: doctor-patient tussle for the public hospitals by!
Patients with early guiyang hospital director of team and group events, leaving an uproar for medical and even the whole society.
In fact, according to a well-known experts, similar to a private hospital dig the corner of the public hospital is to present the spark set the prairie ablaze.
Because a year one or two thousands of new private hospitals, doctors, especially in 3 armour hospital doctor is becoming a popular talent.
In a chain of clinics in guangdong province for example, is a sigh of relief to dig a batch of the backbone of the big three of the doctor, lead to a well-known 3 armour hospital, director of pediatric call doctor was digging up the run, emergency shut down at night. Guihang guiyang hospital, for example, in 2016 alone is guiyang poached six yuan more than 100 health care.
Backbone doctors were poached, patients with natural resources will be lost, the hospital operating conditions will not be affected? Just strange!
Seven, public hospitals will pay cuts, or cuts?
It is reported, although a lot of big hospital not close not to, a real loss, but xiangya hospital dean Sun Hong reluctantly said, in order to ensure that medical staff treatment is not falling, the hospital decided to cut down the equipment purchase cost of 2017 50 million yuan, the development of the hospital or affected.
That is to say, now for some money thicker of large public hospital, whether layoffs or pay cuts, also didn't to that step.
But, in fact, for some secondary public hospitals in big cities is not optimistic. A first-tier cities comprehensive hospital director said in an interview with the media, along with the advancement of cancel the medicine for the medical reform, will allow the drug income drops, can't again send year-end bonuses to doctors.
Not only that, but he also said "appropriate to reduce the size of the internal medicine for the medical core departments, more resources for hospital to orthopaedic surgery such as a medicine for the medical department tilt"; "Many physicians and pharmacists and predicted that in the future will face elimination crisis."
Visible, leather or public hospital will really want to business! |
