Medical network - March 31 March 29, the guangdong province department of health and health conference for the first time. During the meeting, the deepening comprehensive reform of medical care system implementation plan "of guangdong province (hereinafter referred to as" scheme ") issued by the, the province comprehensive health care reform since launch in an all-round way.
▍ cancelled before July drug addition
Controlled fees, fees, or charged fees!
According to the plan content, in the first half of this year will be in full swing in guangdong province city public hospital reform, abolish all public hospital drugs before July (except for Chinese medicine yinpian) addition, control unreasonable medical expenses increased, investigate behavior such as "excessive, check", according to different public hospitals for medical expenses annual fee control indicators.
And there is no doubt, after the drugs to further strengthen supervision, will cause a series of chain reaction in medicine province guangdong.
People's hospital of guangdong province ZhuangJian said yesterday in an interview with local media, commanded, as long as the provincial party committee and government, the provincial medical can immediately cancel the drug addition - "because over the years, the province pharmaceuticals addition are falling, and only about 10% now." He said.
In accordance with the "much starker choices-and graver consequences-in" has been released by the guangdong health and health planning, public hospital compensation mechanism by the service fee, drug addition income and government subsidy three channels, instead of service charge and government subsidies two channels. Hospital which reduce the reasonable income, price compensation 80% by adjusting the medical services. For hospital expenses for drug storage, safekeeping, loss is compensated for in hospital operation cost.
Not only that, the medical staff to set revenue indicators also banned, request medical personnel pay shall not be linked to drugs, supplies, medical examination and other income. Above the provincial level 2 public hospitals gradually stop outpatient intravenous antibiotics. Support for patients to choose their hospital outpatient pharmacy or on prescription to retail pharmacy to buy medicine.
In fact, on the same day that a new drug for trading results were announced in 2017 in guangdong province.
End of quote, a total of 1431 drug production enterprises involved in the quotation, involves the product number 6303, involved in quotation manufacturers accounted for 92.50%, offer products accounted for 73.36%. Clinch a deal the varieties 3208, involved 1245 companies, clinch a deal the total amount is 20.406 billion yuan, compared with last year the province into the market, the price is reduced by 9.50% to save procurement capital of 2.142 billion yuan.
According to statistics, among them, the price drop before 10 product gauge dropped 18.90% on average, individual expired patent medicine gauge a drop by 21.12%; Guangdong market share before 10 rules an average reduction of 14.29%, individual expired patent medicine gauge a drop of 17.95% - drug companies in guangdong, are feeling the pressure through.
▍ fujian wanting to learn? !
It is worth noting that the "solution" in drug supply section division of tasks, are responsible for clubs to people, and this, keep the consistent with fujian, more emphasis on the function of the overall control fee - previously, including shaanxi, ningxia and hainan and other places, by the health committee of planning as a whole.
"Solution", stressed that in order to strengthen the management of orgnaization of health care function, in the province administration of social insurance fund use medical insurance fund management center, brand integration and take the management of medical treatment insurance, drug centralized purchasing management, fund and management, drug procurement and fee settlement negotiations, medicare payment standard, designated agency agreement management and settlement functions.
At the same time, encourage conditional local pilot listed to set up the medical insurance fund management center. In zhuhai, zhongshan, dongguan three public hospital contact national comprehensive reform pilot cities to carry out the pilot reform of mechanism of system of medical insurance fund management. Give full play to the health of drug production supervision function of circulation enterprises, hospitals and doctors, to provide linkage reform gripper. After the unification of insurance agency orgnaization to make greater efforts to promote the reform of medical insurance payment further play to health care to control the medical expense unreasonable growth role.
If contact again after practice of drug purchase platform construction in shenzhen, guangdong drug prices is likely to encounter a "fujian type" price cut.
On July 5, 2016, the shenzhen health development planning commission issued by the shenzhen municipal public hospital drug group procurement reform pilot scheme notice, this is also the only one outside the provincial drug procurement platform, self-built platform to carry out the drug centralized bid procurement plan, one of the goals, is shenzhen drug bidding may set the lowest price.
This pattern of the government in the GPO to achieve KPI is a not small number.
In accordance with the public plan, shenzhen to achieve cost for the centralized purchasing drugs, compared to 2015 in guangdong province "drug electronic trading platform" on purchasing cost for the same amount product gauge drug fell by more than 30%, according to the public hospital drug procurement in shenzhen in 2015 the total cost is 7.9 billion yuan, is expected to save more than one hundred million yuan a year.
As the shenzhen price of pilot experience, not only possess.
After the analysis of the personage inside course of study thinks, no matter how to adjust the rules, guangdong pharmaceutical trade the new scheme in the drug price is always linked to the actual purchase price in shenzhen, shenzhen, the lowest price to guangdong province pulled out a higher price decline, seems to be the foreseeable future.
The attached:
We will deepen reform of the comprehensive medical care system implementation plan in guangdong province
For comprehensively deepen medical health system reform, and promote the basic medical and health services and fair, effectively ensure the people's health, formulates this scheme.
First, general requirements
Fully implement the party's 18 large and 18 sixth plenary session of 3, 4, 5, spirit, carry out general secretary xi series of important speech spirit new ideas new concepts governing principle politics and new strategy, earnestly implement the national health and health conference spirit, adhere to the "focusing on grass-roots, powered by innovation, prevention first, equal emphasis on Chinese and western medicine, the health in all policies, the people sharing" health and health work policy, around the overall health of China, guangdong construction, in order to maintain people's life safety and health as the mission, adhere to the public cause of medical and health care, the implementation of the government leadership, security, management, supervision, responsibility, encourage social forces to participate in. To strengthen basic health service ability as the breakthrough point, increasing financial investment, optimize the allocation of resources, lacking health board, promote the balanced development of the medical and health of urban and rural area. To strengthen the medical and health service supply side structural reform, build collaborative, continuity medical and health service system, perfecting the classification diagnosis and treatment, the modern hospital management, universal health care, drug supply security and comprehensive regulation and other basic system, improve the organization and leadership, financial investment, price forming, personnel salary, personnel and information guarantee mechanism, push forward the reform, was the first to establish a basic medical and health system covering both urban and rural residents, to realize the goal of building a powerful province of health and health in guangdong.
Second, the work target
By 2018, the deepening comprehensive reform of medical health system promoting; The basic medical and health service infrastructure conditions improved significantly, significantly improve service ability, effectively solve the urban and rural, regional resource allocation imbalance and such outstanding problems as lack of high-quality professionals at the basic level; The grading system, the modern hospital management system, universal health care system, drug supply security system, the implementation of integrated supervision system; As the main body of the basic medical insurance, medical treatment, social assistance, commercial health insurance for the supplement of the multi-level medical security system underwent steady improvement, Organizational leadership mechanism, health service financing mechanism, price forming mechanism, the personnel compensation mechanism reform and the talent team construction, information construction further deepening; Order improved markedly, the crowd to see the overall burden continues to reduce. Preliminary establishment and basic medical and health care system that can meet the needs of a well-off society.
By 2020, the complete basic medical and health fill short tasks, in towns and townships, community health service center (station) and village health posts, comprehensive public hospitals at the county level "leading role" obviously improved, the grading system fully established. The basic modernization of medical and health service system, scientific operation and supervision legal system and integration of the basic medical insurance, health services development achieve the intended target, basic medical and health care system to further improve, to effectively ensure people's health, the co-construction and sharing.
Three, the main path
Strengthening comprehensive deepening medical and health system reform of organization and leadership, the party committees and governments clear main responsibility. Gripper with system reform, and promote the medical treatment, medicine, health care "3 d" linkage, reform force. To strengthen the basic health service ability, and communities in reform of health service supply system, established on the basis of the basic medical and health services, people-oriented, integrated health service system, to promote the integration of regional medical and health institutions of the longitudinal and transverse integration between prevention, medical treatment and rehabilitation. Established on the basis of the family doctor system of the grading system, the implementation of unified clinical pathway and two-way referral system, the implementation of throughout the whole life cycle of health management and disease management. To strengthen the public and social forces to participate in, to develop the health services. To establish a system for modern hospital management, improve the public hospital management, improve the quality of medical services. To explore the integration of the basic medical insurance, deepening the reform of medical insurance payment system, give full play to the medical insurance for medical service behavior guidance and specifications. Improve the system of drug supplies procurement, promote to form a reasonable market purchasing price. Establish a comprehensive regulatory system and strengthen the industry regulation. Improve the financial input in accordance with industry characteristics, price forming, personnel salary system, such as perfecting the talent team and informatization construction, establish maintenance public welfare, to mobilize enthusiasm, ensuring the sustainable operation mechanism. Improve medical and health service performance, all-round, the whole cycle to ensure people's health.
Fourth, the key task
(a) integration of regional medical and health services resources, build the collaborative development of medical and health service system.
1. To promote resource sink, coordination services. Adhere to lead, science establishment regional health development planning, optimize the allocation of health resources, strengthen the planning constraints. Different area of the overall planning, type, level of medical and health institutions layout, clear function, strengthen the collaboration, the formation of regional medical treatment, disease prevention, health care, rehabilitation, TCM institutions grid pattern, the service integration. Control the scale of urban public hospitals, in principle, the new health service resources on sinking at the grass-roots level. By 2020, the county office set up hospital beds per thousand permanent population reached 1.8, towns and townships, community health service center (station) and village health posts per thousand permanent population data is 0.9; The province per thousand permanent population (assistant) practicing doctors number 2.8 people, registered nurse number 3.5, number 1 public health personnel; The province thousands every resident population gp number three. County (city, area) on the basis of the population of permanent residents in principle set 1 county general hospital, 1 county run hospital and 1 maternal and child health and family planning technical service institution.
Use resources reorganization, organize the sorting, do medical and so on many kinds of ways of cooperation, encourage and guide the city high quality medical and health resources to the lack of resources or services ability weak regional extension and transfer. Cultivate several through capital operation, have a certain scale, the advantage of bright, regional radiation ability strong vertically integrated healthcare or medical couplet body, implementation services, information, pay and institutional integration. Encourage city hospital through talent cultivation, discipline, technical cooperation and other forms of cooperation, realize accurate sinking, seamless docking, and long-term development. To strengthen the department of obstetrics and gynecology, pediatrics, mental disease, infectious disease, tumor, nursing and rehabilitation hospital of traditional Chinese medicine (TCM) and the planning and construction of hospital. Improve the children's medical and health service system. (province responsible for health and family planning commission, the provincial public and national development and reform commission, financial department, human resources social security department, bureau of traditional Chinese medicine. The first one to lead departments, hereinafter the same)
2. The all-round county (district) domain integration management. To explore the radiating and driving in towns and townships, towns and townships supported county-level hospitals drive way of village health posts. Using the experience of promotion in shenzhen lo wu hospital group, etc. According to actual situation, to explore the medical, medical, healthcare, junior coalition, remote medical help network formed in the form. Between the different levels, categories, medical and health institutions to establish specific goals, clear responsibilities of division of labor cooperation mechanism, form a benefit community, community responsibility. Encourage the medical institutions run by social forces into medicine. Pay attention to establish competitive mechanism of couplet of medical mode, improving the quality of medical services. (province responsible for health and family planning commission, the public sector, financial department, human resources social security department, national development and reform commission, bureau of traditional Chinese medicine)
3. To strengthen the construction of basic health service ability. Insist on focusing on grass-roots, the implementation of strong base to create a plan of action (2016-2018), the provincial finance during the period of 2017-2019, concentrate, increasing investment to support the following medical and health institutions at the county level of hardware and software construction, further improving the capacity of grassroots medical and health services. Complete the existing public hospitals at the county level standardization construction, strengthening the construction of local common disease, frequently-occurring disease related departments, and infectious diseases, mental illness, emergency first aid and intensive medicine, kidney internal medicine (hemodialysis), obstetrics and gynecology, pediatrics, TCM clinical subject construction, rehabilitation, etc. By 2019, the northwest area of guangdong in towns and townships, community health service center (station) all meet the national construction standard limit. Ascension in towns and townships to carry out emergency rescue, second class the following routine operation, normal delivery, at the beginning of the high risk of maternal screening, pediatrics, mental illness and aging, Chinese medicine and rehabilitation, medical and health service capacity. By 2018, complete the construction of standardization of village health posts. Promote the village health posts public private. Formulate province county hospitals counterpart support planning. City of 3 armour hospital counterpart support county-level hospitals, in principle, every year, send health technical personnel number below the floor intermediate professional and technical personnel more than 5% of the total; Appoint, the number of professional and technical qualifications at or above the intermediate level of not less than 80%. Least encouraging urban secondary hospitals to grassroots health institutions more practice, senior title of professional medical personnel for the city to the special policy grassroots medical institutions visit the registration fee. (province responsible for health and family planning commission, the provincial financial department, human resources, the social security hall, the national development and reform commission, bureau of traditional Chinese medicine)
4. To strengthen public health security. Insist on prevention, public health security in the overall deployment across the public security system, establish and improve the government-led, the combination of prevention and control system of public health security. Defense establish and improve the major infectious diseases from spreading mechanism, strengthen the disease prevention and control, health education, mental health, occupational health, first aid, CaiGongXie, food safety standards and risk monitoring and evaluation, maternal and child health care and family planning services and other public health service ability construction. Comprehensively strengthen kindergartens, primary and secondary school health knowledge propaganda, to improve students' active prevention consciousness. Targeted to the implementation of the poor areas and atterngted or nutrition package, growth and development. Protect women's and children's health, for the elderly to provide continuous health management services and medical care, pay attention to the disabled, the floating population health issues, in-depth implementation of health poverty alleviation project. Establishing and perfecting the system of health education, improve the health literacy, advocating health civilized way of life, enhance personal health responsibility consciousness. The development of mass sports, promote the national fitness and health depth fusion. Patriotic health campaign, vigorously advance the urban and rural environmental sanitation clean action, work hard to build healthy cities and villages and towns. Basic research foundation of the increasing mental health problems, to do a good job of popular science knowledge of mental health and mental disease, standardize and develop the psychological therapy and psychological counseling and mental health services. Build the base of a batch of cultural propaganda and education of Chinese medicine, TCM health cultural transmission. To carry out the responsibilities of disease prevention and control of a medical institution, strengthening the construction of infectious disease specialist out-patient and preventive care of standardization. Strengthen the public hospital and public health functions of the basic medical and health institutions, and establish a sound and professional close collaboration between public health agencies, the working mechanisms of connectivity, increase the efficiency of the overall prevention and control of infectious diseases, promote the combination of clinical diagnosis and prevention. (province responsible for health and family planning commission, the provincial financial department, education department, the department, food and drug supervision bureau, environmental protection bureau, sports bureau, bureau of traditional Chinese medicine, disabled persons' federation cooperate)
5. Develop and standardize social do medical. Through public set planning, simplify the administrative examination and approval, ease institutions access, encourage physicians more practice, medicare treated, promote the flow and sharing of resources, promote the development of fusion, encouraging public-private partnerships do medical, regulating public hospital restructuring and other measures, as well as the implementation of the tax policy, strengthen the financial fund support, standard charge policy, guarantee the land demand, broaden the financing channels, enhance the support to social do medical. High levels of development of civilian battalion hospital, priority support non-profit medical institutions run by social forces, further optimize health service supply. For social capital held only provide clinic of traditional Chinese medicine, Chinese medicine clinic of traditional Chinese medicine service, planning and regional health development planning of the establishment of medical institutions do not make layout constraints. Support the qualified professional and technical personnel, especially the name old doctor of traditional Chinese medicine of traditional Chinese medicine clinic of traditional Chinese medicine, Chinese medicine clinics, encourage the establishment of traditional Chinese medicine's seat clinic. To promote the public medical institutions and the public medical institutions in market access, social insurance fixed point, the key subject construction, title evaluation, academic exchanges, grade evaluation and technical access shall enjoy the same treatment. Encourage medical inspection institutions run by social forces, the pathological diagnosis mechanism, medical imaging, disinfection supply mechanism and blood purification. Encourage gp holds family doctors' offices, encouraging high-end, specialized medical institutions run by social forces. By 2018, strive for the public medical institutions of beds and medical services accounted for about 30% of the total. Strengthen the nonprofit social do medical institutions property rights, financial operation and supervision over the use of capital surplus management, promote the development of social do medical health. (province responsible for health and family planning commission, national development and reform commission, financial department, human resources, industrial and commercial bureau, the department of social security hall, bureau of traditional Chinese medicine)
6. Develop the health service related industries. Developing traditional Chinese medicine health care, health services, health services for the disabled, commercial health insurance, medical treatment equipment manufacturing, health care food production, health care, tourism, characteristic of traditional Chinese medicine health tourism and other service related industries, and promote the health industry and pension, travel, Internet, fitness leisure, the five fusion of the food industry. To promote public sports facilities open to the public. In the community are encouraged to establish medical pension association, relying on community health and pension service platform for the elderly medical combination of services. Strengthen the transformation of innovative achievements and intellectual property protection. Encourage medical electricity cross-border integration and development, to explore new drug retailing services model. Health, were further opened up. By 2020, basic establishment covers the whole life cycle, the connotation is rich, reasonable structure of the health service system, build a batch of health services industry group, the overall size of 1 trillion yuan or so. (province, reform office is responsible for the development and reform commission, the provincial department of land and resources, health and family planning commission, bureau of traditional Chinese medicine and national economic and information commission, department of commerce, tourism bureau, sports bureau, disabled persons' federation, guangdong protects inspect bureau to cooperate)
(2) on the basis of family doctor system, we will accelerate the establishment of a scientific and rational classification system of diagnosis and treatment.
Sign 7. Full implementation of the family doctor service system. To form a family doctor as the core, provide the technical support specialist contract service team, take the classification contract, signing contract for value, differentiation in a variety of ways, such as provide residents with long-term continuous public health and basic medical and health management service. Optimize the signing service connotation, in medical treatment, referral, medicine, health care and other aspects of signing residents adopted a policy of differentiation, promote the first option at the grass-roots level. Sound on the basis of the standardized work performance appraisal system. Residents may guide around the home or at the same time of signing with the family physician team, choice a secondary hospital, a tertiary hospital, to establish the combination of "1 + 1 + 1" signing service mode. Within residents can be combined in contract signing any of choosing a medical institution, if to the outside of the combination of treatment, must be signed by the family doctor referral. Signing service charge by medical insurance fund, basic public health services provision and signing residents pay share, fall within the scope of basic medical insurance policy of medical treatment, in accordance with the provisions incorporated into the scope of medical insurance fund pays. By 2020, signing services extended to the whole population, basic realizing a complete coverage of signing the family doctor service system. To promote health management for the disabled, strengthen community rehabilitation for the disabled. (province responsible for health and family planning commission, the provincial financial department, human resources, the social security hall, disabled persons' federation cooperate)
8. Promote the medical and health institutions first option and two-way referral. Gradually expanding the scope of the first confirmed kind. Establish and improve the referral guidance catalogue. Referral for common diseases indications, specification and process. Public hospitals to provide service for referral patients preferred, gradually increase the grassroots medical institutions to make an appointment referral source. Advance treatment and surgery in the day, and the tertiary hospitals in booking the clear downward referral channels. On base of Chinese medicine service system is not sound, ability is weak, Chinese medicine hospital outpatient medical services should be brought into the scope of first option, meet the needs of the people first option to see the traditional Chinese medicine. To promote grassroots medical institutions to carry out rehabilitation comprehensive assessment items included in medical insurance to pay limits and 20 medical rehabilitation project. In primary hospitals, medical and health institutions and establish collaboration mechanism between chronic medical and health institutions, improve the treatment, rehabilitation, long-term care service chain, to promote "hurry slow divide and conquer" pattern formation. (province health and family planning commission is responsible for, the human resources social security hall, the Chinese medicine bureau coordinates)
9. Complete hierarchical diagnosis and guarantee mechanism. Establish a classification for examination and approval of diagnosis and treatment, referral, referral and two-way referral system, comprehensive use of various measures, including administrative, health, price to promote a rational medical order. Exploration of couplet of longitudinal cooperative medical medicare pay total collaboration model, guide the two-way referral. To conform to the provisions of the referral hospitalized patients can continuous computing starting line, promote the orderly flow. Improve the level of different medical institutions differentiation to pay for health care policy, raise the grassroots health institutions medicare payment ratio, reasonable guide to go to a doctor, rational choice of patients with medical institutions to form effective incentive. Establish perfect classification diagnosis and information management platform. Reform and improve the system for basic drugs, health care medicine catalogue applies to both medical and health institutions at the local level. Signing doctors can prescribe chronic drug for a long time. (province responsible for health and family planning commission, provincial bureau of traditional Chinese medicine, human resources, cooperate with social security department, national development and reform commission)
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