my country actively and steadily promotes the reform stake betting appMy stake betting appof pharmaceutical prices in public hospitals，Cancel the drug bonus of public hospitals，Breaking & ldquo;，Reduce the burden of medical expenses of the masses; at the same time, establish a scientific and reasonable compensation mechanism，Focus on increasing project prices that reflect the value of technical labor services in medical staff，Reduce the inspection and inspection price of large medical equipment，Gradually rationalize the relationship between the price of medical services

 

  The relevant person in charge of the National Development and Reform Commission said on August 16th，Since accelerating the reform of the pharmaceutical price of public hospitals in 2012，my country According to the establishment mechanism、Control fee、Tune structure、Principles of Strong Supervision，Strengthen price and medical treatment、Medical Insurance、Policy linkage，Cancellation of the drug bonus、Adjust the price of medical services、Reform payment method、Comprehensive measures such as strengthening cost control and implementation of government medical responsibility，Coordinated reform。As of now，The reform of the pharmaceutical price of public hospitals at the county -level public hospital has been fully covered; the medical price reform of urban public hospitals in Jiangsu、Zhejiang、Anhui、Fujian、Shandong、Qinghai、Shanghai、Tianjin and other 8 provinces pushed open，Other provinces have also carried out some pilots。

 

  Relevant experts said in an interview with the "Economic Daily" reporter，Cancel drug bonus，It is conducive to cracking & ldquo; phenomenon。Promoting with reform，Price mechanism further rational，The enthusiasm of the medical service to explore the new medical services and pay the payment method is significantly improved，In the end, it will cause patients、Medical staff and medical institutions have become beneficiaries of reform。

 

  Precise measurement of medical services price adjustment level

 

  September 2012，National Development and Reform Commission and the Ministry of Health、The Ministry of Human Resources and Social Security jointly issued the "Notice on Promoting the Reform of Medical Price Reform of County -level Public Hospitals"，After a comprehensive deployment of the medical price reform of county -level public hospitals，Orderly promote the reform stake betting appMy stake betting appof pharmaceutical prices in order。Anhui Province has repeatedly investigated the operating income and expenditure of different types of hospitals，Organize the province、The impact of analysis and evaluation reform of many hospitals on patients on patient costs。Jiangsu Province in Nanjing、Suzhou and Provincial Hospitals conducted two analog calculations，Organize experts to demonstrate the price adjustment plan of medical services。Shaanxi Province has passed strengthening cost supervision，Touched the operation and financial status of medical institutions，Talk with data，Unified parties to know。

 

   & ldquo; Generally speaking，Fully considers the affordability of the people and society in all places，From the direction of reform、Implementation steps、Price levels, etc., make detailed arrangements for each link，This is an important guarantee for the smooth progress of reform。& rdquo; Zhu Dezheng, head of the Price Department of the Price Department of the National Development and Reform Commission, said。

 

  After the efforts of all parties，As of now，31 provinces (districts、City) 4107 public hospitals in 1970 counties have achieved full coverage of cancellation of drug bonus policy reforms，Implementation of zero difference in drugs。

 

  Chang Feng, Director of the Institute of Medical Price, China Pharmaceutical University, said，Canceling the drug bonus is conducive to solving the long -term & ldquo; the price of drugs is high、Some medical services are low & rdquo;，Make the price mechanism further rational。

 

  Zhang Zhenzhong, vice chairman of the China Society of Health Economics, told reporters，In the past, 15%medicine bonus，It is because drugs are selling、Transport and storage procedures do need to consume resources。but，As the price of drugs is high，15%of the corresponding net income is also increasing，This design has become an important source of & ldquo; for medicine & rdquo;。Cancel drug bonus，It can greatly reduce the price of drugs，Relieve & ldquo;。

 

  The reporter learned，Current，Jiangsu、Zhejiang、Anhui、Fujian、Shandong、Qinghai、Shanghai、Tianjin and other 8 provinces (cities) urban public hospitals in urban public hospitals have also been pushed open，Other provinces (district、City) also carried out pilots in pharmaceutical price reform in some cities and some hospitals。

 

  Structural adjustment medical service price

 

  After the drug bonus is canceled，Drug unit price is reduced，How to compensate the reasonable income of the hospital，is one of the important issues facing the reform。

 

  In reform，There are 25 provinces based on medical service price compensation (basically 60%to 90%)，Supplemented by financial subsidies and the hospital's self -digestion; Beijing and Chongqing cities are fully compensated by adding medical (pharmaceutical) service fees; Shaanxi、Gansu、Qinghai and Tibet 4 provinces (regions) are compensated by the full financial。

 

  & ldquo; Most places are also in accordance with the requirements of gradual streaming of medical service comparison relationships，Structural adjustment of some medical services prices and landing。& rdquo; Zhu Dezheng said，Control in the total amount of & ldquo;、Structure adjustment、There are ascending and downward、Principles gradually in place & rdquo;，reduced CT、MRI and ultrasound such as medical equipment inspection and treatment price，improved diagnosis stake online sports bettingStake Sports Bettingand treatment、Surgery and other medical services prices that embodies the value of technical labor services in medical staff。

 

  From the specific price adjustment situation，Jiangsu Price Project Relding 50%，Price reduction projects decreased by 15%; Anhui price increase project raised 20%to 50%，Price reduction projects decreased by 10%; Qingdao Comprehensive Project increased by 42%，Surgical projects increase 128.6%，TCM projects increased by 196.8%，Inspection projects decreased by 7.8%，Imaging projects decreased by more than 20%。

 

  According to statistics，Since the reform，Only in the reform of medical prices at county -level public hospitals，There are 72 times of adjustment of medical services in various places，Focus on raising diagnosis stake online sports bettingStake Sports Bettingand treatment、Surgery、Nursing、Traditional Chinese Medicine, etc. The service item price of the technical labor value of medical personnel，Cumulative price increase of about 23 billion yuan，Reduce the price of inspection and inspection service items for large -scale medical equipment inspection and treatment.，Cumulative price reduction of about 5.5 billion yuan。

 

  & ldquo; From an individual perspective，Some patients often use prices for projects，May feel that it has increased the burden，On the contrary, it will feel that the burden is reduced。but，The adjustment of the project cost can be reimbursed at a certain proportion，Medical Insurance Fund will also bear part of the increased cost，In addition, medical control measures are taken in various places。So，The overall burden of patients will not increase。& rdquo; Zhu Dezheng said。

 

  Explore the establishment of a new pricing mechanism

 

  Adjustment of the price of medical services，Active exploration of new pricing mechanisms in various places，Established a target price、Holding pricing、Dynamic price adjustment、Diseases and other methods，The method of receiving and paying medical services has also been further improved。

 

   & ldquo; Actively explore the disease species、According to the service unit、A variety of fees and paid linkage policies such as heads，Focusing on unreasonable growth of medical expenses。& rdquo; Zhu Dezheng said。

 

  More than 100 county -level public hospitals in Shandong Province implemented a head -to -person、Pressing the day、Paids for species according to disease。Henan Province has identified 140 treatment methods of 98 diseases in all county -level public hospitals in the province to carry out payment according to the disease，500,000 cases in 2015，The average hospitalization cost is 14%lower than the project payment.，Average medication accounting for only 18%，Save 300 million yuan for the NSCC and patients。

 

  Changfeng said，Past charging methods are easy to cause & ldquo; supply party induction needs & rdquo;。In the context where the price and medical service price tend to be reasonable，Take multiple pricing methods，It can control the cost of seeing a doctor more effective。

 

  & ldquo; Change medical service pricing method is an important trend in the future。& rdquo; Zhang Zhenzhong said，With the advancement of reform，Establish different charging standards for different types of diseases，Drugs and consumables My stake betting appstake betting apphave become part of the treatment cost of hospitals，This will force the hospital to take reasonable medication，Control the purchase cost，Improving the enthusiasm of the hospital's independent fee control。

 

  The reporter learned，In order to enable the reform to bear the scope of all aspects，Special emphasis on the reform of medical prices and medical treatment、Medicine、Medical Insurance and other policies，Clarify the total amount of medical expenses in the region and indicator of control fees，Form policy joint for policy。

 

  Fujian Province Sanming City Reinforcement Drug Use Management，Clarify the limited edition of the prescription at one time of ordinary outpatient clinics，It is required that medical institutions will publicize the top 10 antibacterial drugs of the dosage per month，Determine 53 common diseases and multiple diseases without infusion treatment，Auxiliary、Nutrition、High -buckle 129 product regulations for key monitoring，And set the positive rate index to control the big check。At the same time，Actively promote the reform of medical insurance payment methods，Implementation of total medical expenses control、Payment of single disease、Pay for the average cost limit、Differential reimbursement compensation、Full reimbursement of Chinese medicine、The third precision compensation and other systems。

 

  In addition，Anhui and Jiangsu provinces also set up & ldquo; convenient outpatient & rdquo; project，Regular check -ups for simple drug purchase and chronic patients do not need to provide new treatment plans，Diagnosis and treatment fee is 1 to 2 yuan or free。

 

  Reform realized the expected target

 

  Since the reform，The total cost growth rate is generally generally increased、Gate (emergency) average cost of diagnosis、The daily cost of the hospital bed、Pharmaceutical ratio、Consumption proportion、Inspection and inspection income accounted for indicators and other indicators incorporated into the county -level public hospital target management responsibility system and performance assessment goals，Strengthen the operation supervision of county -level public hospitals。

 

  From the perspective of the reform effect，Patient's medical expense burden changes and social response overall stable，Medical service quality and work enthusiasm of medical staff are improved，Doctors' occupational standards and public hospital public welfare properties return。

 

  The reporter learned，The proportion of drugs in public hospitals in various counties has decreased to varying degrees after the reform，Decrease between 1 and 13 percentage points。Some places (urgent) consultation、Responsible expenses and consumables income、Inspection and inspection income accounting (or increase) has decreased。Look at the outpatient and inpatient average cost indicators，The highest drop in Qinghai Province，decreased by 23%and 19%, respectively.，Other provinces decrease within 5%。The proportion of income from consumables and inspection and inspection income，Jilin Province's inspection and inspection income accounts for the largest proportion，from 23%to 12%; Guangxi consumables revenue accounted for the largest proportion，decreased from 13.4%to 11.5%。Heilongjiang Province'stake online sports bettingstake sports betting apps consumables revenue proportion and inspection income increase decreased，Falling 18 percentage points and 3 percentage points, respectively。

 

  From the perspective of the patient，Most places include adjusted medical services into the scope of medical insurance reimbursement，In some places, the increase in the total reimbursement of the increase in the diagnosis and treatment fee of the door (urgent)。Personal hygiene expenditure expenditure in Qinghai Province accounted for from 33%in 2008 to 25.9%in 2014，The largest decrease; Shanxi、Inner Mongolia、Heilongjiang、Zhejiang、Henan、Yunnan and Chongqing provinces have been reduced，Decrease within 5 percentage points。

 

  Since the local regions are adjusting the medical service price project，Pay attention to reflecting the value of medical staff's labor service，Doctors' income growth is faster，Stimulate medical staff to continuously improve the level of medical services。2015，The average salary of 288 county -level public hospitals in Hebei Province increased by 24%compared with 2012。Beijing pilot county -level public medical personnel in 2015 increased by about 1,000 yuan compared with 2014。Heilongjiang、Jilin、Qinghai Three Provincial Provincial Medical Personnel Reform of the Three Provincial Provincial Provincial Provincial Provincial Provincial Provincial Provincial Provincial Provincial Medical Persons' income increased by 30%、20.4%、19.1%。

 

 

 

 

In addition，Local localities rationalize the relationship between medical services through price reform、Optimized income structure，improved the hospital & ldquo; soft power & rdquo;，The business volume of the hospital has increased to varying degrees of increase，Hospital service capabilities and efficiency gradually improve。2014，Anhui Province (emergency) diagnostic number increased by 48.3%over 2011，The number of discharges increased by 40.8%。