Community hospital reform 9 months showing “siphon effects”

on April 8, 2017, as the health of the first national demonstration city, Beijing opened health care reform, all public medical institutions opened the medicine separate comprehensive reform, cancel the drug addition and the registration fee, and set up the medical service charge, standard adjustment of 435 item of medical service prices, organize the implementation of medicine procurement sunshine.

on April 10, 2017, tumor hospital fees reform banners hanging hall, patient queuing to expend. The Beijing news reporter Peng Ziyang taken

2 ZhenLiaoLiang lower tertiary hospital, grassroots medical institutions risen; Insiders say the drugs in hospitals with different grades barrier has been broken into main

on April 8, 2017, the first national demonstration cities as health reform, Beijing opened health care reform, all public medical institutions opened the medicine separate comprehensive reform, cancel the drug addition and the registration fee, and set up the medical service charge, standard adjustment of 435 item of medical service prices, organize the implementation of medicine procurement sunshine.

the health nine months, the effect how? Many chief physician told the Beijing news reporter interviewed, accepts patients dropped by more than thirty percent less, prescribing, treatment of patients with mild and stable.

who in Beijing development planning commission to provide the latest monitoring data show that secondary ZhenLiaoLiang lower tertiary hospital, third overall workload basic medical institutions fell by 11.6%, and the level of medical institution ZhenLiaoLiang rose 15.3%. The official evaluation, classification diagnosis and treatment work.

big hospital doctors, medical service fees to get more patients in the grass-roots, open visit prescriptions & other; Luxury & throughout; Age is no longer. Grassroots doctors feel, different grade hospital drug barrier is broken, is an important reason.

a lot of patients have the confidence of the community hospital in the back. Patients said that grassroots can enjoy two months at a cheaper price advantages, running errands time to save more than half, for the elderly is a big positive. However there are also reflect patients, lack of basic medicine, check too little, the lack of pediatrics and large hospital is still the preferred treatment.

reporters found that some areas through the building & other; The online pharmacy & throughout; To compensate for grassroots medical institutions pharmacy of the space is little, early results show.

on

big hospital expert accepts from 25 to 15 people

as a Beijing 3 armour hospital, hospital of Beijing elderly last year to join the health. The hospital respiratory 2 families, director of the physician Liu Qiangui experience the biggest change, is much less patient.

Liu Qiangui the outpatient service twice a week, all is expert outpatient service. Liu Qiangui previous visits, and the patient feeling is the same as the big hospital, just view the other way around: there are too many people.

registered to wait, to see a doctor to, such as checking etc. Every time they go to a hospital, & other; Line up for three hours, see a doctor for three minutes, the doctor precious little words & throughout; . Many patients, it is the characteristic of Beijing to see the doctor.

switch to Liu Qiangui perspective, a half a day, he want to see 20 to 25 patients. The patient went to the table sat down, more people also eagerly wait outside the consulting room, doctors visits, after the check, he can only rush out a prescription, let a patient can as soon as possible & other; In place throughout the &; What, no time to talk again told.

after the reform, and his own department, general MenZhenLiang down two to thirty percent, the visit is more apparent, a drop of about forty percent. Now, every time he accepts about 15 people, the time to come out at last.

wan-fa fu is a hospital gastroenterology dept., director of the physician, and Liu Qiangui are colleagues. Since the reform, he has experienced the same changes, he thinks, brought natural shunt in patients with medical service charge. & other; Before hanging chief physician himself only a few dollars. The elderly gastric bowel disease, some old people take medicine for a long time, don’t hang on ordinary, hangs a visit. Throughout the &;

the establishment of medical service, is each patients first feel the change after the reform. The same general practitioners, tertiary hospitals 50 yuan, 10 yuan level hospital, health care, tearing up the former pay 10 yuan, the latter only 1 yuan. And ordinary physicians and famous experts, it is the difference between 50 yuan and 100 yuan. In the face of such price difference, wan-fa fu and Liu Qiangui patients who take medicine for a long time, in a stable condition, gradually went away.

drivers

& other; The difference & throughout; Promote grading diagnosis and treatment to achieve

in fact, the medical service charge is not something new. As early as six years ago, Beijing has pioneered this concept.

2012, friendship hospital, chaoyang hospital, tongren hospital, the temple of heaven hospital and jishuitan hospital five city tertiary hospitals and yanqing, two of the six hospitals in miyun pilot cancellation of drug addition and the registration fee, the fee, set up the medical service charge. Six years later, the reform on covering, the medical service charge will be standard for public hospitals in Beijing. Ordinary outpatient medical service charge, changed from 42 yuan to 50 yuan. Party secretary of the Beijing health planning commission party to Britain, said it was considering the whole situation of the new hospital, but also to open and spread for diagnosis and classification.

why spend so much effort to push grading diagnosis?

joon is introduced, the Beijing health planning commission spokesman is high in 2016, Beijing 249 million er visits, a significant proportion of patients is slow, city level 3 general hospital in Beijing, there are three to fifty percent of patients the clinic registered only to get medicine. Situation if not adjusted, precious expert resources wasted, difficult critically ill patients, from all parts of the country still faces not in trouble.

for reducing patients, Liu Qiangui neutral attitude.

& other; As a doctor, hope to be able to help patients as much as possible, of course, but just the common cold, cough, or even to prescribe medicine, let the high qualification doctor, no need. Throughout the &;

these patients left, he now accepts as severe infection, severe pneumonia, or from secondary hospital, suburb areas, and even from other provinces to the difficulty of critically ill patients. In addition to the difficulty in severe cases, the need to review or involving patients with stomach and other community could not provide inspection, also left wan-fa fu’s office.

people less, per time. Wan-fa fu, sickly coexistence is the characteristic of elderly patients, the examination of the old man, a lot of people with high blood pressure at the same time, diseases such as coronary heart disease, diabetes, gastrointestinal diseases, symptoms may not all come from the digestive system, such as abdominal pain may be a heart attack or angina pectoris, as a result, the doctor appointments time relatively longer than for young patients. But when patients too much, time is not enough, in the past, after open the check he always rush 1 & other Hurriedly go check. Throughout the &; Now, he can use the extra time, for the old man’s medication, diet instruction, a nasty YiHuan under, the clinic experience of patients with different.

according to data released by the who in Beijing development planning commission, eight months after reform, this clinic registered, deputy director of the physician has fallen by 12%, down 22.9%, director of the physician, famous experts fell by 12.6%, which means that the visit to ease difficulty, experts and more time on the exchange for each patient.

incremental

community doctor didn’t space & other; Bookworms & throughout; The

visit people less, on patients to have a big hospital. Who in Beijing development planning commission relevant controller introduces, health care for eight months, compared to a year ago, tertiary ZhenLiaoLiang medical institutions fell by 12.1%, the overall workload largely decreased by 11.6%.

Liu Qiangui and wan-fa fu old patients go on?

according to the monitoring data, the fall in two tertiary hospital medical consultations at the same time, the level of medical institution risen, ZhenLiaoLiang rose 15.3%. More people choose from a big hospital to return home, to the grassroots medical institutions for medical treatment.

Song Lianhui tuanjiehu thinks community health service center, deputy chief physician, director of the regions. Since the reform, his department, ZhenLiaoLiang overall increased by about 16%.

& other; A lot more raw faces, some patients had never seen. Throughout the &; Song Lianhui said.

Song Lianhui, engaged in TCM diagnosis and treatment of their own professional is very loving, like to study Chinese medicine professional books. In the past, no patients the door, he often read books in the interrogation interval. Now, the time gap is filled. His day MenZhenLiang have increased to 50 people from 30-40, noon time was also extended & ndash; & ndash; Song Lianhui are no longer free in the unit when & other; Bookworms & throughout; .

the price is part of the siphon principle. After reform, the community medical service charge number of ordinary people pay only 1 yuan. For the convenience of the elderly at home, Beijing introduced policy, from the community medical treatment over 60 years old residents average out-of-pocket expenses. Prices street built in the 1980 s, the elderly accounted for more than a third of the population, which means many Song Lianhui register patient need not pay, and in the community clinic, obtain reimbursement ratio is also higher.

locate

community hospitals advantage & other; Be found throughout the &;

however, from the big hospital to the community hospital, changes to the patient, not happen overnight.

in the impression of Liu Qiangui, reform has just launched the first three months, patients have no obvious change, patients took a wait-and-see attitude. Because of the increase in medical service a lot of people complain, he also & other; Clean & throughout; Patient: inspection fee and expenses for medicine cheap. Some patients just to prescribe medicine, drug costs $20, medical service fee of RMB 100, could not bear him as a patient, prescribing, suggest they go to community for a simple test.

patients don’t want to go, one is accustomed to the big hospital, on the other hand, also trust in basic-level hospitals.

as early as before the launch of health reform, there are patients with & other; The final deadline & throughout; , big hospital in advance. In xuanwu hospital, there have been several patients to reporters & other; Fun & throughout; Limited, community hospital can treat disease, drugs also less, cannot solve the problem at a time, last more than a big hospital.

Song Lianhui argues that community hospitals and large hospital location, must be transferred to acute disease, serious illness, not deliberately processing. He exploded a resident, hypodynamia, think they just caught a cold, take medicine has no effect, Song Lianhui ekg should be done for it, found it is wrong, immediately call 120 patients will be sent to go to large hospital, finally find out patients for myocardial infarction, for in time to do the support, finally back to health.

& other; Patients with high blood pressure, cancer, discovery will be sent to the hospital. Throughout the &; Song Lianhui said, community can only part of the solution, patients should be aware of that.

and confidence in the basic-level hospitals, time is needed to create, Song Lianhui expertise on cough, in the treatment of digestive diseases, some residents cough for a long time, eat anti-inflammatory drugs and antibiotics cannot effect a radical cure and health care community hospitals to find him later, found that the treatment effect is very good, then recommend to neighbors, friends, health care, he accepts such patients increased.

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