Five departments power control unreasonable medical expenses growth

Implementing national health promotion strategy, from the source control prevalence and cost growth. Set up the accountability mechanism and monitoring system, to reach the target will be held accountable

The 2015-11-09

Source: health

Report from our correspondent (chief reporter han) moves the state health and family planning commission, the national development and reform commission, ministry of finance, the ministry of human resources and social security, state administration of traditional Chinese medicine recently issued "on the control of public hospital medical expense unreasonable growth several opinions, put forward by the end of June 2016, around the reasonable and quantify regional medical costs increase, public key monitoring indicators on a regular basis, preliminary to establish surveillance system of public hospital medical expenses, city public hospital medical expenses and outpatient medical expenses, increase total inpatient medical expenses per capita growth decreased; By the end of 2017, public hospital medical expense control gradually establish and improve the monitoring and assessment mechanism, ginseng protect patients personal spending accounted for gradually reduced. To achieve this goal, the "opinions" various comprehensive control measures are put forward.

"Opinion" is put forward, and strengthen prevention and control of chronic diseases, work, and improve the basic public health services and major public health service project performance, the implementation of national health promotion strategy, from the source control prevalence and medical expenses.

By the norms of medical behavior lead to excessive treatment costs control is the focus of attention. "Opinion" is put forward, the implementation of clinical pathway management, taking prescription negative inventory management, the implementation of prescription reviews, antibiotic use, auxiliary medication, use consumables management system, etc. Strengthen the regulation of Chinese medicine yinpian reasonable application, set up a special Chinese medicine yinpian prescription review system. Set up over the use of adjuvant, hospital supernormal drugs and high value medical consumables such as tracking monitoring system, definite number of drug product rules need to be monitored, establish and perfect, with emphasis on the basic drugs synthetic evaluation system of clinical medication. Strictly carry out plain code marks a price of medical institutions and medical expenses system list.

"Opinion" stressed the establishment conforms to the characteristics of the medical and health industry personnel salary system. Set revenue target is strictly forbidden to medical staff, medical staff shall be individual compensation and the hospital drugs, consumables, such as large medical equipment inspection treatment business income.

"Opinion" is put forward, strengthen budget constraint, and strengthen the public hospital cost accounting, improve the public hospital medical record, clinical pathway, drug, consumables, cost audit, financial and budget the elaborating management level, to control unnecessary expenses. Reasonable controls the scale of public hospital beds, strictly forbid add beds. Strict implementation of large medical equipment planning, strengthen the use of evaluation and supervision and management. Public hospitals are strictly prohibited borrowing construction, strictly control the construction standards.

"Opinions" clear, the implementation of drug classification procurement. For clinical use, the purchase amount is high, the enterprise production and a number of essential drugs and generic drugs, by provincial drug procurement agencies to adopt double envelope system of public bidding procurement. For part of patent medicine, the sole drug production, the price negotiation mechanism is established. The implementation of high value medical consumables procurement sunshine, encourage purchasing home-made high value medical consumables.

"Opinions" requirement, build on the basis of cost and income structure change of price dynamic adjustment mechanism. By reducing drug supplies cost and strengthen the cost control, to set aside space for medical service price adjustment. Earnestly implement the government policy on public medical institutions of various inputs, ensure that the medical insurance fund in accordance with the provisions in full settlement in time.

"Opinion" is put forward, and gradually to the region as a whole all the medical establishment that decide a dot, and payment to the reform of all diseases. Strengthen the medical insurance fund budget, set up mainly by macro-reforms, according to head, according to multiple service units and other payment methods, gradually reduce pay according to the project. Encouraged to implement according to the disease diagnosis related group (DRGs) payment method. Improve and implement medical insurance agency orgnaization and negotiation mechanism of medical institutions. Gradually expand into the medical insurance payment ambulatory surgery and medical institutions of TCM, acupuncture, therapeutic massage and other non-drug treatment technology in TCM. For high drugs and consumables into medical insurance directory strict economics evaluation and review.

In order to ensure the accused of having success, "opinions" requirement to establish medical expense control assessment accountability mechanism and monitoring system, and regularly publish the main monitoring indicators sort the provinces (autonomous regions and municipalities). Will be charged fee goal implementation and public hospital infrastructure, equipment purchase inputs, focus on learning (designed) construction investment, fiscal appropriation budget, etc. To reach control cost target hospitals, subtract or cancel the money. To control medical costs as public hospital level review access, for examination and approval of new beds and large medical equipment and other important basis.

"Opinion" is put forward, the medical expense control work in public hospitals to belong to target management, dean, dean of the annual performance appraisal and term examination scope, examination of higher fee index weight, dean of not according to the target cost control requirements, shall be investigated for the corresponding management responsibility. The public medical institutions should reasonable diagnosis and treatment behavior as an important part of the performance appraisal to the medical personnel evaluation, the reasonable inspection, implementation and medical staff's recommendation for the rational use of drugs, PingXian performance wage distribution, promotion, employment, etc.