Five departments jointly issued "about control public hospital medical expense unreasonable growth of several opinions"

Not used in traditional Chinese medicine diagnosis and treatment technology will help medical fee

Time: 2015-11-09

Source: China's traditional Chinese medicine

Author: hu bin

Report from our correspondent (reporter hu bin) recently, the national health and family planning commission, the national development and reform commission, ministry of finance, human resources department of social security and the state administration of traditional Chinese medicine jointly issued by the public hospitals on the control unreasonable medical expenses growth of several opinions "(hereinafter referred to as" control fee opinions "). Which is put forward, in ambulatory surgery and non-drug treatment of traditional Chinese medicine, on the basis of expanding into the medical insurance payment of ambulatory surgery and medical organizations of TCM, acupuncture, therapeutic massage and other non-drug treatment technology in TCM.

The charged fees opinions put forward the phased target of cost control, that is in the first half of 2016, combining with the actual reasonable and quantitative area around the medical expense growth, public key monitoring indicators on a regular basis, preliminary to establish surveillance system of public hospital medical expenses, medical expense unreasonable growth got preliminary control. By the end of 2017, public hospital medical expense control gradually establish and improve the monitoring and assessment mechanism, ginseng protect patients of medical expenses in personal spending accounted gradually reduce, further reduce burden of residents to see.

Charged fees opinions clearly, will take the standard medical personnel and treatment behavior, strengthening medical institutions internal control system, and strictly control the scale of public hospitals, reducing drug supplies inflated prices, promote the reform of medical insurance payment methods, change public hospital compensation mechanism, build medical expense control comprehensive measures such as grading diagnosis system. Negative listing will implement clinical pathway management, take the prescription management, strengthen the regulation of Chinese medicine yinpian reasonable application, build system of Chinese medicine yinpian prescription special review, promote the rational drug use. Strengthen the budget constraint and audit on hospital budgets. 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. To optimize medical resources structure and layout, and promote the high-quality medical resources sinking, enhance the service ability, among them, the grassroots service ability is insufficient and weak areas of traditional Chinese medicine hospital of traditional Chinese medicine should be treated differently.

By the end of 2015, the city public hospital comprehensive reform pilot area health care payment reform to cover area all public hospitals, the number of cases of the implementation of clinical pathway management reached 30% of the public hospital discharge the number of cases, the press disease to plant the diseases were paid no less than 100. Public hospital medical drugs accounted for revenue decline year by year, the proportion of the years 2017 to pilot city public hospital medicine proportion (excluding Chinese medicine yinpian) fell to about 30% overall.

At the same time, the control cost views also explicitly proposed medical expense control assessment accountability mechanism, strengthen the monitoring of the medical expenses and medical cost sorting and publicly, strict implementation of the accountability. To control medical costs as public hospital level review access, for examination and approval of new beds and important basis of the large medical equipment allocation and reasonable diagnosis and treatment behavior as an important part of the performance appraisal to the medical personnel evaluation.

To strengthen monitoring of medical treatment charge, is advantageous for the quantitative comparison of cost control, the control cost on 21 indicators is put forward, including cost change, residents burden, medical service system overall efficiency, income structure of medical institutions, the efficiency of operation and management, etc., and clearly put forward the indicators guide requirements.