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新华社石家庄8月18日电(记者巩志宏)记者18日从河北省政府了解到,在之前实施公立医院综合改革试点的基础上,从8月26日零时起,河北石家庄等5个设区市所有城市公立医院将同时启动药品零差率销售、全部取消药品加成(中药饮片除外),河北城市公立医院综合改革将实现全覆盖。
河北省卫计委副主任段云波介绍说,河北公立医院综合改革分别从市级、县级两个层面开展试点、逐步推开。2012年到2014年,县级公立医院综合改革实现了全覆盖。2014年到2016年,唐山、邯郸、张家口、沧州、衡水、邢台6市先后纳入国家城市公立医院综合改革试点。今年,石家庄、承德、秦皇岛、廊坊和保定5市,共确定82家城市公立医院参加改革。
取消医院药品加成后,河北将通过调整医疗服务价格、改革支付方式、加大政府投入等建立科学合理的补偿机制,以维护医院的公益性。其中,在医疗服务价格调整上,主要上调诊察、护理、中医、手术、治疗等体现医护人员劳务价值的项目价格,并下调大型医用设备检查治疗及检验价格。同时,将调整后的医疗服务项目纳入医保支付报销范围。
“总体看,改革后群众就医费用负担不会增加,但具体到某个服务项目或某项治疗手段上有所不同。”段云波说,如省级医院普通门诊、副主任医师、主任医师门诊诊察费,分别由原来的每次4元、6元、9元调整为15元、20元、30元,医保均报销14元,患者分别自付1元、6元、16元。最终,普通门诊诊察费患者少负担3元,主任医师诊察费多负担7元,既保障群众基本看病需求,又可体现医务人员技术劳务价值,进而引导患者合理分流。
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