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七部委推动委局属管医院综合改革 全部取消药品加成

2017-07-05 16:26:12   国际在线

国际在线报道:据国家卫计委网站消息,国家卫计委、财政部等七部委近日印发通知要求,全面推开国家卫生计生委、国家中医药局直属医院和预算管理的高校附属医院综合改革,全部取消药品加成。

通知要求,委局属管医院要突出抓好重点改革任务落实。一是2017年9月30日前全面推开综合改革,全部取消药品加成(中药饮片除外),破除以药补医机制,加快建立现代医院管理制度。

二是认真执行属地医疗服务价格改革政策,配合做好调整医疗服务价格结构工作,提高体现医务人员技术劳务价值的医疗服务收入在医院总收入中的比例。严格执行政府指导价,严格控制特需医疗服务规模,提供特需医疗服务的比例不超过全部医疗服务的10%。

三是积极参与分级诊疗制度建设,率先全部参与医疗联合体建设并发挥引领作用。积极为家庭医生团队提供技术支持和业务指导,引导优质医疗资源下沉,提升基层医疗服务能力。鼓励跨区域与若干医联体建立合作关系,组建高层次、优势互补的医联体,辐射带动区域医疗服务能力提升。

四是积极参加属地药品、高值医用耗材集中采购,医院使用的所有药品(不含中药饮片)均应当通过属地省级药品集中采购平台(省级公共资源交易平台)采购。率先实施药品采购“两票制”。

五是积极参加属地医保支付方式改革,逐步减少按项目收付费数量,扩大按病种和按服务单元收付费范围。积极参与医保异地就医联网结算工作。

六是完善医院收入分配机制。完善绩效工资分配办法,健全内部绩效考核制度。严禁向科室和医务人员下达创收指标,医务人员个人薪酬不得与药品、卫生材料、检查、化验等业务收入挂钩。

七是带头贯彻落实《关于控制公立医院医疗费用不合理增长的若干意见》,采取规范医务人员诊疗行为、强化医院内控制度、严格控制医院规模、降低药品耗材虚高价格、推进医保支付方式改革、构建分级诊疗体系、实施全民健康促进和健康管理等综合措施,控制医疗费用不合理增长。按照属地化原则,委局属管医院纳入属地医疗费用控制范围。

八是率先建立现代医院管理制度。严格落实医疗质量安全核心制度,推进合理检查、用药和治疗。在岗位设置、收入分配、职称评定、管理使用等方面,对编制内外人员统筹考虑。

九是率先落实进一步改善医疗服务行动计划。科学实施预约诊疗,实现分时段精准预约,推行实名制预约诊疗。根据患者就诊情况,灵活调配院内门急诊、住院病床、药房等医疗资源,打通影响患者看病就医体验的瓶颈环节。加强日间手术质量精细化管理,探索将部分住院服务转变为日间医疗服务,缓解患者“住院难”和“手术难”问题。

十是成立由主要负责同志任组长的改革领导小组,主要负责同志亲自抓、负总责,切实做好改革实施工作。要做好成本测算和经济运行情况分析,为属地有关部门制定医疗服务价格调整方案提供依据,并积极争取政策支持。

十一是对医务人员和行政管理人员开展全员培训,加强改革政策宣传,向患者解读改革政策、宣传改革成效,引导合理预期,及时回应社会关切,为改革营造良好舆论环境。

通知要求,有关部门和地方要积极支持委局属管医院改革工作。一是落实政府投入和监管责任。二是各有关省(市)承担全面推开各级各类公立医院综合改革的主体责任,要将委局属管医院纳入当地公立医院综合改革范围统筹考虑,指导委局属管医院所在城市完善改革政策措施。三是对已经推开改革的委局属管医院,各有关省(市)要密切跟踪改革进展,实时监测医疗服务、经济运行等指标,及时解决改革中出现的新情况、新问题。对受影响较大、价格补偿不到位的医院,要限时提出解决办法,确保医院的稳定和发展。

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