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医生的“处方之笔”怎样管好? 国家卫计委发文加强药事管理
新华社北京7月17日电(记者邓华宁、王宾)建立完善处方审核制度,开展处方点评活动,对临床使用不规范、价格昂贵及用药金额占比较大的药品,加大监管力度……国家卫生计生委日前发布《关于加强药事管理转变药学服务模式的通知》,进一步深化医改,破除以药补医。
据国家卫计委相关负责人介绍,2017年我国医改的一个主要任务是破除以药补医,个人卫生支出占卫生总费用的比例将降低到30%以下,百元医疗收入中消耗的卫生材料降到20元以下。实现医药控费杜绝“看病贵”,除了加强对药品价格和高值医药耗材的价格监管,还要管好医生“处方之笔”,卡住“水分”黑手。
通知明确要求医疗机构开展处方点评活动,对点评中发现的超常用药和不合理用药,进行干预和跟踪管理。“将处方点评结果作为科室和医务人员处方权授予、绩效考核、职称评定和评价药师审核处方质量的重要依据,纳入当地卫生计生行政部门对医疗机构的绩效考核指标中。”
通知还要求,各地医疗机构要建立完善的处方审核制度,优化管理流程,确保所有处方经药师审核后调配发放。药师审核发现问题,要与医师沟通进行干预和纠正。医疗机构将临床用药管理要求通过信息化手段予以体现,建立药事管理绩效考核制度。中医医院还要建立严格的中药饮片处方专项点评制度,重点对不符合辨证论治等中医药理论的不合理用药,进行干预管理。
随着公立医院改革逐步推进,以药补医做法逐步被破除,一些医疗机构也出现药学服务削弱的现象和趋势。为此,通知提出,各地要大力培训和合理配备临床药师,发展以病人为中心、以合理用药为核心的临床药师队伍。各地要通过完善培养培训、绩效考核和分配机制,保障并逐步提高药师待遇,吸引优秀药学人才,稳定药师队伍。有条件的医疗机构可开设药师咨询门诊,为患者提供用药咨询和指导。鼓励各地在理顺医疗服务价格过程中,建立合理补偿机制,促进合理用药。
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