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北京:医改两个月 大医院门诊量减少

2017-06-10 08:40:43   北京晨报

卫计委相关负责人表示,上述工作量和结构变化由于时间较短,患者就医需求和行为尚在调整中,需要进一步观察。

官方回应

卫计委:“跨小科”开药由医生酌情定夺

针对有患者反映,部分医院的医生拒绝给患者跨科开药的问题,昨日,市卫计委医政处副处长刘颖解释,市卫计委此前已经下发通知到各参与医改的医疗机构,临床医师可以酌情跨科开药,不过在医学上所谓的“跨科”存在“跨大科”和“跨小科”的区别。大科指的是内科、外科、妇科、儿科等这样的不同科室,根据临床医师的职业行为要求,医生是不能跨这样的大科室开具处方药的。而跨小科则是指比如同属内科系统的不同科室或专业,卫计委通知可酌情“跨科开药”指的是后一种“跨小科”的情况。

例如糖尿病的老病号在内分泌科,同时患者又有高血压,医生在看好本专业病的前提下,自行判断患者病情是否稳定,同时是否能查询到患者此前在该院诊治高血压疾病的开药记录,在满足这些条件下可酌情开具降压药。

同时,刘颖也明确表示,市卫计委并不鼓励三级医院继续开设专门用于开药的“简易门诊”,因为这与三级医院的功能定位并不相符。不过,医院可以根据自身专业特点,有条件地开设“老年病综合门诊”,用以解决慢病患者需要在不同专科就诊的问题。另外,对于一些患者反映个别医院在医改后出现“多挂号少开药”的现象,市卫计委新闻发言人高小俊也表示,他们正在对此督导检查。

三级医院

妇产医院:主任级专家号降15%

昨日,北京晨报记者从北京妇产医院了解到,医改以来,取消挂号费和诊疗费并设立医事服务费,该院的收益略有提高。门诊医疗收入从2016年5月份5413.65万元到2017年5月份5937.91万元,增幅9.68%;住院医疗收入从2016年5月份2423.96万元到2017年5月份2659.76万元,增幅9.73%。

医院的门诊次均费用增幅放缓,次均药费降低比较明显。医改取消药品加成后药占比明显下降。门诊药品收入从2017年3月份1726.61万元降至5月份1182.1万元;门诊药占比从2017年3月份27.87%降至5月份的20.25%。取消药品加成后,减轻了患者医药负担。

另外,医保次均费用总体平稳,患者实际负担没有明显增加。医改后来院就诊患者结构发生了变化,医保患者比例增加,患者负担无明显增加。例如:2016年5月份医保患者在该院个人负担费用201.11元,2017年5月份医保个人负担费用为217.14元。

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