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河南所有公立医院 8月底前全部取消药品加成

2017-07-11 09:27:04   大河网-河南商报

服务改革

水平高的大夫收费高

主要内容:取消药品加成后减少的合理收入,通过医疗服务价格调整补偿90%,财政按照原供给渠道补偿10%。在保证公立医院良性运行、医保基金可承受、群众整体负担不增加的前提下,降低药品耗材、大型设备检查和化验价格,提高体现医务人员技术劳务价值的项目价格,特别是诊疗、手术、康复、护理、中医、儿科等服务项目价格,逐步理顺比价关系。

解读:取消药品加成后,医院势必要减少一部分收入,而这部分,90%将通过医疗价格调整补偿。也就是说,知名专家的挂号费、诊疗费等能体现医护人员技术水平的服务,将会提高。

优化秩序

加强分级诊疗推进基层首诊

主要内容:强化区域医疗卫生规划的刚性约束,落实公立医院功能定位,加强机构协作,推动资源共享。强化三级医院引领带动作用,以组建医联体和家庭医生签约服务为抓手,建立分级诊疗制度,促进形成有序就医。

解读:举例说,一个人得病后不能大小病都到市级、省级医院看病,像头疼发热等,先在基层首诊,确实需要转诊的,先转到市级医院,如果市级医院不能治疗再转诊到省级医院。

将来,在省、市级医院治疗后的恢复期的患者,以及高血压、糖尿病等慢性病患者,需要转诊到基层医院治疗。

严控费用

深化支付方式改革

推进按病种付费等

主要内容:强化医保监管调控作用,深化支付方式改革,建立以按病种付费为主,按人头付费、按床日付费、按服务单元付费等复合型付费方式,逐步减少按项目付费。试点开展医保经办机构承担药品采购和费用结算、医保支付标准谈判等职能,充分发挥医保对药品生产流通企业、医院和医生的监督制约作用。

解读:一直以来,我国医疗付费机制中占主导地位的是按“项目付费”制度,即根据医疗机构诊疗中所提供项目进行后付费的制度,此种“后付制”的优点是操作方便,但与医疗机构的收入直接挂钩的特点,被公认为推动医疗费用不断冲高的原因之一。约束机制的建立,有利于医保费用支出安全,可以高效利用医保基金,合理分配利用医疗资源,杜绝大处方、重复检查等不规范的诊疗行为。

责任编辑:杨晓晨 CN067
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