How about the medical reform in 2016? Recommend 5 typical cases of medical reform

[market analysis of chinapharma.com] how is the progress of medical reform in China in 2016? At the recent national teleconference on medical reform, the leaders of Fujian Province, Zhejiang Province, Sichuan Province, Shenzhen city of Guangdong Province and Tianchang City of Anhui Province introduced the ideas and typical practices of local medical reform (how about the medical reform in 2016? Recommended 5 typical pictures of medical reform: Baidu pictures) on March 28, 2017, the national teleconference on medical reform was held in Beijing, and Liu Yandong, vice premier of the State Council and leader of the leading group of medical reform of the State Council, made an important speech Li Bin, director of the national health and Family Planning Commission and deputy leader of the leading group of medical reform of the State Council, attended the meeting and reported the progress of medical reform in 2016 and the key work arrangements in 2017 Then, the leaders of Fujian Province, Zhejiang Province, Sichuan Province, Shenzhen city of Guangdong Province and Tianchang City of Anhui Province introduced the local medical reform ideas and typical practices Medical insurance system reform: Fujian establishes an independent medical insurance institution At the scene of the above teleconference, Li Hong, vice chairman of the CPPCC Fujian Provincial Committee and vice leader of the provincial medical reform leading group, introduced the highlights of medical insurance system reform in Fujian Province There are three main local measures: first, merge and restructure, optimize functions On the basis of "Three Guarantees in one", we will continue to merge related functions such as birth insurance of human resources and social security department, medical assistance of Civil Affairs Department, and drug distribution of commercial department, so as to change the situation of "Jiulong water treatment" and division of medical insurance departments More importantly, the functions of drug bidding of health and family planning departments and medical price management of price departments were incorporated into medical insurance, which concentrated the three leading elements of the economic operation of public hospitals, namely "drug, price and insurance", and strengthened the constraint and incentive effect on medical behaviors Secondly, the mode of relatively independent operation should be implemented The provincial medical security management committee is established, which is composed of 13 departments and the director is the deputy governor in charge It has a medical insurance office, which is currently affiliated with the Provincial Department of Finance and operates relatively independently Third, rationalize the city and county medical insurance system With reference to the integration mode of provincial medical insurance institutions, each city has established a municipal medical insurance administration bureau, which is affiliated with the Municipal Finance Bureau, and forms a unified medical insurance management system of the whole province At present, the provincial and municipal two-level medical insurance institutions have all been integrated in place The reason why they use these strategies is that in the reform, they realized that medical insurance is the foundation of the basic medical and health system, the core of the medical reform, and the "three medical linkage" of the ox nose Moreover, Sanming medical reform experience shows that in order to reduce the virtual high cost of medical consumables and make room for hospital control fees, to improve the price of medical services, to increase the salary and treatment of doctors, to optimize the income structure of hospitals and to promote sound development, we must change the links of drug purchase, drug use and payment from decentralized management to centralized management Therefore, the reform must first change the medical insurance, establish an independent medical insurance institution, let the "payer" take charge of the "order", let the person in charge of the money take care of the medical behavior According to the information provided by Li Hong, up to now, Fujian Province has focused on four tasks in improving the medical insurance system: first, to establish a new compensation mechanism for public hospitals through the linkage of "medicine, price and insurance" In the second half of 2016, using the expense space vacated by drug bidding, hospital fee control and the combination of various medical insurance systems, such as the increase of balance plate, we adjusted the price of medical services in 15 provincial hospitals for three times, with the amount of more than 200 million yuan The medical insurance was reimbursed in the same proportion, without additional financial investment or increasing the burden of patients Second, reform the drug purchase system based on the payment and settlement price of medical insurance The medical insurance department adopts the method of setting two prices in "two identities" to promote the reform of drug procurement For example, the provincial medical insurance office takes the lead in formulating the payment and settlement price of medical insurance, for about 80% of therapeutic drugs, medical insurance determines a representative drug for the same kind of drugs to pay, and the payment standard is used as the settlement price of the same kind of drugs The excess part shall be paid by the hospital itself, and the surplus part shall be retained by the hospital Third, we will push forward the reform of medical service prices by charging for diseases At the end of 2016, Fujian Province launched the reform of charging and paying for 100 diseases simultaneously The provincial medical insurance office shall negotiate with the hospital to determine the charging standards for these diseases, so that the masses can clearly consume and restrain the disorderly charging behavior of the hospital In 2017, the province will expand the range of diseases charged and paid by diseases to more than 600 The fourth is to regulate and regulate medical behaviors through the whole process of supervision After the integration of medical insurance, the provincial medical insurance office was given four responsibilities to supervise hospitals, doctors, drug circulation, services and prices, forming a joint supervision force The measures include: ① strengthen the fund safety supervision We will take measures to crack down on defrauding medical insurance funds and infringing the rights and interests of patients, and list illegal enterprises, medical institutions and individuals in the "blacklist" of the provincial medical security management system ② take sunshine limited price purchase of drugs, open the drug catalog selection process and responsible person, and open the whole process of drug purchase ③ strengthen the supervision of medical behaviors The code management of medical insurance doctors has been carried out, and a unified code base of medical insurance doctors in the whole province has been built to manage medical behaviors of doctors in the whole process ④ strengthen information supervision Establish a medical insurance service management platform to provide technical support for medical insurance supervision Urban public hospital reform: explore modern hospital management in Zhejiang Province According to Cheng yuechong, vice governor of Zhejiang Province, the province started the comprehensive reform of county-level public hospitals in 2011 with "zero drug difference rate" as the breakthrough point, and then gradually promoted the comprehensive reform of municipal and provincial public hospitals In April 2014, all public hospitals in the province cancelled the drug mark up, and simultaneously implemented the reform of service price, medical insurance, financial security, management and other institutional mechanisms Their main methods are: first, improve the management system of public hospitals To formulate the assessment method and index system for the operation objective responsibility system of provincial public hospitals, and strengthen the assessment and evaluation of presidents and hospitals Strictly control the unreasonable growth of medical expenses, and the growth index of medical expenses in public hospitals has been lower than the national average for many years Second, improve the operation mechanism of public hospitals According to the basic path of making space, adjusting structure and ensuring connection, we will gradually rationalize the price of medical services In view of the "short board" of paediatric medical services, on the basis of price reform in the past few years, the outpatient fees, inpatient fees and bed fees of paediatric are adjusted The adjusted medical service prices are included in the payment scope of medical insurance, without increasing the burden of patients Guided by the new mechanism of drug classified procurement, we will implement the requirements of "two ticket system", and promote the construction of a provincial comprehensive platform for drug and equipment procurement that integrates commodity flow, information flow and capital flow All public hospital drug procurement will be included in the operation and management of the new platform We will accelerate the reform of the medical insurance payment system While improving the total prepayment management, we will expand pilot reforms such as payment by disease, payment by head for outpatient services, and lump sum medical insurance fees for doctors in charge of contracted services at the grassroots level Three is to implement the operation and management autonomy of public hospitals We will transform the functions of the government, cut down on matters related to medical examination and approval, and promote the implementation of autonomy in hospital's internal personnel management, institutional setting, income distribution, and annual budget implementation We will establish a flexible employment mechanism, and comprehensively carry out the pilot reform of the public hospital filing system For the short of professional and technical personnel or high-level talents, the hospital shall recruit them independently according to the regulations In addition, Zhejiang Province has comprehensively deepened "double sinking and two upgrading" and actively promoted the extension of urban medical resources to the grassroots level First, strictly control the expansion of urban public hospitals Formulate and strictly implement the plan of medical service system, make clear that during the 13th Five Year Plan period, the number of provincial hospitals will only be reduced or not increased, and the number of beds per thousand will be reduced from 0.47 to 0.45 In principle, the municipal government will not hold a new urban comprehensive hospital alone Second, we will promote vertical integration of urban medical resources At present, 15 provincial hospitals and 39 municipal hospitals cooperate with 122 county-level hospitals to run medical services, and urban medical resources are fully covered at the county level Vigorously promote the establishment of asset linked medical groups or medical consortiums between urban hospitals and county-level hospitals Seven provincial hospitals and eight county (city) governments have jointly built 11 specialized (special disease) centers, with a total investment of 300 million yuan from provincial hospitals Third, the gradual formation of county-level hospital gradient sinking pattern In recent years, relying on the county-level leading hospitals, the province has promoted the establishment of county-level medical image, clinical examination, ECG examination, chronic disease management and other sharing centers On this basis, while receiving the support of provincial and municipal hospitals, county-level hospitals take the initiative to sink, send medical staff to stay at the grass-roots level, set up grass-roots inpatient branches, arrange experts to visit the grass-roots teaching rooms regularly, and build medical service cooperation and consortia with township hospitals and community health centers Medical equipment procurement reform: 6160 public medical and health institutions in Sichuan Province have been included in the supervision According to Yang Xingping, vice governor of the people's Government of Sichuan Province, in practical work, Sichuan Province adheres to the information platform as the carrier, seizing the key points of drugs, medical consumables, medical equipment, diagnostic reagents, class II vaccines, etc., and promoting standardized, orderly supply of medical equipment As for the specific methods, there are mainly five: first, implement the centralized and classified procurement of drugs in public hospitals According to the procurement mode determined by the state, a new round of centralized and classified procurement of drugs will be completed by the end of 2016 Drug prices are down 10.6% year-on-year, and it is expected to reduce drug expenses by nearly 4 billion yuan More than 37000 products were directly purchased online, with an average year-on-year decrease of 16.1% Second, we will promote the purchase of medical consumables through the provincial grid In 2014, it was carried out nationwide At present, the provincial online procurement has reached 10 categories, 41 sub categories and 56000 products, basically realizing the full caliber procurement of medical consumables, and the provincial average price has dropped by 9.4% year on year At the same time, the province is actively negotiating the inter provincial Collaborative Procurement of medical consumables Third, promote the sunshine record purchase of medical equipment On the basis of more than 200 kinds of large and medium-sized medical equipment networking work in 2015, 17 kinds of large and 80 kinds of equipment were newly added for filing in 2016, realizing the full category procurement and use supervision of large and medium-sized medical equipment Fourth, carry out the provincial screening sunshine procurement of diagnostic reagents Since the launch in August 2016, more than 35000 products of 6 categories, 458 types have been connected to the Internet, and the rest 796 types will be completed in the first half of 2017 Fifthly, we will carry out the procurement of class II vaccine on the provincial Internet In March 2016, the implementation plan was issued nationwide and the centralized network connection was realized by taking the province as the unit At present, the construction of information system has been completed, and 122 products of all varieties have been linked to the network at the provincial level 120 products have been negotiated and implemented at the provincial level All county-level disease control institutions have realized online procurement It is worth mentioning that Sichuan Province, while establishing the procurement mechanism of medical equipment, insists on constantly moving the supervision port forward, from the original post supervision to the current pre-warning and timely correction in advance and in the process, which realizes the real-time supervision of the whole process of procurement and use of medical equipment First, establish a comprehensive procurement supervision platform At present, the platform after system upgrading has covered the purchase and sale of medicine such as production and operation enterprises, medical institutions, health and family planning administrative departments, etc