The performance appraisal of secondary public hospitals was announced for the first time!

On January 10, the Office of the State Administration of Traditional Chinese Medicine released a report on the national monitoring and analysis of the performance assessment of second-level public traditional Chinese medicine hospitals in the country in 2019
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It is worth noting that the assessment results of quantitative indicators such as "antibacterial drug use intensity (DDDs)", "proportion of the purchase amount of essential drugs", "proportion of the amount of the bid-winning drugs in the centralized procurement of drugs organized by the state", "the proportion of revenue from key monitored drugs and" were disclosed.

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Just last week, the General Office of the National Health and Health Commission released a report on the national monitoring and analysis of the performance assessment of secondary public hospitals in the country in 2019.
This is the first report card after the country launched the performance assessment of secondary public hospitals
.
Judging from the results of the "National Examination" of the national secondary public hospitals in 2019, drugs for chronic diseases and antibacterial drugs have fully established the basis for market sinking
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From the perspective of industry insiders, with the implementation of hierarchical diagnosis and treatment, the pharmaceutical market structure will undergo great changes
.
70% of nationally sourced drugs account for less than 6% of key monitored drugs On December 5, 2019, the National Health and Health Commission issued the "Notice on Strengthening the Performance Evaluation of Secondary Public Hospitals", requiring the launch of secondary public hospitals across the country in 2020 In the performance appraisal work, the provinces (autonomous regions and municipalities) will gradually incorporate the second-level public hospitals within their jurisdiction into the scope of performance appraisal in light of their actual conditions
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Among them, in the column of "rational drug use" of the performance evaluation indicators of secondary public hospitals, "antibacterial drug use intensity (DDDs)", "proportion of essential drug purchase amount", "proportion of the amount of winning drugs in centralized procurement of state-organized drugs", "key monitoring drugs" The proportion of income and the five quantitative indicators of "focus on monitoring the proportion of income of high-value medical consumables" are included in the assessment
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From the perspective of the industry, the performance appraisal of secondary public hospitals is the sinking of the performance appraisal of tertiary public hospitals
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While promoting the performance appraisal of secondary public hospitals, on May 27, 2020, the website of the State Administration of Traditional Chinese Medicine released the "Performance Assessment Indicators for Secondary Public TCM Hospitals" to further clarify the performance appraisal work of secondary public TCM hospitals
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Compared with a total of 28 performance evaluation indicators for second-level public hospitals, it is found that there are 34 performance evaluation indicators for second-level public TCM hospitals, which have differentiated requirements in terms of medical quality, operational efficiency, and sustainable development
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In the assessment of medical quality, the assessment of the functional positioning of secondary public TCM hospitals pays more attention to the proportion of outpatient TCM prescriptions, the proportion of outpatient bulk TCM decoction pieces and small packaged TCM decoction pieces, the utilization rate of TCM decoction pieces, and the non-drugs of traditional Chinese medicine.
The proportion of therapy use and the proportion of discharged patients treated with traditional Chinese medicine
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According to the report, in 2019, the intensity of antimicrobial use in secondary public hospitals was 40.
96 DDDs, which has not yet met the requirement that the intensity of antimicrobial use in inpatients in general hospitals should not exceed 40 DDDs, and there are still 967 (44.
64%) general hospitals with antimicrobial use intensity.
over 40DDDs
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The amount of the winning drugs in the centralized procurement of drugs organized by the state accounted for about 70%, and the procurement amount of essential drugs accounted for 41.
49%; the revenue of key monitoring drugs (according to the first batch of national key monitoring and rational drug use drug catalogues) accounted for 5.
63%
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Among them, patients with common non-surgical medical diseases such as hypertension, coronary atherosclerosis, and bronchitis are mainly concentrated in secondary public hospitals, and the market for drugs related to chronic disease care and postoperative rehabilitation is sinking
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In terms of secondary public TCM hospitals, in 2019, the intensity of antimicrobial use was 37.
78 DDDs, meeting the national requirements for the intensity of antimicrobial use in hospitalized patients
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The amount of the winning drugs in the centralized procurement of drugs organized by the state accounted for 77.
09%, the procurement amount of essential drugs accounted for 40.
34%, and the revenue of key monitoring drugs (according to the first batch of national key monitoring and rational drug use drug catalogues) accounted for 5.
25%
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In 2019, the revenue of TCM decoction pieces of secondary public TCM hospitals accounted for 24.
3%, the revenue of TCM medical service projects accounted for 9.
42%, the average cost of outpatient and inpatient visits increased by 7.
72% and 6.
21% respectively, and the average cost of drugs for outpatient and inpatient visits The increase was 9.
59% and 2.
24% respectively
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According to industry insiders, under the background of further tightening of medical insurance cost control and deepening structural adjustment, judging from the current relevant data, the market share of therapeutic drugs is increasing, while the market share of adjuvant drugs and other drugs is shrinking
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With the implementation of standardization, informatization, and precise performance appraisal of supercomputing technology and big data technology, rational drug use in medical institutions will be brought to a new level
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Hierarchical diagnosis and treatment guides the rearrangement of chronic diseases, anesthesia, and antibacterial patterns.
One or two can also be seen in the first report card of the performance appraisal of the first-level public hospital
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With the effective control of the epidemic, the number of visits to public medical institutions has increased significantly
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According to the data from Minet.
com, the number of patients diagnosed in public hospitals from January to April 2021 increased by 46.
8% compared with that from January to April 2020, among which tertiary hospitals increased the most, reaching 63.
6%.
Sales also resumed growth
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Urban public hospitals are the main channels for patients to seek medical treatment, and their drug categories are mainly therapeutic drugs for severe, serious diseases and emergencies such as tumors, cardiovascular and cerebrovascular diseases, and diabetes
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Rigid drug demand has led to a rapid recovery in drug sales of urban public hospitals in the first half of 2021, with a large year-on-year increase, up 12.
57% compared with the first half of 2020; the sales of county-level public hospitals were similar to those in the first half of 2020.
The ratio also increased by 5.
65%
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It is worth noting that in recent years, policies have been continuously introduced to explore the construction of medical community, and continue to promote the sinking of medical resources to grassroots counties
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With the increasing attention paid to the field of chronic diseases, especially in the context of the continuous expansion of the number of sick people in grass-roots counties, the field of chronic diseases has become an important entry point for promoting hierarchical diagnosis and treatment
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Judging from the first performance appraisal report of a secondary hospital, among inpatients, the top 5 diseases for diagnosis and treatment are cerebral infarction, pneumonia, chronic ischemic heart disease, other chronic obstructive pulmonary disease, and acute bronchitis. .
In order to further improve the willingness of patients with chronic diseases to seek medical treatment in primary medical institutions, on August 12, 2020, the Medical Administration and Hospital Administration of the National Health and Health Commission issued the "Notice on Printing and Distributing Long-term Prescription Management Specifications (Trial)" to encourage primary medical and health care.
For institutions that issue long-term prescriptions, if the primary medical and health institutions do not have the corresponding conditions, they can be issued under the guidance of qualified higher-level medical institutions in the medical alliance through remote consultation, Internet follow-up, hospital consultation,
etc.
In primary medical institutions, community health service centers (stations) are chronic disease management centers, and chronic disease medication is dominant in this channel.
Center (station) drug market growth
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According to the latest data from Minet.
com, in the first half of 2021, the sales of medicines at community health service centers (stations) increased by 4.
93% compared with the first half of 2020
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On the other hand, with the implementation of the work procedures for the adjustment of the national key monitoring and rational drug use list, the varieties in the national key monitoring list continued to decline, and the sales of terminals in China's public medical institutions in the first half of 2021 fell by 38.
94% compared with the first half of 2020.
%, and its sales share has also dropped from 3.
95% in the first half of 2019 to 0.
85% in the first half of 2021, and its market share has been shrinking
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Most of these products have relatively low clinical value and will be gradually eliminated from the market in the future
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With the continuous advancement of hierarchical diagnosis and treatment, the division of labor in medical institutions has become more clear.
The third-level hospitals are mainly responsible for larger third- and fourth-level surgeries, rare diseases and intractable diseases, and the second-level hospitals are responsible for the diagnosis and treatment services of common diseases, frequently-occurring diseases, and chronic diseases.

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Some industry insiders pointed out that the distribution pattern of chronic disease drugs, anesthetics and antibacterial drugs will be rearranged
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