Jiangsu zero difference lead community's hospital " Have palpitation " Two major doubts wait to analyse and explain

Jiangsu zero difference lead community's hospital " Have palpitation " Two major doubts wait to analyse and explain
Jiangsu Province Price Bureau announces, Qin the Huaihe River, building Ye, rain to spend Taiwan district and community hospital of Gaochun county in Nanjing from the 23rd of this month, will take the lead in the pilot project and implement a difference rate " The basic medicine system " ,Stipulate clearly the community hospital of the pilot project will only allow to use the basic medicine to enter the catalogue, do not make one fen on the medicine price, will also implement this system in an all-round way later. As to this, citizens take a welcoming attitude more, and some communities hospital " cautious optimism " ,Some combine actual conditions that they face, worry, will cause medicine " force, answer " patient while being enough implement, The large hospital, even will cause the new " the difficulty and high cost of getting medical treatment " Phenomenon. However, the community hospitals giving an interview all require it is " stealthy " .
Present situation
The basic medicine catalogue has not been assigned formally so far The medicine price of community's hospital is still higher than the dispensary
Will it be morning 15, blue flag the intersection of street and Mr. Wang, resident of Residential Area, telegraph this newspaper, reflect, say, the intersection of they and the intersection of community and the intersection of hospital and some costly than the intersection of outside and dispensary medicine of there. If cold drug price 8.8 three nine-day periods after the winter solstice, the intersection of benzene and yellow sour the intersection of ammonia and chlorine 27.4 in low flat slice, fat of blood health 14.8 yuan. A par dispensary on peaceful South Road of what he said of reporter is seen, the price of cold drug is 6.3 yuan in same three nine-day periods after the winter solstice brand and the same producer, low flat slice of yellow sour ammonia chlorine of benzene is 25.6 yuan, the health of fat of blood is 12.9 yuan.
Mr. Wang also says, he usually finishes reading the disease in the large hospital, and then hold the prescription form to go to community's hospital to take medicines, find some medicines of community's hospital higher than the dispensary medicine price of the par now, take medicines in the dispensary, also wrote a prescription to go to community's hospital to add some labour costs and hang water in the par dispensary sometimes.
The governments all say that will let citizens go to community's hospital to see the doctor, but wonder why the medicine price of community's hospital is higher than the dispensary.
It causes the price differential that purchase channels are different
A staff member of hospital of this community near the blue flag street tells reporters, the price of medicines is offsetted to some extent because channels that everybody stocks up are different to some extent, the par dispensary some medicines price is low because the purchase batch of the dispensary is large.
One of reporter make medical the intersection of friend and Xiao Zhang of representative reveal because some the intersection of community and hospital try " basic medicine system " now ,The one that was held is medicines of a price differential, because the other community hospitals should " raise " Doctor and nurse, so there is price differential in selling medicine, it is normal that prices are slightly a bit higher than the par dispensary.
The country has a relevant regulation to the selling medicine price of hospital of every rank, so long as the medicine price of community's hospital is allowed in the area where the country stipulates.
Moreover, in some community hospitals because many daily medicines enter the price of medicine low, consumption is large, it is lower than the par dispensary.
The catalogue was not assigned formally so far
Then, what does basic medicine catalogue system mean to community's hospital? An anonymous person in charge of hospital of community says, " national basic medicine catalogue " which Ministry of Public Health put out, aim at providing the medical guarantee for citizen and reducing the medical cost, the starting point is good, and pointed out community's hospital reforms the direction, it is basically feasible. But as a great system reform, there should be corresponding supplementary measure and operation regulation.
Community's hospital implements " The basic medicine catalogue " And then the lost part of price differential of medicines, how does the government compensate? If influence medical personnel's income and even influence community's hospital to survive after implementing, government ask bottom and how about ask ins and outs? Does not see these supplementary measures so far.
A Vice President of hospital of a community says even more, 599 kinds of basic medicine catalogues that will be implemented soon, he just sees from network too, but they have not received the formal notice in writing so far.
Worry Does the patient knows the quilt once again " Force " To the large hospital?
The person in charge of the hospital of a community of the west of the city says, daily medicine nearly have 500 multi-type at present in the hospital which they belong to, and 307 kinds stipulating of centre halfback's growing department of basic medicine catalogue are added by 292 kinds that Jiangsu Province augmented, there are 599 kinds in all, though the quantity is similar, some medicine their hospitals do not need in the catalogue, but the daily medicine that some patients need is " The catalogue " There is not China.
A person of willow is surnamed a patient as often going to their hospital to get it filled, take " catalogue " for a long time What China does not have is called " It is gentle to take the place of " Depressor. After the new rule is implemented, if does not allow community's hospital to buy " catalogue " on behalf Medicines outside, will cause such a patient's loss.
And to some section hospitals, this kind of contradiction is more conspicuous. It is so oncoming force must a little patient" Force " To the dispensary in the large hospital or society. And the intersection of community and one basic demand that hospital reform, or " small disease in community, serious disease gets to the hospital, recovers back to the community " ,Similar problem solve, can run counter to desire while being fine.
The expert of the high title acts as " Slice of medicine " Really waste resources
The reporter finds in the interview, it is more difficult that those make the transition for the situation of second hospital of community's hospital. A president of second hospital says, Ministry of Public Health no longer runs the statement of second medical organization in cities, but not stipulated original second hospital all change into community's hospital, this kind " makes it rigidly uniform " Method remain to be discussed.
Second present hospital is each medical organization which districts disposed in the main city, such important tasks as the medical care, the public health event happen suddenly which takes charge of the residents of this district is handled. After making the transition into community's hospital, the range of making a diagnosis is limited, some large and medium sized operations can't be done, the medical worker of the high-level and high professional title does not have ample scope for abilities, some large and medium sized medical facilities will be left unused. Taking their hospital as examples, there are more than 300 medical workers now, it is exactly high with ten or twenty medical workers of a high professional title, it is public and sanitary that these medical workers will be mainly engaged in residents too " Slice of medicine " Work, this is all the wasting seriously of a medical resource that put one's back into the country a few years ago. Six second hospital in the whole city of such a situation is roughly the same.
Paradox The hospital saw the doctor more to become instead " The bad thing "
Implement " basic medicine catalogue " After the system, there is not the price differential of medicines of community's hospital, the lost part is born by government finance, does not this have a question? Another person in charge of this hospital says, if have any further problems, and the big problem very different to solve.
Primary problem is working out, it is the personnel allocation that the people according to the basic population served of community's hospital definitely determine a post that adopt at present, then according to performance, service quality, patient's satisfaction, social assessment of the medical worker,etc., deficiency payment of offering.
But the problem is, like wearing community's hospital " cap " such as oneself Second hospital,because it is medical level high for community hospitals other, medical apparatus,etc. is advanced too, not only the residents of this community come to go to a doctor, the residents of other communities also come, far exceed the service population that asserts according to zoning, but medical workers on the permanent staff of the hospital do not have enough at all, in order to guarantee medical quality, have to recruit personnel and bear the expenses by oneself.
Because the hospital charges to collect according to the public service standard, the expenditure of recruiting the staff presses the cost of market, so to hospital such as them, medical care make well, make a diagnosis patient more, it is a one that sustain economic losses " The bad thing " ,This is obviously too unreasonable.
Helpless The president prevents the teacup from being broken again with the paper cup
When the reporter is interviewing the president of this hospital, find he makes tea with the paper cup. He explains, his teacup is washed and breaks his patient of the office to break by one. " basic medicine catalogue " Begin to implement in March, he is afraid, therefore will cause new contradictions of doctors and patients, he makes good preparations for washing and pounded again in the office, does not change the teacup, uses the paper cup.
As to " basic medicine catalogue " ,The difficulty that the hospital of this community meets is bigger, because it was second hospital, the project of making a diagnosis is up to 1100 multi-type in administration more, among them there are eight or nine hundred kinds of daily medicines, if according to " basic medicine catalogue " ,Existing medicines will be reduced by half soon quickly, how will the disease be returned to see?
In addition, should implement " catalogue " ,The tertiary hospital must coordinate to cooperate with community's hospital well, otherwise what patients prescribed in the tertiary hospital is a medicine, it is another kind of medicine to get back to what community's hospital prescribed, and medicine of community's hospital is cheap, the result is not so good as the tertiary hospital to hold naturally, he is afraid that there should be patients to break the president's office.
Whom the president worry about even more that allow community's hospital according to " catalogue " only Using medicine, some patients can only go back to the tertiary hospital again or buy medicines to the dispensary on the outside, this will make the patient diagnose the illness " It is still difficult, still expensive " . (Li Ke Zheng YouMing)
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