National Assessment Group: The problem of high prices of supplies in Fujian can not be ignored

According to the unified deployment of the State Council Health Reform Committee and the State Council's Health Reform Committee, April 25th to 21st, the effectiveness of the comprehensive reform of public hospitals in the country was evaluated by Jiang Jianming, deputy director of the Hebei Provincial Health and Family Planning Commission. Nine people from the appraisal group came to our province to carry out the reassessment of the evaluation of the comprehensive reform of public hospitals.

According to the request, the re-evaluation team listened to the reports of the comprehensive reforms of Longyan City, Zhenghe County, and the province's public hospitals. They discussed the opinions of the hospital administrators, medical staff, and patients in the forms of interviews, interviews, and questionnaires; Through review of data, on-site data approval, etc., self-assessment of the evaluation of the overall reform effect of provincial and county-level public hospitals, review materials at the provincial level, etc. were checked one by one.

On April 20, the province’s provincial hospital comprehensive reform provincial report and feedback meeting was held in Fuzhou. At the meeting, the deputy inspector of the provincial government office and the deputy director of the provincial medical reform office Li Wenzhe introduced the comprehensive reform of public hospitals in our province to the review team. The situation pointed out that the Fujian Provincial Party Committee and the provincial government have attached great importance to the comprehensive reform of public hospitals and strictly followed the national plan for the deployment of medical reforms and national health and health The spirit of the conference has made great efforts in deepening the key areas and key links in the comprehensive reform of public hospitals. First, we insist on high-level promotion and effectively strengthen the overall reform of the medical reform; Second, we must eliminate the use of drugs to supplement medical services and establish a compensation mechanism for public hospitals; Medical insurance function to solve the problem of management fragmentation; Fourth, do a good job of controlling fees and strengthen the public welfare nature of public hospitals; Fifth, reform the operating mechanism and increase incentives and constraints for medical staff; Sixth, 'grab both ends, supplement short boards', accelerate Build a hierarchical diagnosis and treatment system.

According to the medical reform monitoring, the public hospitals in the province had a “four-liter, five-drop” trend in 2017, ie the proportion of medical service revenue, the proportion of personnel expenditure to business expenditure, the proportion of outpatient emergency medical services at the primary level, the overall hospital satisfaction, etc. Increase; medicine The increase in expenses, the increase in the average cost of outpatient and inpatient expenses, and the average length of stay of discharged patients decreased.

After the re-evaluation team heard the provincial work report and completed the re-evaluation work, Jiang Jianming, deputy director of the re-appraisal group on the public of Fujian Province hospital Feedback on the results of the comprehensive evaluation of the comprehensive reform evaluation was conducted. It was believed that the comprehensive reform work of public hospitals in Fujian Province under the leadership of the provincial party committee and the provincial government attached great importance and strengthened leadership. It summed up the experiences of Sanming, Xiamen and other places in the first trial and revolved around the people's difficulty in seeing the doctor. The problem of “expensive medical care” has brought forth a new path for the reform of the “three-drug linkage” public hospitals; in 2017, it continued to seize the key to the reform of the institutional mechanism, adhered to problem-based guidance, continuously adjusted and improved related policies, and achieved significant results.

The main highlights and lessons worth learning are as follows: First, highlight the 'top leaders' responsibility, strengthen the promotion mechanism of medical reform. Second, integrate the functions of 'drug price protection' and innovate the medical insurance management system. Third, adhere to the principle of 'guarantee convergence' and establish public hospital compensation. The fourth mechanism is to implement the 'strong grassroots' initiative and accelerate the promotion of grading diagnosis and treatment. The fifth is to implement the 'annual salary system' reform to mobilize the enthusiasm of medical personnel. In particular, the reform of the medical insurance management system provides the establishment of the Medical Security Bureau in the State Council’s institutional reform this year. A good reference.

While fully affirming the achievements of the comprehensive reform of public hospitals in Fujian, Jiang Jianming, the team leader, also pointed out that medical reform is a global problem after all. With the continuous deepening of reform, it will inevitably face new problems and new challenges. Fujian is no exception. In addition to Sanming City, the income structure of public hospitals in provinces and other regions is still not optimized. In particular, the issue of high consumables prices cannot be ignored, and the price of medical services needs to be further adjusted; the primary medical and health institutions have a low proportion of outpatients. At the national average level, basic medical service capabilities urgently need to be improved; the financial long-term investment mechanism needs to be further improved. At the same time, we hope that Fujian Province can continue to try and continue to provide more useful experience for national medical reform.

Zhao Zhiqiang, deputy director of the Provincial Party Committee, Chen Xiaochun, deputy director of the Provincial Health Planning Commission, and Gao Yan, deputy director of the Provincial People's Association, Provincial Health Reform Commission, Health and Planning Commission, People's Club, Department of Finance, and Health Insurance Office attended the meeting. Report, feedback meeting.