21,000 medical institutions, stopped outpatient infusion! Consumables affected

Medical Network July 6th Wide range! 21,000 medical institutions are required to stop outpatient infusion. Some medical consumables related to this will be affected.

On July 4th, the Guangxi Health and Family Planning Commission issued the Notice of the Office of the Autonomous Region Health and Family Planning Commission on the revision of the Notice of the Autonomous Region Health and Family Planning Commission on Regulating the Management of Intravenous Infusions in Medical Clinics (Draft for Comment) (hereinafter referred to as the Notice) ) .

The Notice mainly has the following two requirements:

1, the second-level and above medical institutions in the district (including comprehensive hospital , specialist hospitals, Chinese medicine hospitals, maternal and child health hospitals, private hospitals, etc.) On August 1, 2018, in addition to pediatric outpatient and emergency department, the outpatient intravenous infusion service was completely stopped.

Primary medical institutions (including community health service centers (stations), township health centers, village clinics), clinics, outpatient departments, first-level medical institutions in line with medical institutions standard , "Administrative Measures for the Clinical Application of Antimicrobial Drugs" (Order No. 84 of the Ministry of Health), Regulations on the Administration of Rural Doctors (Order No. 386 of the State Council), "Administrative Measures for Prescriptions", "Administrative Measures for Medical Institutions in Guangxi", "Guangxi Zhuang" The Autonomous Region's Clinical Application Classification Management (Trial) Notice (Guo Wei Medical [2012] No. 80), etc., can only carry out outpatient intravenous infusion services. Since September 1, 2018, the grassroots medical and health institutions in the district have also Should gradually reduce the outpatient intravenous infusion medical services.

According to statistics from the Health Planning Commission, in 2017, there were 34,012 health and family planning institutions in Guangxi, including 20,770 village clinics and more than 300 secondary and above medical institutions. In other words, in fact, the total number exceeded 21,000. Medical institutions must be banned from infusion.

In addition, the Longgang District of Shenzhen City has also stopped the intravenous infusion of medical institutions from July 1st.

The rules of Longgang District are as follows:

(1) Public hospitals (including first-class hospitals) in Longgang District, except for the emergency department, stop the general intravenous infusion service.

(2) Chinese Medicine Museum, Chinese Medicine Clinic, Medical Office, since July 1, 2018, infusion therapy is forbidden.

community health Service Center, Outpatient Department, Western Medicine Clinic, July 1, 2018, in principle, infusion therapy for 53 common diseases and multiple diseases is prohibited.

The number of medical institutions that stopped intravenous infusions in Longgang District, Shenzhen, was significantly larger than that in mid-April.

According to the official WeChat report of the Shenzhen Health Planning Commission, on April 6, Shenzhen Longgang Central Hospital has officially canceled the general outpatient intravenous infusion. At this point, 12 districts in Longgang District are public hospitals, all of which have stopped intravenous infusions in general outpatient clinics.

The scope of this ban on infusion has been extended from public hospitals to the infirmary, community health service center. It can be seen that the breadth of infusion is prohibited from extending further to the grassroots. According to statistics, at least 11 provinces and municipalities have issued corresponding policies so far. , for the grassroots infusion restrictions.

According to the statistics of the Cypress Blue-based doctors' commune, there are currently at least 11 provinces in the country that support the infusion of the village clinics and clinics:

Anhui: In August 2014, Anhui Province took the lead in proposing 53 lists of common diseases that do not require intravenous infusion.

In June 2017, the Shandong Provincial Health and Family Planning Commission issued the “Notice on Strengthening the Clinical Application Management of Antimicrobial Drugs to Curb Bacterial Resistance”, requiring the management of outstanding problems such as preventive use, combined use and intravenous infusion of antibiotics for outpatients.

Medical institutions and medical personnel must strictly control the use of antibacterial drugs to prevent infection, strictly control the proportion of antibiotics used in intravenous infusions in outpatients. Strengthen the clinical application management of antibacterial drugs in primary medical institutions, use antibacterials in village clinics, clinics and community health service stations. 2. Drugs for intravenous infusion activities must be approved by the county health and family planning administrative department.

In August 2017, the Guangxi Zhuang Autonomous Region Health Planning Commission issued the “Administrative Measures for Medical Institutions in Guangxi Zhuang Autonomous Region”, which clearly stipulates that medical institutions are not equipped with registered physicians, nurses and pharmacy technicians who have been qualified according to law, and there is no corresponding emergency medical equipment. Carry out intravenous drug business.

Shaanxi: No infusion service can be carried out without approval

In April 2016, the health department of Baoji City issued the “Notice on Strengthening the Management of Intravenous Infusion in Village Clinics”, proposing that village clinics that meet the requirements and can carry out infusion services must be declared by the health authorities under their jurisdiction. After the district health and family planning administrative department approves and records the infusion, the infusion service can be carried out and included in the annual review of the village clinic. The infusion service may not be carried out without approval.

In May 2016, the Hunan Provincial Health and Family Planning Commission issued the “Implementation Rules for the Administration of Village Health Offices in Hunan Province (Trial)”, which clarified that the village clinics can only infuse the following conditions, and the standard is prohibited. Drug delivery service:

1. It has an independent intravenous observation room and an observation bed, and the use area of ​​the observation room is not less than 10 square meters;

2. Equipped with commonly used rescue drugs, equipment and oxygen supply;

3. Have the conditions for intravenous drug configuration;

4. Village clinic personnel who carry out intravenous drug delivery services should have ambulance measures and first aid capabilities to prevent and treat infusion reactions;

5. Carrying out the intravenous administration of antibacterial drugs should comply with the relevant regulations on the clinical application of antibacterial drugs.

Beginning in April 2016, according to the Jiangsu Provincial Antibacterial Drug Clinical Application Classification Management Regulations, the village clinic is not allowed. purchase The following antibiotics: azlocillin, amoxicillin clavulanic acid, cefotaxime, cefixime, ceftizoxime, azithromycin injection, levofloxacin injection.

The notice is sent directly to the purchasing and dean of the hospitals. The hospitals are required to carefully review the village clinic procurement plan and strictly check it. Otherwise, any consequences will be caused by the president of the hospital.

As early as 2012, the Health Department of Gansu Province issued the "Notice on Regulating Intravenous Infusions in Village Clinics", which stipulated that the village clinics held by the government within the province could not carry out intravenous infusion business without approval.

The village clinics that have confirmed violations shall be given a warning and ordered to make corrections within a time limit; if they fail to make corrections within the time limit, they shall be ordered to suspend their practice activities for more than 3 months and less than 6 months; the village clinics with serious circumstances shall cancel their designated medical institutions for new rural cooperative medical institutions. 3. Qualification, the rural license certificate is revoked by the original license department.

In March 2016, Chengdu, Sichuan Province penalized six clinics for “intravenous use of antibiotics for intravenous infusion activities”, with a maximum fine of nearly 20,000, and the Municipal Health Planning Commission issued administrative penalties on the health official website.

Hubei: In May 2017, all village clinics in Yidu City, Hubei Province, individual clinics may not carry out intravenous infusion business without approval.

Guangdong: In July 2017, Guangdong Province issued a document to strictly manage the intravenous infusion of primary health care institutions, and clarified that 53 common diseases should not be infused in principle.

Hainan: In August 2017, the Hainan Provincial Health Planning Commission determined the list of 53 common diseases that do not require infusion therapy.

In general, there are four main types of measures for restricting grassroots infusion in 11 provinces and cities:

The first category is Anhui, Guangdong, Hainan, to determine the list of common diseases that do not require infusion, to limit the infusion from the disease;

The first category is Shandong, Shaanxi, Hunan, Gansu, Sichuan, Hubei, and the infusion is pre-recorded for approval to restrict infusion;

One type is Jiangsu, starting with restricting the procurement of antibacterial drugs;

The last category is Guangxi, which imposes strict restrictions on the infusion qualifications of primary care institutions.

Taken together, these four categories are undoubtedly the most powerful measures in Guangxi, and the limiting effect is also the strongest. In fact, as early as 2014, the National Health and Family Planning Commission issued a similar document - "Village Health Office Management Measures (Trial) 》.

The method clearly stipulates that the village clinic must have the following conditions at the same time, and the intravenous drug delivery service can be provided after approval by the county health and family planning administrative department:

(1) Having an independent intravenous observation room and observation bed;

(2) equipped with common rescue drug , equipment and oxygen supply facilities;

(3) Having the conditions for the configuration of intravenous drugs;

(4) Village clinic personnel who carry out intravenous drug delivery services shall have ambulance measures and first aid capabilities to prevent and treat infusion reactions;

(5) The implementation of the intravenous administration of antibacterial drugs shall comply with the relevant provisions on the clinical application of antibacterial drugs.

It can be seen that among the five requirements of the Health Planning Commission, only the second one is equipped with commonly used rescue drugs, equipment and oxygen supply facilities, and there are a large number of village clinics that cannot meet the standards. A large number of village clinics do not qualify for infusion.