公立醫(yī)院已全部開展綜合改革
China will carry out reforms at public hospitals to optimize medical care resources, according to a decision made at a State Council executive meeting chaired by Premier Li Keqiang on Monday.
國務(wù)院總理李克強(qiáng)10月9日主持召開的國務(wù)院常務(wù)會議指出，我國將推進(jìn)公立醫(yī)院改革，優(yōu)化醫(yī)療保障資源。
Reforms in the pricing of medical services will continue to move toward dynamic price adjustments to better reflect the expertise of medical workers, the panel determined.
會議決定，醫(yī)療服務(wù)定價機(jī)制改革將繼續(xù)推進(jìn)動態(tài)價格調(diào)整，以更好地反應(yīng)醫(yī)務(wù)工作者的專業(yè)能力。
今年的《政府工作報告》指出，“全面推開公立醫(yī)院綜合改革，全部取消藥品加成，協(xié)調(diào)推進(jìn)醫(yī)療價格、人事薪酬、藥品流通、醫(yī)保支付方式等改革(We will introduce overall reform in public hospitals nationwide, abolish all markups on pharmaceuticals, and make coordinated progress in reforming health care pricing, staffing and remuneration, medicine distribution, and models of health insurance payment)。”
會議指出，到今年9月全國所有公立醫(yī)院已全部開展綜合改革，逐步建立了維護(hù)公益性、調(diào)動積極性、保障可持續(xù)的運(yùn)行新機(jī)制(public-oriented, motivated and sustainable mechanism)。
截至目前，醫(yī)改已經(jīng)取得了一定的成效，取消了實行60多年的藥品加成政策(drug price markups removed)，醫(yī)院收入的藥占比(drug sales as a share of total revenue for hospitals)從2010年新一輪醫(yī)改之初的46.3%降至2016年的38.1%，居民個人衛(wèi)生支出占衛(wèi)生總費(fèi)用比重從2008年的40.4%降至2016年的30%以下，65%的二級以上公立醫(yī)院開展了按病種付費(fèi)的醫(yī)保支付方式改革(reform of category-based insurance payment)，患者就醫(yī)負(fù)擔(dān)持續(xù)下降。
公立醫(yī)院綜合改革接下來的任務(wù)包括：
一是要完善公立醫(yī)院運(yùn)行新機(jī)制(to improve the new mechanism of public hospital operation)。
二是用體制機(jī)制改革推進(jìn)醫(yī)聯(lián)體建設(shè)(to speed up efforts to establish medical treatment partnerships to promote effective cooperation and coordination between different types of medical institutions)。
三是有關(guān)部門要集中力量開展疑難高發(fā)癌癥治療(treatment of difficult and high-incidence cancer)專項重點攻關(guān)，采取措施支持發(fā)展先進(jìn)醫(yī)療設(shè)備和醫(yī)藥產(chǎn)業(yè)，突破提純、質(zhì)量控制等關(guān)鍵技術(shù)。
四是以“互聯(lián)網(wǎng)+醫(yī)療”(Internet plus medical care)破解難題，加快推廣遠(yuǎn)程醫(yī)療(telemedicine)、預(yù)約診療(medical service pre-registration)、日間手術(shù)(daytime surgery)等醫(yī)療服務(wù)模式，推動在醫(yī)療機(jī)構(gòu)之間實現(xiàn)就診卡和診療信息共享，深入推進(jìn)家庭醫(yī)生簽約服務(wù)，全面推進(jìn)醫(yī)療便民惠民服務(wù)。
