Tianjin health care reform set seven key tasks in public hospitals canceled drug addition-3344111

Tianjin health care reform set seven key tasks of public hospitals canceled drug addition, the deepening comprehensive reform plan of medical and health system have been identified within the year, identified seven key tasks in basic medical and health system construction, through the promotion of grading clinics, modern hospital management, the reform of health care, drug supply, comprehensive supervision and other key areas and key links, to 2020 to enable the city to establish a comprehensive national basic medical and health system matched with the high quality of the well-off society, the construction of basic medical and health care system, medical security system and the construction of national basic medical and health service level at the forefront of the country. To strengthen the grassroots level as the focus of the establishment of hierarchical diagnosis and treatment system, by 2020, to achieve every 10000 permanent residents with more than 3 general practitioners. The formation is composed of community nurses, public health physician of the family doctor service team, to 2017, family doctor service coverage of more than 30%, focus groups signing more than 60% coverage, and strive to 2020 family physician system to achieve full coverage. In 2017, the city opened in the construction of regional medical conjoined, relying on three hospitals built a regional consultation center in the District of conjoined, to promote telemedicine services, achieve the mutual recognition of the test results of conjoined in; explore the implementation of medical insurance fund payment reform package body. By 2017, 40% of patients with diabetes and hypertension pilot diseases should be treated at the grassroots level. Implement differential medical insurance reimbursement policy, appropriately improve the outpatient reimbursement rate of first level hospitals, reduce the outpatient reimbursement rate of two or three level hospitals simultaneously, give preferential treatment to patients transferred from primary health care institutions to higher level hospitals, and appropriately increase reimbursement ratio. In order to build a mechanism to focus on establishing modern hospital management system implementation of public hospital operation and management autonomy, the implementation of occupation management and general accounting system, the phasing out of the public hospital administrative level, the first in the Medical University General Hospital, second hospital to carry out a comprehensive reform pilot. During the year, the total amount of drugs added to the public hospitals in the city was cancelled, and the fees for large medical inspection equipment were reduced, and the consumables addition was cancelled in 2017. More than two hospitals established drug use dynamic monitoring and ultra long use early warning system, strengthen the use of drugs, high-value medical consumables and health materials monitoring; by 2017, the proportion of public hospital drug fell to 30% (excluding Chinese herbal pieces). In order to protect the basic focus and improve the universal health care system to explore the integration of workers and residents medical insurance system; to explore the dynamic adjustment mechanism of individual contributions and income, financial subsidies and economic growth coordinated; gradually improve the health of urban and rural residents per capita subsidies and individual payment standard, steadily improve the residents Medicare inpatient treatment level; the medical expenses advanced network card delay settlement. The composite type of propulsion total management, capitation, DRGs combined with the implementation of outpatient payment reform; capitation, preference for diabetes, hemophilia and other medical treatment burden of outpatient special disease and chronic disease to carry out the pilot, and gradually expand the scope of diseases and medical institutions to promote the city. In order to reduce costs, we should improve the drug supply security system through bidding, bargaining and consultation.

天津医改设七项重点任务 公立医院年内取消药品加成   本市深化医药卫生体制综合改革方案已经确定,明确了在基本医疗卫生制度建设中的七项重点任务,通过推动分级诊疗、现代医院管理、全民医保、药品供应保障、综合监管等重点领域和关键环节改革,到2020年使本市全面建立与高质量小康社会相匹配的全民基本医疗卫生制度,全民基本医疗卫生制度建设、全民医疗保障制度建设和基本医疗卫生服务水平走在全国前列。   以强基层为重点建立分级诊疗制度   到2020年,实现每万名常住人口拥有3名以上全科医生。组建由社区护士、公共卫生医师等构成的家庭医生服务团队,到2017年,家庭医生签约服务覆盖率达30%以上,重点人群签约覆盖率达到60%以上,到2020年力争家庭医生签约服务制度实现全覆盖。2017年,在全市推开区域医联体建设,在各区医联体中依托三级医院建成一批区域会诊中心,推进远程医疗服务,实现医联体内检验结果互认;探索实施医联体内医保基金打包付费方式改革。到2017年,实现40%的糖尿病、高血压试点病种患者到基层就诊。实行差别化医保报销政策,适当提高一级医院门诊报销比例,同步降低二、三级医院门诊报销比例,对从基层医疗卫生机构向上级医院转诊的患者给予优惠,适当提高报销比例。   以建机制为重点建立现代医院管理制度   落实公立医院运营管理自主权,推行院长职业化管理和总会计师制度,逐步取消公立医院行政级别,率先在医大总医院、市第二医院开展综合改革试点。今年年内,取消全市公立医院药品全部加成,同时降低大型医用检查设备收费,2017年取消耗材加成。二级以上医院建立药品使用动态监测和超长使用预警系统,加强对药品、高值医用耗材和卫生材料等的使用监控;到2017年,公立医院药占比总体降至30%(不含中药饮片)。   以保基本为重点完善全民医保体系   探索整合职工和居民医保制度;探索个人缴费与居民收入、财政补贴与经济增长相协调的动态调整机制;逐步提高城乡居民医保人均财政补助和个人缴费标准,稳步提高居民医保住院待遇水平;实行垫付医疗费用联网刷卡延时结算。推进总额管理、按人头付费、按病种付费等相结合的复合型付费方式改革;结合门诊实行按人头付费,优先选择糖尿病、血友病等医疗负担重的门诊特殊病、慢性病开展试点,逐步扩大病种和医疗机构范围向全市推广。   以降低成本为重点完善药品供应保障体系   通过竞价、议价、询价等多种手段,开展药品和耗材集中采购,实现供需双方直接交易,降低药品和耗材采购价格。推行从生产企业到流通企业、从流通企业到医疗机构各开一次发票的“两票制”,探索医疗机构与生产企业直接结算药品和耗材货款、生产企业与配送企业结算配送费用的“一票制”,减少药品流通环节。   以全行业为重点完善综合监管体系   建立并完善多部门参与的联合执法机制,杜绝“大检查”“大药方”等过度医疗行为,打击欺诈骗保等违法行为,查处药品耗材购销领域商业贿赂行为。建立社会监督员制度,建立第三方专业机构参与公立医院绩效考核评价机制。   以均等化为重点完善公共卫生服务体系   加强儿童、孕产妇系统保健和三级预防措施,有效监测和干预影响妇女儿童健康的重点问题;全面完成市、区两级疾控机构标准化建设,做好艾滋病、肺结核等重大传染病、重点地方病防治;规范设置市、区两级精神卫生中心,建立覆盖全市的精神卫生防治网络。   以信息化为重点建设智慧医疗   构建全市医疗、医保、医药“三医一体化”的大健康信息共享平台,实现医疗、医保、医药等网络数据信息的互联互通。建立全市统一的电子病历和住院病案首页;整合居民、用人单位、医疗服务机构、医师药师、药品、耗材、价格、检查检测结果、电子病历、健康档案等各类数据,推动大健康数据协同共享。加快实施居民健康卡与社会保障卡“双卡合一”,实现医疗健康“一卡通”。相关的主题文章:

 

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