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Local：Home-> Industry The separate medical reform in Beijing will be fully implemented, and registration fees wi
Time：2020-08-17Click：
From dengyuan public number
On March 22, "Beijing medicine separate comprehensive reform implementation plan" was officially released.
Starting April 8, more than 3,600 medical institutions in the city's administrative region will eliminate drug mark-ups, set up medical service fees to replace drug mark-ups, registration fees and treatment fees, and adjust prices of 435 medical services, according to the plan.
Beijing medicine separate comprehensive reform press conference site
Photo credit: Xinhua/Zhang Chenlin
Question and answer on Reform Interpretation
For your convenience, the Beijing Municipal Commission of Health and Family Planning has produced a comprehensive policy map on the separation of medicine in Beijing, which I believe you have read. Beijing health and family planning commission official interpretation of the doctor more concerned about a few issues, the following will take you to have a look.
1. What is medical service charge?
Medical service fee is a charge item set up to compensate the operating cost of medical institutions after the cancellation of drug addition and registration fee in the comprehensive reform of medicine separation in Beijing, which reflects the labor value of medical personnel.
After the establishment of medical service fee, the original registration fee and consultation fee will be cancelled. In order not to increase the burden of medical treatment on the public, the Beijing Medical Insurance Fund has included the medical service fee into the coverage of basic medical insurance for urban workers, basic medical insurance for urban and rural residents, maternity insurance and work-related injury insurance.
2. When I register, I have to pay the medical service fee. Is it the increase of the registration fee?
The essence of medical service fee is to reimburse the operating cost and the medical team providing diagnosis and treatment services to patients after the medical institution cancels the drug addition and registration fee.
The goal of the reform is to cut off the compensation mode of hospitals and doctors making money by "prescribing medicine", and guide medical institutions and medical personnel to obtain reasonable compensation by providing more and better medical services.
3. What items have been regulated in the price aspect of the separate and comprehensive medical reform this time?
In the project arrangement, adhere to highlight the key points, step by step. Priority will be given to 435 medical services in five categories with prominent conflicts and high demands.
Specifically, they include:
125 comprehensive medical services (beds, nursing, etc.), accounting for 28.7%;
185 imaging diagnoses (CT, NMR, etc.), accounting for 42.5%;
96 medical services of Traditional Chinese medicine (acupuncture, massage, etc.), accounting for 22.1%;
There were 26 cases of clinical surgical treatment (appendectomy, etc.) and 3 cases of clinical physical therapy (radiotherapy, etc.), accounting for 6.7%.
4. How to reflect the "total volume control, there is a rise and a fall"?
Maintain the total amount of medical expenses in the city basically balanced, the price level "one rise and two falls" :
The price of the items reflecting the technical and labor value of medical personnel, such as beds, nursing, general treatment, surgery and traditional Chinese medicine, will be increased.
Reduced the price of CT, NMR and other large equipment inspection items;
Drug prices have been reduced through the elimination of drug mark-up and drug sunshine procurement.
5. What is sunshine shopping?
"Sunshine procurement" is a new mechanism of drug procurement in Our city, which is based on the original centralized procurement of drugs, giving full play to the decisive role of the market in the allocation of resources and better playing the role of the government to form a market-led price mechanism.
Through open and transparent, multi-party negotiation, dynamic adjustment, and results sharing measures, the government will strengthen comprehensive supervision, so as to achieve transparent procurement behavior and fair and standardized transaction process.
6. What measures did Sunshine Purchase adopt to reduce the price of medicine? Can ordinary people feel the benefits of lower drug prices?
In order to further reduce the artificially high price of drugs, for common drugs with sufficient supply on the market, the lowest procurement price at the national provincial level is dynamically linked with the procurement price of public medical institutions in the city, guiding the price of similar drugs in our city to remain at a lower level throughout the country.
For example, in 2015, the purchase amount of atorvastatin calcium tablets, the two major brands (imported lipitor and domestic Arlo) sold in Zhuhai, reached 824 million yuan. After the purchase of Sunshine, the purchase price decreased by 9.76% and 11.47% respectively. These two drugs alone can save purchase cost of 83 million yuan.
For example, "Hydroclopidogrel tablets" for cardiovascular and cerebrovascular anticoagulation, the two brands with the largest purchase amount (imported product "Polyvie" and domestic product "Taijia") in Zhuhai in 2015 were purchased with an amount of 831 million yuan. After the purchase of Sunshine, the purchase price decreased by 6.14% and 9.56% respectively, and the purchase cost could be saved by 60 million yuan.
After the official implementation of the procurement results, we will pay real-time attention to the centralized procurement results of other provincial drugs, dynamically adjust the minimum reference price of drugs according to the process, and set the price warning function in the procurement platform to warn high prices in real time.
7. The quality of drugs is related to people's life and health, how to ensure the quality and safety of drugs? Can the quality of the medicine be guaranteed not to deteriorate?
In sunlight procurement process, health and family planning commission will drug quality as the first element of evaluation of drugs, the existing serious adr events cause serious adverse social influence of enterprise, in the Beijing area of repeated serious illegal advertising enterprises and verify of commercial bribery, and production of proper varieties, there are serious quality problem for one ticket veto, directly into the bad record.
We have formulated an 11-item drug quality percentage evaluation system, and these indicators and evaluation results will be published to medical institutions. When medical institutions select drugs for their own units, they must pay attention to product quality, refer to the quality score, and encourage the continuous and stable supply of drugs with reliable quality and accurate efficacy.
8. How to realize the docking of drug catalogue between primary medical institutions and large hospitals? Are commonly used medicines in all secondary and tertiary care facilities available in the community?
Sunshine procurement adhere to the grassroots as the focus of the expansion of grass-roots medical institutions drug catalogue varieties.
We combine the drug procurement platforms of primary medical institutions and secondary and tertiary hospitals into one. Through the "one platform, the upper and lower linkage", the procurement catalogue of primary medical institutions and secondary and tertiary hospitals are consistent from top to bottom, laying the foundation for the hierarchical medical system and facilitating patients' access to medicines.
However, this does not mean that all drugs can be used in the community. On the basis of satisfying the needs of patients, community health service institutions must adhere to the principle of medical quality and safety, adhere to the principle of rational allocation of drugs in combination with functional positioning, adhere to the principle of priority of essential drugs, adhere to the principle of priority of four chronic diseases (hypertension, diabetes, coronary heart disease, cerebrovascular disease and other four chronic diseases) drugs.
How to ensure the supply of medicine in short supply?
In the drug sunlight procurement process, must for clinical treatment and irreplaceable shortage of cheap drugs, the net purchase directly, only listed the legality of the materials for the drugs to review of the public, not to set the national minimum reference price, supply and price can be adjusted at any time based on market supply and demand change, alleviate the problem of tight supply.
In view of the long-term shortage of drugs in the market, the MUNICIPAL Food and Drug Administration shall, on the one hand, take measures to encourage local enterprises to copy different kinds of drugs, and on the other hand, explore ways to sign long-term strategic cooperation agreements with foreign enterprises to ensure supply.
10. After the comprehensive reform of separating medicine, how do ordinary people apply for medical insurance reimbursement?
With regard to the measures to benefit the people through medical insurance, we have introduced a series of supporting measures in line with the reform to separate medical services. In particular, we have made it easier for patients with common diseases, chronic diseases and geriatric diseases to use medicines nearby in their communities, so as to avoid the trouble of having to travel to and from major hospitals for prescriptions.
Increasing the number of designated medical institutions in the community. At present, there are more than 1,400 designated medical institutions in the community, which are convenient for people to seek medical treatment nearby.
Unify the reimbursement scope of medical insurance drugs in community and large hospitals, and reimburse all drugs that can be reimbursed in large hospitals in the community;
Patients with 4 chronic diseases, such as hypertension, diabetes, coronary heart disease and cerebrovascular disease, can enjoy the convenience of reimbursement for 2 months.
Encourage community health institutions to carry out home-based home-based medical services and establish home hospital beds, and the medical expenses incurred in medical insurance shall be reimbursed in accordance with regulations;
No matter outpatient service and be in hospital, because condition needs, ginseng protect personnel to be able to carry on smoothly, transfer hospital;
"Differentiated" reimbursement policies for medical service fees are implemented for communities and large hospitals, so that the burden of patients seeking medical treatment in communities is significantly lower than that of large hospitals, and hierarchical diagnosis and treatment is promoted.
11. How to build a consultation platform to facilitate grassroots diagnosis?
The city and district will increase investment, strengthen the establishment of remote consultation information network system, promote the construction and application of "one multi-platform consultation center" and "four medical technology consultation centers" (ecg, pathology, examination and imaging), improve service efficiency, so that patients can get reasonable treatment in the shortest time and reduce disordered flow.
12. After the separation of medicine reform, pharmacists can not play a role?
The hospital will continue to provide pharmaceutical care after the drug surcharge is removed. The separation of medicine does not mean the weakening of pharmaceutical work, but more focus on the development of pharmaceutical technology and clinical services. The hospital pharmacy department will be the internal controller and cost controller for the rational use of medicines.
What about the pilot?
In fact, before this reform is fully implemented, Beijing has already concluded a lot of experience through the pilot.
Since the second half of 2012, Beijing has carried out the reform of separating medicine with the first batch of five public level-3 hospitals, namely Friendship Hospital, Chaoyang Hospital, Tongren Hospital, Tiantan Hospital and Jishuitan Hospital. After the reform, the proportion of non-conforming prescriptions dropped, the proportion of drugs decreased year by year, patients were rationally divided, the increase of medical expenses in hospitals slowed down, and the burden of personal expenses for medical treatment remained stable.