患者可两年内分期支付医疗费 Patients can be an installment payment medical treatment within two years

6月起山东全省县级医院推广先看病后交钱 6 month shandong province county hospital to see a doctor, make money after first promotion

全国已有10多个省份 200 家医疗机构去考察 The country had been more than 10 provinces of 200 medical institutions to explore

　　入院不用交押金，只需留下医保或新农合证件，与医院签订协议，出院时结算自付部分。如果不是因为两年前的一场困境，山东兖州中医院还只是一个普通的县级医院，孔庆民的名字在医改领域也不会为人熟知。如今，兖州中医院被看作是“先看病，后交钱”服务模式的成功先行者，接待全国各地的学习考察团也成为孔庆民日常工作的一部分。

Hospital to use pay the deposit，Just leave medical insurance or new farming and certificates，Signed an agreement with the hospital，The hospital settlement pays part。If not for the two years ago a dilemma，Shandong yanzhou city hospital was just a common county hospital，KongQingMin name in the medical sector will not well known。now，Yanzhou city hospital is seen as“To see a doctor，Make money after”The success of the service mode pioneer，Reception of the study tour around the country KongQingMin also become part of the daily routine。

　　目前，这一模式已在全国10多个省份部分医院推行。今年6月，山东开始在全省县及县级以下医院全面推行，至7月底山东只有120名患者逃费，占所有“先看后付”患者的0.013%，这个比例在山东省卫生厅看来并不高。

At present，The model in the country has more than 10 provinces hospital implementation part。In June this year，Shandong province began in counties and below the county level the full implementation of the hospital，To the end of July, shandong only 120 patients fled fee，Accounted for all“See first pay later”0.013% of the patients，The proportion in the shandong province health department does not appear to be high。

先看病后交钱就诊流程 After the first doctor make money medical procedures

　　门(急)诊就诊，确定是否住院治疗。持住院通知书到住院处做入院登记，办理住院手续。向医保办提供医保或新农合证，核查身份确定是不是医保、新农合范围。向住院处提供医保、新农合证及身份证或户口本复印件，与住院处签订《住院病人出院结算协议书》。持住院通知书、《住院病人出院结算协议书》到病房住院治疗。住院将要结束时医护人员告知住院期间大体所花的费用及需要个人承担的大致费用，以备筹款出院结算。接出院通知后，在医护人员帮助下到医保处办理出院结算报销手续。到住院处结算交费办理出院手续。出院。与医院签订住院病人分期(缓期)还款协议书，作分期还款处理。

door(urgent)Clinical medical，To determine whether the hospital。The hospital admission notice to ZhuYuanChu do register，Formalities of be in hospital。To provide health insurance or medical insurance for new farm and certificate，Check identification is health care、New farming close range。ZhuYuanChu to provide medical care、New farming and card and id card or copy of registered permanent residence，And ZhuYuanChu sign《Hospital patients discharged settlement agreement》。Notice the hospital、《Hospital patients discharged settlement agreement》To ward hospitalization。The end in hospital medical staff told during be in hospital in the expenses and need to individual to assume the likely costs，To prepare for fundraising discharge settlement。Meet discharge after notice，In the medical staff to help medical insurance place go through the discharge formalities settlement to submit an expense account。To ZhuYuanChu settlement fee go through the discharge formalities。discharge。Signed with the hospital patients hospitalized in staging(With suspension)Reimbursement agreement，Be in installment reimbursement processing。

院长突围 Dean breakthrough

在成都开会先看病后交钱吸引了他，诱惑了他 The meeting after a doctor in chengdu first hand in money attracted him，Tempted him

　　时间退回到2年前。2010年8月，孔庆民时任济宁兖州市第二医院院长，当时医院欠债近6000万元，新建的13层大楼因为没钱空着5层没装修。此时，孔庆民接到兖州市二医院与兖州中医院合并的通知。

Time to go back to 2 years ago。August 2010，Then the second hospital YanZhouShi jining KongQingMin dean，When hospital in debt nearly 60 million yuan，The new 13 layer building because no money empty 5 layers didn't decorate。At this time，KongQingMin received YanZhouShi two hospital and the notice of yanzhou hospital merger。

　　当年10月，两院完成合并。从原中医院过来的不仅有149个员工，还有1000万元的债务，新的兖州市中医院负债7000万元。而2009年，原兖州二院全年业务收入仅为2900万。

In October，Senate complete the merger。From the original hospital come over not only have 149 employees，And debt of $10 million，New YanZhouShi hospital liabilities 70 million yuan。And in 2009，The second annual business income of yanzhou only for 29 million。

　　忆及当初，孔庆民直言感觉很郁闷：“这么多医务人员总要吃饭吧？压力大，一下不知所措。”同年11月底，第四届中国医院院长年会在成都举行，孔庆民来参加。会上，他专挑关于基层医院如何适应医改的论坛听，郑州市金水区医院对贫困的新农合患者实行“先看病，后交钱”的分期付款方式吸引了他。

Recalls that had，KongQingMin to feel very depressed：“So many medical personnel total want to eat？Pressure big，Once at a loss。”In the same year the end of November，China fourth annual meeting held in chengdu hospital director，KongQingMin to。meeting，He designed pick about how to adapt to the cure of basic-level hospitals BBS to listen to，Zhengzhou jinshui district hospital in poverty and patients in new farm“To see a doctor，Make money after”The payment by installment attracted him。

　　“先看病，后交钱，这6个字太诱人了！”还在会场，孔庆民就盘算在该院实行，扩大推行面。孔庆民说，当时医院的状况是：在职人数多，接近500人；编制床位400多张，但住院病人仅200人，大量床位空起。“反正都是这么个状况了，破釜沉舟，一定要改变。”

“To see a doctor，Make money after，The six words irresistible！”Is still in the，KongQingMin in a planned nays，Expand TuiHangMian。KongQingMin said，At that time the status of the hospital is：On-the-job number more，Close to 500 people；More than 400 zhang authorized beds，But only 200 patients hospitalized，A large empty bed up。“It's such a situation，with，Must change。”

改革实施 reformation

患者没钱看病可两年分期付款 Patients have no money to see a doctor can two years payment by installment

　　2010年12月初，孔庆民去郑州考察后定了实施方案。12月27日全院召开动员大会，正式开始实施“先看病，后交钱”。

In 2010, in early December，KongQingMin to zhengzhou inspected after set the implementation plan。December 27, at partial mobilization meeting，Formally implement“To see a doctor，Make money after”。

　　实施前，孔庆民算过一笔账，原则上医院也不会亏，顶多白忙活。“可如果患者全逃费，这个社会就太可怕了。”

Before the implementation of，KongQingMin calculate on a bill，In principle, the hospital will not deficient，At most white get busy living。“But if patients all fled fee，This society is terrible。”

　　“先治病，后交钱”实施范围为参加城镇职工基本医疗保险、城镇居民基本医疗保险和新型农村合作医疗的居民，“三无”病人(无姓名、无住址、无陪人)，以及病情严重需采取紧急救治的患者。因交通事故、打架斗殴等责任事故受伤致病者、未参加医保或新农合的患者等不在实施范围内。

“Does first，Make money after”Scope of implementation for the town worker is basic medical insurance、Urban resident basic medical insurance and the new rural cooperative medical residents，“3 without the”The patient(No name、No address、With people without)，And in serious condition should be taken to the emergency treatment of patients。Because of a traffic accident、The fight and liability accident injury the disease、Not medicare or new farming, the patient and not within the scope of implementation。

　　病人在出院时只缴纳报销后的自付部分。实在交不起，可与医院签协议，两年内分期或一次性付清医疗费。

The patient in the hospital only pay after the part of the reimbursement pay。Really can not afford to pay，With the hospital can sign the agreement，Two years stage or paid off in medical treatment。

　　3个月后，“先看病，后交钱”模式甜头初现。兖州市中医院住院患者数达到300多名，5月份住院人数已保持在400人左右。直到现在，孔庆民仍不否认改革的初衷是为了“吸引更多患者来看病。”

Three months after，“To see a doctor，Make money after”Miley mode is beginning。YanZhouShi hospital inpatients' number to more than 300，In may the number of hospital stays at about 400。Until now，KongQingMin still don't deny that the reform of the original intention in order to“To attract more patients to see a doctor。”

　　2010年，兖州市中医院全年业务收入4600万，2011年这个数字达到9100万，增长几乎翻番。“简直是不可思议的发展。”孔庆民说，想到会有改变，但没想到改变如此明显。这种服务模式，让医院和患者实现了双赢：不仅吸引了患者来源，也使医院的公益性得以体现。

2010 years，YanZhouShi hospital operation income is 46 million throughout the year，In 2011 the number to 91 million，Growth nearly doubled。“It is incredible development。”KongQingMin said，Think of will have changed，But it wasn't so obvious change。The service mode，Let hospitals and patients achieve a win-win situation：Not only attracted patients source，Also make the hospital is reflected the public welfare。

　　截至目前，该院已有2万4千多例患者“先看病，后交钱”，占全院住院患者92%以上，没有一例恶意欠费，也没有人实行分期付款。

So far，The more than 24000 patients“To see a doctor，Make money after”，Institution of hospitalized patients with more than 92%，Not a malicious to owe a fee，And no man a payment by installment。

　　孔庆民分析，该院住院平均费用为3600元左右，自付部分本来就只有一两千元，患者有能力承担，逃费风险小。另外社会诚信度提高，“为一千多元钱逃费上黑名单不值得。”

KongQingMin analysis，The average cost in hospital for 3600 yuan，Since pay part could only 12000 yuan，Patients have the ability to bear，Fled fee small risk。Additional social integrity improve，“For one thousand multivariate money fled the blacklist is not worth the cost。”

改革反馈 Reform feedback

济宁模式迎来十省取经 Ten provinces to take in jining mode

　　7月24日，兖州市中医院迎来了山东菏泽巨野县的一个考察团。2011年以来，已有10多个省份的200多家医疗机构前来考察，这种效应与当地政府部门的推动和媒体报道不无关系。

July 24，YanZhouShi hospital ushered in the shandong heze the juye a tour。Since 2011，More than 10 provinces of the more than 200 medical institutions to investigate，This effect and local government departments to promote and media reports do not have nothing。

　　在孔庆民看来，政府的推动热情超出想象。2011年3月，济宁已有相关领导来考察。5月18日，济宁市卫生局在兖州中医院开现场会，发出《关于在全市医疗机构推广先看病后付费就诊模式的指导意见》，要求6月底前各县市区选一家中医院、乡镇卫生院试点，二级以上综合医院及三级中医院启动临床科室试点。

In KongQingMin seems，The government's push beyond imagination enthusiasm。March 2011，Has relevant leaders to investigate apoptosis。May 18，Jining city health bureau in yanzhou city hospital will open，issued《About in the whole city medical institutions to pay medical doctor promotion after the model guidance》，Request before the end of the counties 6 choose a hospital、The new pilot，The second class above general hospital and level 3 hospital start clinical departments pilot。

　　今年2月，济宁市卫生局发文，在全市各级各类医疗机构全面推行该模式。接受华西都市报采访时，济宁市卫生局医政科科长仲署光说，不管兖州中医院改革的初衷如何，这一模式确实实施效果好，值得推广。

February，Jining city health bureau dispatch，In the city of medical institutions at various levels and the full implementation of the model。Accept of west China city newspaper in an interview，Jining city health bureau YiZhengKe section chief still department light said，No matter how the original intention of yanzhou hospital reform，The model really good effect，Worth popularization。

　　据华西都市报记者不完全统计，自2011年5月至今年4月不足一年时间，围绕“先看病，后付费”，济宁市相关部门已下发12个文件，涵盖多项推动该模式实施的配套政策。

According to not complete count of west China city newspaper reporters，Since May 2011 to April this year less than a year，around“To see a doctor，Pay after”，Relevant departments have issued jining city 12 documents，Cover the model implementation of many promote matching policy。

　　其中最受欢迎的莫过于调整完善新农合和医保政策。去年11月济宁市卫生局、人社局、财政局联合发文要求，今年1月起，新农合经办机构要按上年度医院结算资金15%的比例，预拨周转金给实行“先看病后付费”的医院，医保预拨资金由原来的10%提高到15%，用于缓解医院垫付资金的压力。今年4月济宁市又设立“先看病后付费”专项资金以应对运行风险，为医院加上双重保险。

One of the most popular way to adjust and improve the new farming and close medicare policy。Last November jining city health bureau、People club innings、A joint mandate of bureau of finance requirements，January this year，New farming and agency orgnaization to prepay hospital settlement funds 15% proportion，Concentrating its efforts to implement revolving funds“After the first doctor pay”hospital，Medical insurance fund concentrating its efforts increased from the original 10% to 15%，To relieve the pressure of funds or hospital。In April this year jining city and set up“After the first doctor pay”Special funds in response to run the risk，For hospital and double insurance。