五部委发布2012年公立医院改革工作通知(全文)

Five ministries release 2012 public hospital reform work notice(Full text)

　　中新网8月7日电 据卫生部网站消息，卫生部、国务院医改办等五部委日前联合印发关于做好2012年公立医院改革工作的通知。通知指出，2012年所有公立医院改革国家联系试点城市均要探索采取调整医药价格、改革医保支付方式和落实政府办医责任等综合措施和联动政策，破除以药补医机制。

Beijing August 07 dec according to the health ministry's website reported，health、Cure of the state council office, etc by five ministries jointly issued by about 2012 years to public hospital reform work notice。Notice points out that，2012 all public hospital reform national pilot city to explore all contact take medicine price adjustment、Health-care reform payment and implement comprehensive measures such as medical liability government policy and linkage，Break up with drug medical mechanism。

　　通知称，试点城市以破除以药补医机制为重点，进一步推进“四个分开”等体制机制综合改革。

Notice said，Pilot city to break up with medicine is to focus on the medical system，Further advance the“Four separate”The systems for comprehensive reform mechanism。

——破除以药补医，完善公立医院补偿机制 Breaking up with medicine, medical，Perfect public hospital compensation mechanism

　　2012年所有公立医院改革国家联系试点城市(以下简称国家联系试点城市)均要探索采取调整医药价格、改革医保支付方式和落实政府办医责任等综合措施和联动政策，破除以药补医机制。将公立医院补偿由服务收费、药品加成收入和财政补助三个渠道改为服务收费和财政补助两个渠道。

2012 all public hospital reform experiment city national contact(Hereinafter referred to as the state contact pilot city)All should explore take medicine price adjustment、Health-care reform payment and implement comprehensive measures such as medical liability government policy and linkage，Break up with drug medical mechanism。Will the public hospital compensation by the service charge、Drug bonus income and financial aid three channels to service charges and financial aid two channels。

　　发挥医保的补偿和控费作用。同步推进总额预付、按人头付费、按病种付费等复合支付方式，加强付费总额控制，通过购买服务对医疗机构给予及时合理补偿，引导医疗机构主动控制成本、规范诊疗行为、提高服务质量。严格考核基本医保药品目录使用率及自费药品控制率等指标，控制或降低群众个人负担。积极推动建立医保经办机构与医疗机构的谈判机制和购买服务的付费机制，通过谈判确定服务范围、支付方式、支付标准和服务质量要求。要按照临床路径和诊疗规范加强对诊疗行为的监督管理，防范减少服务内容、降低服务标准、服务提供不足、推诿重症患者等行为。各地要积极推行支付方式改革，逐步覆盖统筹区域内医保定点机构，国家联系试点城市要加快步伐、加大力度推进支付方式改革。

Play the medical insurance compensation and control cost function。Synchronized advancement total amount paid in advance、On a per head pay、Press disease to pay on composite payment，Strengthen the total pay for control，By purchasing services for medical institutions in time to give reasonable compensation，Guide medical institutions active control costs、Diagnosis standard behavior、Improve service quality。Strict appraisal catalog of medicines and basic medical insurance and drug control and utilization at index，Control or reduce the individual responsibility。Actively promote the establishment of a medical insurance agency orgnaization and medical institutions of negotiations and buying services payment mechanism mechanism，Service scope fixed through negotiations、payment、To pay a standard and service quality requirements。According to the clinical pathway and diagnosis and treatment of diagnosis and treatment of behavior standard to strengthen the supervision and management，Guard against reduce the service content、Reduce service standard、Service provide inadequate、Excuse in severe cases, etc。The various localities should actively promote payment reform，Will gradually cover plan as a whole to regional medical insurance in designated institutions，National contact pilot city will speed up、Intensify efforts to promote payment reform。

　　合理调整医疗服务价格。按照总量控制、结构调整的原则，降低药品和高值医用耗材价格，降低大型医用设备检查价格，合理提高诊疗费、护理费、手术费等医疗服务价格，体现医疗服务合理成本和医务人员技术劳务价值。调整后的医疗技术服务收费按规定纳入医保支付范围。要在价格调整方面给予国家联系试点城市一定自主权。

Reasonable price adjustment of medical service。According to the total amount control、The principle of structure adjustment，Lower drug prices and high value of medical consumables，Reduce large medical equipment check the price，Reasonable fee increase、nurse、The prices of medical service operation expenses，Reflect the medical service reasonable cost and medical personnel technical labor value。After the adjustment medical technical service fees according to the regulations into medical insurance pay limits。To adjust the price to national pilot city certainly contact autonomy。

　　落实政府办医责任。政府负责公立医院基本建设和设备购置、重点学科发展、人才培养补助、符合国家规定的离退休人员费用、政策性亏损补贴、承担公共卫生任务和紧急救治、支边、支农等公共服务任务补助等。

The government implement medical liability。The government is responsible for public hospital infrastructure and equipment purchase、Key discipline development、Personnel training subsidy、Conforming to the provisions of the state retired personnel expense、Policy-related losses subsidies、Take on the public health task and emergency treatment、wants、Support of public services such as task subsidies, etc。

——创新体制机制，建立现代医院管理制度 -the innovation system mechanism，The establishment of a modern hospital management system

　　合理区分医疗服务监管职能与医疗机构举办职能。深化公立医院管理体制改革，理顺公立医院所有者和管理者责权。落实公立医院经营管理自主权和用人自主权，全面推行聘用制度和岗位管理制度，按照相关规定，坚持按需设岗、竞聘上岗、按岗聘用、合同管理，建立能进能出、能上能下的灵活用人机制；新进人员实行公开招聘，择优聘用。探索建立理事会等多种形式的公立医院法人治理结构。建立严格有效的医疗服务监管体系，加强监管能力建设。

Differentiate medical services and regulatory functions of medical institutions held functions。Deepen the reform of the management system of public hospital，Straighten out public hospital ZeQuan owners and management。Implement public hospital management autonomy and the autonomy，The full implementation of the recruitment system and post management system，According to the relevant provisions，SheGang according to need、Hired mount guard、According to the employment、Contract management，Set up can be hired out、Can the flexible to personnel mechanism；The new employees implement open recruitment，According to hire。Explore the council set up a variety of forms such as public hospital of corporate governance。Establish strict and effective medical service of the supervision system，Enhancing regulatory ability construction。

　　推进院长专业化、职业化建设。建立完善院长负责制和任期目标责任考核制度，探索建立院长任职资格管理制度，完善院长选拔、任用、考核、薪酬、奖惩等制度。开展院长专业化、职业化培训，不断提高院长管理水平。

Promote dean specialization、Professional building。Establish a perfect system and the term goal responsibility assessment system，Explore to establish the management system of qualifications，Perfect selection of、employment、assessment、salary、System of rewards and punishments, etc。Carry out dean specialization、Professional training，Continuously improve the level of management。

　　建立健全对公立医院的绩效考核制度。国家层面制订意见，指导建立以公益性为核心的公立医院绩效考核体系，体现医院服务能力、运行绩效、患者满意度等，将考核结果与院长任免、奖惩和医院财政补助、工作人员平均收入水平等挂钩，促进医院持续改善服务、提高效率。2012年所有国家联系试点城市要制订绩效考核方案，开展绩效考核工作。

Establish and perfect to public hospital performance evaluation system。The national level make comments，Guide to public welfare established as the core of the public hospital performance evaluation system，Reflect hospital service ability、Operation performance、Patient satisfaction, etc，Will assess result and appointed dean、Rewards and punishments and hospital financial aid、Staff average income level, hooks，Promote hospital continued to improve service、Improve efficiency。2012 all countries to develop pilot city contact performance evaluation scheme，Carry out inspection work performance。