陕西县级公立医院改革全面推开 Shaanxi full implementation of reform of public hospitals at the county level

　　陕西省今年全面推开县级公立医院改革，按照“先易后难、突出重点、整体推进”的思路稳步推进，各地探索出一批因地制宜的好经验和好做法，初步缓解了老百姓看病难、看病贵。

Shaanxi province this year at or above the county level full implementation of public hospital reform,According to the"After the first easy to/Highlight the key/Whole advancement"The train of thought of steadily,To explore all over a number of adjust measures to local conditions of good experience and good practice,Preliminary relieves the common people to see a doctor difficult/The doctor your.

　　陕西省经济发展水平相对落后，医疗卫生条件较差，长期以来县级医院难以满足老百姓的就医需求。对此，近几年陕西把工作重点放在通过医改提高县级公立医院的服务能力上。陕西省副省长郑小明说：“县级医院提供的是基本医疗服务，医改就是要在县级这个区域里实现小病不出乡镇、大病不出县城，预防在基层，90%的人在县里得到救治的目标。”

Shaanxi province economic development level is relatively backward,Medical and health conditions are relatively poor,For a long time to meet people at or above the county level of the hospital medical treatment demand.this,Shaanxi province in recent years the work emphasis on through the reform, improve the public hospital at or above the county level of the service ability.Vice governor of shaanxi province ZhengXiaoMing said:"The hospital is at or above the county level shall provide basic medical service,Reform in this area is at or above the county level in the villages and towns to realize ailment/A serious illness not out of town,Prevention in the basic unit,90% of the people in the county to get the goal of treatment."

　　陕西县级公立医院改革从2010年开始在5个县进行试点，2011年扩大到37个县，今年开始在全省107个县区全面推行。通过政府财政保障、改革医药购销体系、强化医院运行管理等措施，使患者医药费用总额和次均费用明显下降。通过试点县级公立医院改革，陕西的县级医院提升了服务水平，降低了医药费用，看病难、看病贵问题得到初步缓解。

At or above the county level in shaanxi province public hospital reform since 2010 in 5 counties to pilot,2011 it expanded to 37 county,At the beginning of this year the province in 107 counties and the full implementation of the.Through the government financial security/Reform medicine purchase and sale system/Strengthening the hospital operation management measures,So that patients with total medical expenses and time cost were decreased obviously.Through the pilot reform of public hospitals at the county level,Shaanxi at or above the county level of the hospital enhance the service level,To reduce the medical cost,See a doctor difficult/The doctor your problems are preliminary ease.

　　今年61岁的子长县马家砭镇农民王翠琴刚刚在县医院做了腹腔镜胆囊切除手术。她告诉记者，为保证治疗效果，县医院专门请了西安交通大学第一附属医院的专家对她进行远程会诊，“这次看病花了6000元，经过新农合报销后自己只掏了2000多元，而且在县城看病跟去大医院看病一样呢！”

This year 61 - year - old ZiChangXian horse span home town WangCuiQin just farmers in county hospital to do the peritoneoscope gallbladder excision surgery.She told reporters,To ensure the therapeutic effect,County hospital special please the xi 'an jiaotong university first affiliated hospital of remote consultation experts on her,"The doctor spent 6000 yuan,After the new agriculture close to submit an expense account only after the cut 2000 multivariate,And in the county to go to large hospital see a doctor to see a doctor as it!"

　　公立医院完全回归公益属性，是子长县医改的亮点。据子长县医改办主任靳晓宏介绍，子长县公立医院取消了15%的药品加成，由此形成的300万元减收由财政补贴，同时把公立医院由差额单位改为全额预算单位，将医务人员津贴补助和人才培养费用纳入财政预算，并将公立医院所欠1900多万元历史债务由县财政经审计后，统一打包，逐年清还。

Public hospital completely regression public attribute,ZiChangXian is the highlight of medical reform.According to ZiChangXian do medical director JinXiaoHong is introduced,ZiChangXian public hospital cancelled 15% of drug addition,In form of 3 million yuan reduce the fiscal subsidy,At the same time the public hospital by balance unit to full budget unit,Will the medical staff allowance subsidy and talent training costs into the fiscal budget,And the public hospitals owe more than 1900 yuan history debt by the county finance after the audit,Unified packing,Together year after year.

　　这一做法增加了医院的诊疗人次，有效解决了医院效益和医护人员工资资金、福利待遇问题。与改革前相比，医院总诊疗人次增长了31%，门诊人次上升了79.4%，县医院病床使用率最高达到139%。县医院、中医医院职工的年平均工资分别达到了6万元和5万元，医务人员的正常收入翻了一番。子长县医院内科医生郝晓勇说：“现在‘灰色收入’没有了，我们的收入完全和工作量挂钩，奖金从几年前的每月千元左右，增加到现在的三四千元，我每个月可以拿到六七千元。”

This practice increased hospital medical people,Effectively solve the hospital benefit and medical personnel salary funds/Welfare treatment problems.Compared with before reform,The hospital total medical people increased by 31%,Outpatient service people rose by 79.4%,County hospital bed top utilization rate reached 139%.County hospital/The doctor of traditional Chinese medicine hospital worker year of average wage reached to 60000 yuan and 50000 yuan,The medical staff of the normal income doubled.ZiChangXian hospital physicians HaoXiaoYong said:"now‘Gray income’no,Our income completely and workload hook,Bonus from a few years ago about one thousand yuan a month,Increase to the present three or yuan,I every month can get 67000 yuan."

　　据了解，陕西通过3年的医改实践，涌现出了以构建“平价医院”为特点的子长模式、以“供需双方并补”为特点的府谷模式、以“全民免费医疗”为特点的神木模式、以“区镇医疗卫生一体化”管理为特点的阎良模式、以基层医疗卫生机构综合改革为特点的镇安模式和以城市医院托管县医院为特点的洛川、太白经验。

It is understood,Shaanxi through three years of medical practice,Emerging out of the building"Parity hospital"For the characteristics of smaller mode/to"Supply and demand both sides and complement"For the characteristics of the mansion valley model/to"The free medical care"For the characteristics of shenmu mode/to"Area town health integration"Management as the characteristics of YanLiang mode/With basic medical and health institutions comprehensive reform for characteristics of ZhenAn mode and to city hospital trusteeship county hospital for characteristics of luochuan/Taibai experience.

　　陕西省卫生厅厅长刘少明说，通过体制机制不断创新，建立政府财政投入机制、完善现代医院的管理制度，同时深化人事制度改革及监管机制，使县级医院正逐步恢复公益性质，面貌焕然一新。(记者杨一苗)

Shaanxi provincial health bureau director liu testified, less,Through the system mechanism innovation,Establish the government fiscal input mechanism/Improve the modern hospital management system,At the same time deepening reform of personnel system and supervision mechanism,At or above the county level shall make hospital is gradually restore public property,Looks grately different.(Reporter YangYiMiao)