无棣试水住院“全报销”近俩月，居民不再“看病难” Company test the waters in hospital"Full to submit an expense account"Nearly two months,People no longer"See a doctor difficult"

“免费医疗”后住院人数增3倍 "Free medical care"The number of hospitalized after add 3 times

　　自8月1日起，(山东)滨州市无棣县推行了住院“全报销”制度，凡参加新农合、城镇居民基本医保的城乡居民，在全县11处乡镇卫生院(含2处街道社区卫生服务中心)住院只需掏出200元起付线费用，基本医疗费用全部报销。试水“免费医疗”后统计数字显示，去年8月该县住院人数为170人次，今年8月为612人次，增加了近3倍。

Since aug. 1,,(shandong)Binzhou wudi introduced a hospital"Full to submit an expense account"system,All the new agriculture together/The urban resident basic medical insurance for urban and rural residents,In the county and township health center in(Including 2 place street community health service center)Hospital just take out 200 dollars to start to pay cost line,Basic medical treatment charge all to submit an expense account.Test the waters"Free medical care"After statistics show,Last August in the county a total of 170 people,August for 612 people,Increased almost three times.

患者叫好 住院“全报销”，居民不敢相信 Patients in hospital were"Full to submit an expense account",Residents can't believe

　　“这个政策太好了，以前想都不敢想啊！”9月12日，在无棣县海丰街道社区卫生服务中心住院的马长凤逢人就夸。

"This policy is too good,I used to think all dare not to think ah!"On September 12,,In wudi haifeng street community health service center hospital MaChangFeng meet a person I will boast.

　　“以前到医院检查一圈下来就好几百块。在这里医生查了，说让住院，也不用交钱，说是出院的时候交200块就行。”谈起入院时的经历，70多岁的马长凤至今仍有些不敢相信。自8月1日，无棣县实行城乡居民卫生院住院全报销制度后，许多像马长凤一样的患者，原本怕花钱不敢入院，现在也开始住院治病了。

"To the hospital the examination before a lap down when he hundreds of block.Here the doctor checked,Said let in hospital,Also need not make money,Say the hospital hand over 200 pieces will do."Talk about the experience of admission,More than 70 years old MaChangFeng still some to dare not believe.Since aug. 1,,Wudi to urban and rural residents health center hospital after all to submit an expense account system,As many as MaChangFeng patients,Originally afraid of money can't to the hospital,Now also began to heal the hospital.

　　“以前新农合报销的也不少，可是毕竟多住一天就多花一天的钱啊，现在可以放心了。”今年43岁的王景峰患有腰椎间盘突出，此前一直不舍得住院。听说了这个政策后，他来到了社区卫生中心。在海丰街道社区卫生服务中心，记者看到，干净整洁的病房里住满了病人，48个床位几乎被占满，病房里还配备了电视和空调，许多病人在病房里看电视。

"Before the new agriculture and many close to submit an expense account,But after all many live a day to spend a day of money,Now can rest assured."43 years old this year WangJingFeng with lumbar intervertebral disc herniation,Do not be willing to part with or use had been hospitalized.Heard of the policy,He went to community health center.In haifeng street community health service center,The reporter sees,Clean and tidy ward filled with patients,48 beds almost occupied,In the ward is equipped with TV and air conditioning,Many patients in the hospital ward to watch TV.

　　对于可能出现的住院人数“井喷”问题，无棣县卫生部门提前进行了准备。县卫生局副局长佘洪林说，该县11处乡镇卫生院共投资170余万元，更新或新增必要医疗设备40余台(套)，增加备用床位200张等。同时充实了乡镇卫生院的专业技术力量。

For possible number of be in hospital"blowout"problems,Wudi department of health on the preparation in advance.County health bureau deputy director SheHongLin said,The county and township health center in total investment of 170 yuan,Update or new necessary medical equipment more than 40 sets(set),Increasing spare 200 beds, etc.At the same time enriched the township health center of professional and technical strength.

资金保障 降低医疗费，财政不掏钱 Funding to reduce medical expenses,Financial pay

　　“从一个多月的实践看，住院患者虽然大增，但增加数量是完全可控的。”无棣县新农合管理委员会办公室(简称合管办)副主任王清泉说，去年8月全县乡镇卫生院住院人数为170人次，新农合报销资金为19.1万元左右，而今年8月份住院人数为612人次，报销资金为66.8万元。“这与我们的测算也是相符的”。

"From the practice of more than a month to see,Although a hospitalized patients,But increase the quantity is completely controllable."Wudi new farming joint management committee office(Referred to as joint tube to do)Deputy director WangQingQuan said,Last August the county township health center hospital number for 170 people,New farmers close to submit an expense account funds for 191000 yuan,But August this year the number of hospitalized for 612 people,To submit an expense account funds for 668000 yuan."This with our calculation is also consistent".

　　“经测算发现，如果控制得当，在乡镇住院交纳200元起付线后全报销，新农合基金是可以承受的。”王清泉介绍，2012年无棣县新农合参合农民38.8万人，基金总额1.38亿元，城镇居民基本医疗保险参保人数5580人，基金总额134万元。“全报销”后，新农合和城镇居民基本医保会新增补偿费用1350多万元，通过“一调双控”完全可以消化掉这块新增费用，县财政不用为此“背包袱”。

"According to the calculation found,If proper control,In the villages and towns in hospital cost 200 yuan up pay line full to submit an expense account,New farmers joint fund is to be accepted."WangQingQuan introduced,2012 wudi new farming $ginseng adds up to farmer 388000 people,Fund total 138 million yuan,Urban resident basic medical insurance ginseng protect number 5580 people,Fund total 1.34 million yuan."Full to submit an expense account"after,New farmers joint and urban resident basic medical insurance will be new compensation costs more than 1350 yuan,Through the"Find double control"Can digest the the new charges,County financial don't have to"Take on a mental burden".

　　所谓“一调双控”是指，“一调”，即调整乡镇卫生院住院补偿起付线、报销比例。新农合乡镇卫生院住院起付线、报销比例由150元、80%调整为200元、100%，城镇居民基本医保乡镇卫生院住院起付线、报销比例由500元、70%调整为200元、100%。“双控”就是既控制乡镇卫生院次均费用、总体费用和单病种费用，又控制县内其他医疗机构医药费用不合理增长。

The so-called"Find double control"Refers to,"find",Township health center hospital compensation adjustment is to start to pay of the line/Reimbursement ratio.New farming township health center hospital close to start to pay of the line/To submit an expense account proportion by 150 yuan/80% adjustment for 200 yuan/100%,Urban resident basic medical insurance township health center hospital up pay line/To submit an expense account proportion by 500 yuan/70% adjustment for 200 yuan/100%."Double control"Is control township health center second all expenses/The overall cost and single disease cost,Other medical institutions and control the county medical costs is not reasonable growth.

　　“我们在充分调研论证的基础上，现在将乡镇卫生院次均费用控制在1200元，超出部分由医院承担。”王清泉介绍，“最突出的是单病种限额，目前我们已就46种常见病进行了最高限额。比如阑尾炎手术，去年县中心医院的次均费用是2680元，现在限额是2200元。”

"We are fully research based on the test,Township health center will now second all cost control is in 1200 yuan,Beyond the hospital bear part."WangQingQuan introduced,"The most prominent is the limitation of single disease,At present, we have a common 46 species on the ceiling.Such as appendicitis operation,Last year the county center hospital second all cost is 2680 yuan,Now limit is 2200 yuan."

　　自“全报销”实施以来，无棣县内各医疗机构次均费用平均下降35%，乡镇卫生院次均费用、人均补偿费用、人均自付费用分别下降640元、279元、360元，共减少新农合和城镇居民基本医保不合理支出49万元，预计全年可减少1700万元左右，完全能消化掉“全报销”后新增的1350万元补偿费用。

since"Full to submit an expense account"Since the implementation of,Within the county medical institutions second all cost decrease 35%,Township health center second all expenses/Per capita compensation fees/Per capita out-of-pocket expenses were down 640 yuan/279 yuan/360 yuan,Common reduce new farming together and urban resident basic medical insurance is not reasonable spending 490000 yuan,Expected annual can reduce 17 million yuan or so,Can fully digest"Full to submit an expense account"After the new 13.5 million yuan compensation fees.

制度把关 既不过度医疗又不推诿病人 System control is not excessive medical treatment and don't shuffle patients

　　王清泉说，为了限制医疗机构随意收治病人入院，造成不必要的过度医疗，县合管办要求各医疗机构制定严格的出入院标准，详细列出患者出入院所需的指征，并报请县合管办批准。“而且我们与医疗机构签署了协议，将定期对医生处方等进行检查。”

WangQingQuan said,In order to limit at medical institutions treated the patient to the hospital,Cause unnecessary excessive medical treatment,County joint tube do request various medical institutions to make strict ChuRuYuan standard,Detailed list ChuRuYuan patients required indications,And submitted to the county joint tube for approval."And we and medical institutions signed the agreement,Will regularly for a prescription from a doctor check, etc."

　　“啥样的该住院，啥时候该出院，都是有参考标准的，我们可不敢马虎。”无棣县车王镇卫生院医生孙连彬提高声调说。

"What kind of the hospital,What time the hospital discharge,Are the reference standard,We can't careless."Like other nominees county township health centers SunLianBin doctors improve tone of voice said.

　　海丰街道社区卫生服务中心主任唐秀春分析说，乡镇卫生院主要侧重于常见病、多发病的基本医疗服务，这类病的治疗费用一般不高。“而且有1200元的人均费用限制，过度医疗不会发生，医院不会逮着一个病人不让走。”

Haifeng street community health service center director said TangXiuChun analysis,Township health center mainly focus on the common diseases/Frequently encountered disease of the basic medical service,This kind of disease treatment costs generally is not high."And there are 1200 yuan per capita expense limit,Excessive medical treatment won't happen,The hospital won't catch a patients do not let go."

　　如果“过度医疗”能因1200元的限额避免的话，那会不会出现推诿病人的情况？“这个1200元，并不是要求每一个病人都不能超过这个限额，而是个平均值，只要医疗机构一年平均下来不超过就行。”王清泉说，即使个别病人超出1200元，病人达不到出院指征也不能随便让病人出院。

if"Excessive medical"Because of 1200 yuan limit avoid it,It will not be shuffle the patient's condition?"This is 1200 yuan,Not asking for every patient cannot exceed the limit,But a mean value,As long as the medical institutions a year average down no more than will do."WangQingQuan said,Even if the individual patient exceed $1200,The patient can not reach the discharge indications can't literally let the patient will be discharged.

　　“现在这个政策才刚刚试行，可能会出现一些新情况。”王清泉说，该制度从8月1日至12月31日为试运行期，然后根据试运行情况，对相关标准和政策进行测算、调整后，2013年正式实施。(记者 李钢 张卫建)

"Now this policy has just for trial implementation,May appear some new situation."WangQingQuan said,This system from August 1 to December 31, for commissioning period,And then based on the commissioning situation,To measure standards and policies/adjusted,In 2013, after the official implementation.(Reporter LiGang ZhangWeiJian)