我省(山东)30县试点取消药品加成 Our province(shandong)30 county pilot cancel drug addition

　　

医院药价降低15%，但诊疗服务费将提高 Hospital 15% lower drug prices,But medical service charge will improve

　　24日，记者从全省县级公立医院改革试点暨新农合大病保险工作电视会议上获悉，我省要求全省30个试点县(市区)的县级公立医院要在12月31日前全部取消药品加成。此举将使试点医院药价降低15%左右。明年下半年我省将总结评估试点经验，并于2014年在全省范围内全面推开。

24,Reporters from the province trial reform of public hospitals at the county level and the new agriculture close a serious illness insurance work conference heard on TV,In the whole province for 30 ShiDianXian(urban)At or above the county level of the public hospital in December 31 to cancel all drug addition.The move will make the pilot hospital drug prices reduced by 15% or so.In the second half of next year will be the summary of evaluation pilot experience,And in 2014 throughout the province comprehensive push away.

　　

年底前实现不加价卖药 By the end of the year not achieve tariffs sell medicine

　　24日的电视会议上，我省正式印发了《关于县级公立医院综合改革试点工作的实施意见》。意见提出，为破除“以药补医”，我省将取消药品加成政策。

24 television meeting,The official in our province issued by[At or above the county level about public hospital comprehensive reform pilot work of the implementation opinions].Opinions put forward,To break"In medicine for medical",Our province will cancel the drug addition policy.

　　长期以来，为弥补财政投入的不足，国家允许公立医院将药品加价后提供给患者。因此，公立医院收入形成了服务收费、药品加成收入和政府补助三个渠道。但药品加成一定程度上推动了医药费用的不合理上涨，加重了患者的看病负担。

For a long time,In order to make up for the deficiency of the financial investment,Countries allow public hospital drugs will be provided to patients after the price hike.therefore,Public hospital income formed the service charge/Drug addition income and government subsidies three channels.But drug addition to some extent promote the medical expenses unreasonable rise,Increasing the burden of patients to see a doctor.

　　为此，我省提出，要取消药品加成，改为服务收费和政府补助两个渠道。出席会议的省发改委相关负责人明确提出，今年12月31日前，我省30个试点县(市区)的县级公立医院全部药品不再加价销售。

therefore,Put forward in our province,To cancel the drug addition,To service charges and the government subsidies two channels.Present at the meeting the relevant person in charge of the provincial development and reform commission (NDRC) put forward,On December 31 of this year,30 ShiDianXian in our province(urban)At or above the county level of the public hospital drug no longer all increase sales.

　　出席会议的省物价局相关负责人指出，取消药品加成后，要确保试点医院的药品价格降低15%左右，同时要求医院向社会公示药品售价。

Present at the meeting pointed out that the relevant person in charge of provincial price bureau,Cancel after drug addition,To ensure the pilot hospital drug price down about 15%,At the same time the requirement to social public hospital drug price.

　　

医疗服务费提价有“限高杆” Medical service price increase has"Limit high bar"

　　据悉，药品收入一般占医院收入的50%左右，有的甚至能占到70%-80%。取消药品加成，医院如何维持正常运营？

It is reported,Drug income general hospital income accounted for 50%,Some can even 70% - 80%.Cancel the drug addition,The hospital how to maintain normal operation?

　　意见提出，要通过调整医疗技术服务价格和增加政府投入等途径补偿试点县级医院。合理提高中医和体现医务人员技术劳务价值的诊疗、护理、床位、手术等项目价格，使医疗机构通过提供优质服务获得合理补偿。

Opinions put forward,Through adjustment of medical technical service price and increase government investment way compensation pilot hospital at or above the county level.Reasonable improve the doctor of traditional Chinese medicine and reflect the medical staff technology service value of the diagnosis and treatment/nursing/beds/Surgery for the project price,The medical institution shall, through providing the quality service at reasonable compensation.

　　医疗服务提价会否加重患者负担？意见要求，调整价格总量原则上不超过2011年度药品合理价差总量的80%，即取消药品加成若减少收入1万元，医院最高可通过服务提价补收8000元。同时，调整后增加的医疗服务费按规定纳入医保支付范围。

The medical service price increase will not increase patients burden?Opinion request,Total price adjustment in principle of no more than 2011 annual drug reasonable 80% of the total price,Namely cancel if drug addition to reduce income is 10000 yuan,The highest hospital through service receives 8000 yuan for the price.At the same time,Adjusted in accordance with the provisions of the increase of medical service charge included in medical insurance to pay limits.

　　据悉，北京、深圳等地的多家公立医院已经试行取消药品加成，并适当提高诊疗费用。比如，友谊医院取消药品加成后，增设42元至100元的医事服务费。从该院的实行情况看，因政府投入增加，医保报销增加，患者次均费用有所下降。

It is reported,Beijing/Shenzhen, the number of home public hospitals have been cancelled for drug addition,Appropriate diagnosis and treatment cost and improve.For example,Friendship hospital cancel after drug addition,Add 42 yuan to 100 yuan of medical service charge.From the practice of the hospital at,Because the government investment increase,Medical insurance to submit an expense account increase,Patients second all cost declined.

　　

改革定价方式，试点按病种收费 Pricing reform,Pilot press disease to charge

　　为控制医疗费用增长，我省还将积极推进医疗服务定价方式改革。改革医疗服务以项目为主的定价方式，积极开展按病种、按服务单元等收费试点，不断扩大试点病种和范围，逐步建立起多种收费方式相互补充衔接的医疗服务价格体系。今年年底前，各市开展按病种收费试点病种不少于10个，2015年底前试点病种不少于50个。

In order to control medical cost growth,Our province will also actively promote medical service pricing mode reform.The reform of medical service to project is given priority to pricing,Actively carry out according to the disease/According to the service unit and charges site,Constantly expand the pilot diseases and scope,Step by step build up a variety of charging methods on the complementary medical service price system.Before the end of this year,Various cities to carry out press disease to charges site diseases of not less than 10,Before the end of the year 2015 pilot diseases not less than 50.

　　此外，意见要求，力争到2012年年底，全省30万人口以上的县(市区)至少有一所医院达到二级甲等水平，30个试点县(市区)率先完成。同时确定20余家三级综合医院对口支援试点县(市区)，提高其基本医疗能力，力争使县域内就诊率提高到90%左右，基本实现大病不出县。(记者 李钢 实习生 魏冉)

In addition,Opinion request,Strive to that by the end of 2012,The province more than 300000 population of the county(urban)At least one hospital to achieve the secondary of first-class level,30 ShiDianXian(urban)Take the lead in complete.At the same time to determine more than 20 tertiary general hospital of ShiDianXian support(urban),Improve the basic medical ability,Strive to make in the county JiuZhenLv increased to 90%,The basic realization of a serious illness county.(Reporter LiGang interns wei mannequins)

　　

公立医院改革 我省30县试点 Public hospital reform 30 county in hunan province pilot

　　济南市：章丘市、平阴县；

jinan:ZhangQiuShi/PingYinXian;

　　青岛市：即墨市、胶南市；

Qingdao:jimo/jiaonan;

　　淄博市：桓台县、临淄区；

zibo:Huantai county/LinZiOu;

　　枣庄市：薛城区；

zaozhuang:.20 xuechengqu;

　　东营市：垦利县、利津县、广饶县；

Dongying city:KenLiXian/LiJinXian/GuangRaoXian;

　　烟台市：龙口市、蓬莱市；

yantai:Longkou city/city;

　　潍坊市：青州市、诸城市、寿光市、安丘市、高密市、昌邑市、临朐县、昌乐县；

weifang:QingZhouShi/zhucheng/ShouGuangShi/Anqiu city/Gaomi city/ChangYiShi/LinQuXian/ms;

　　济宁市：邹城市、汶上县；

jining:zoucheng/MenShangXian;

　　泰安市：新泰市；

TaiAnShi:XinTaiShi;

　　威海市：乳山市；

Weihai city:RuShanShi;

　　日照市：五莲县；

Rizhao city:WuLianXian;

　　临沂市：费县；

Linyi city:Fei county;

　　聊城市：东阿县；

liaocheng:DongAXian;

　　德州市：平原县；

dezhou:PingYuanXian;

　　滨州市：邹平县；

binzhou:Zouping county in the;

　　菏泽市：单县。

Heze city:Shan county.

　　

专家点评 财政补偿到位 各方才能放心 Expert comments on financial compensation in place the parties can rest assured

　　“药价降了，医院会不会给病人多做检查多收钱啊？”对于我省试点取消药品加成的政策，在省城工作的张晓鑫仍有担心。

"Prices down,The hospital would not give the patient to do more check collect more money?"For our province pilot cancel drug addition policy,In the provincial capital ZhangXiaoXin work there are still worried.

　　“这一政策如果落实不好，确实可能会出现‘大检查’的现象。”山东大学社会医学与卫生事业管理专业教授徐凌忠表示，“我调研过许多地方，不少县要想做到补偿及时到位还是有困难的。”

"This policy if carries out not well,Really may appear‘examination’phenomenon."Shandong university social medicine and health management professional professor XuLingZhong said,"I research many place,Many county to be compensated timely in place or has difficulty."

　　“由于医患双方的信息不对称，哪些检查该做、哪些不该做，患者自己很难分辨。”徐凌忠说，当医院收入不能保障，且医院对医生考核办法不变的情况下，医院和医生势必想出各种“增收”办法，以弥补收入减少的部分。“所以，政府财政补贴及时到位才是最重要的，否则，很难有效降低患者负担。”

"Due to both sides of the medical information asymmetry,What inspection should do/What not to do,It's hard to tell the patient's own."XuLingZhong said,When the hospital income can't guarantee,And the hospital to a doctor examining method under the condition of constant,Hospitals and doctors will inevitably come up with all kinds of"'income"way,To make up for the part of the income decrease."so,Government financial subsidies timely in place is the most important,otherwise,It is difficult to effectively reduce the burden of patients."

　　在此之前，我省的基层医疗机构已经取消了药品加成，实行基本药物零差价销售，由政府对基层医疗机构进行适当补偿，但补偿情况不太理想。

Before this,Our province at the grass-roots level of medical institution has been canceled drug addition,The essential drugs zero spread sales,By the government to basic level medical institutions appropriate compensation,But compensation condition is not too ideal.

　　24日，出席全省县级公立医院改革试点暨新农合大病保险工作电视会议的省委副书记、省长姜大明坦称有许多县(市区)的补偿没有到位，他甚至现场点名批评了个别县(市区)。

24,To attend the trial reform of public hospitals at the county level and the new agriculture close a serious illness insurance work TV conference vice secretary of provincial party committee/The governor admitted JiangDaMing there are many county(urban)The compensation is not in place,He even field singled out the individual county(urban).

　　在徐凌忠看来，要想彻底减轻患者的看病负担，不能单单取消药品加成和适当提高诊疗服务费。他建议，全面实行临床路径，推行规范化治疗，“这样患者才能对哪些检查有必要做有一定判断。”(记者 李钢)

In XuLingZhong seems,If you want to completely relieve the patient to see a doctor of the burden,Can't just cancel the drug addition and appropriate service to improve diagnosis and treatment.He suggested that,To implement clinical pathway,Implementation of standardized treatment,"Such patients to what inspection have need to do have certain judgment."(Reporter LiGang)