探索“两个分开” 建立“三种机制” exploration"Two separate" To establish"Three kinds of mechanism"

北京公立医院改革初见成效 Beijing public hospital reform wins initial success

　　继友谊医院后，北京第二家大型公立医院——朝阳医院也启动“医药分开”，9月1日起取消15%药品加成，以及挂号费、诊疗费，并设医事服务费。这既遏制了医院多卖药，让患者得到实惠，又保障了医院收入，医务人员受鼓舞。调查显示，患者对两家医院的总体满意度均超过90%，显示北京公立医院改革初见成效。

After the friendship hospital,Beijing second large-scale public hospital - chaoyang hospital also start"Medicine separate",September 1 cancel 15% drug addition,And registration fee/fee,It also has a medical service charge.This not only contain the hospital sell more drugs,Let benefit the patients,And guarantee the hospital income,Medical staff encouraged.Investigation shows that,The two hospitals in patients with the overall satisfaction are more than 90%,Display Beijing public hospital reform wins initial success.

　　5月18日，北京启动大型公立医院综合改革。此次改革的总体思路是探索管办分开、医药分开，建立财政价格补偿调控机制、医疗保险调节机制、医院法人治理运行机制。最引人注目的是取消“以药补医”，实施“医药分开”，这是公立医院改革推行3年来，医院运行机制改革力度最大的举措。此前，北京市成立医管局，负责“办医院”，卫生局则“管行业”，在“管办分开”上迈出实质性一步。

On May 18,,Beijing launched large public hospital comprehensive reform.The reform of the general idea is to explore pipe run separate/Medicine separate,Establishment of financial compensation price regulation and control mechanism/Medical insurance regulatory mechanism/Hospital corporate governance mechanism.The most striking is cancelled"In medicine for medical",implementation"Medicine separate",This is the implementation of the reform of public hospitals for three years,The hospital operating mechanism reform the biggest move.after,Beijing was established,Responsible for"Do hospital",Health bureau is"Tube industry",in"Pipe run separate"Take substantive step on.

　　7月1日，友谊医院作为综合改革试点，率先实施“医药分开”，1700种药品全以“进价销售”，医院和药品收入脱钩。医药分开后，截至9月30日，门诊医保患者次均费用从450元降至384元，减少66元；门诊医保患者次均药费从344元降至246元，减少98元；医保患者自付部分从176元降至105元，减少71元。

On July 1,,Friendship hospital as a comprehensive reform pilot,Take the lead in implementing"Medicine separate",1700 kinds of drugs in all"Purchase price, sales",The hospital and drug income decoupling.Separated medicine,By September 30,,Outpatient service medical insurance patients second all cost from $450 down to 384 yuan,A decrease of 66 yuan;Outpatient service medical insurance patients second all expenses for medicine from 344 yuan down to 246 yuan,A decrease of 98 yuan;Since medical insurance patients pay part from 176 yuan down to 105 yuan,A decrease of 71 yuan.

　　朝阳医院紧随友谊医院试点医药分开。近两个月来，门诊医保患者次均费用、门诊医保患者次均药费、医保患者次均自付费用分别减少40元、73元、78元。取消药品加成的同时，朝阳医院收取医事服务费，标准与友谊医院相同：门诊普通号42元，副主任医师60元，主任医师80元，知名专家100元，医保患者每人次直接报销40元。

Chaoyang hospital followed friendship hospital pilot medicine apart.Nearly two months,Outpatient service medical insurance patients second all expenses/Outpatient service medical insurance patients second all expenses for medicine/Medical insurance patients second all out-of-pocket costs were reduced 40 yuan/73 yuan/78 yuan.Cancel the drug addition at the same time,Chaoyang hospital medical service charge,Standard and friendship hospital the same:Outpatient service ordinary number 42 yuan,Deputy chief physician 60 yuan,Chief physician 80 yuan,Famous experts 100 yuan,Medical insurance patients directly submit an expense account each time 40 yuan.

　　此次改革试点最重要的目标，仍是探索建立有利于公立医院体系可持续发展的体制机制。法人治理运行机制加快推进，友谊、朝阳医院均成立理事会，产生新的院长执行团队。今后医管局将建立监事会，向医院派驻监事，委任总会计师，形成医院法人治理结构。同时对医院内部运行机制进行改革，建立以公益性为核心的绩效考核制度，建立与公益性绩效考核结果挂钩的工资动态调整和薪酬分配制度。

The pilot reform of the most important goals,Is still exploring to establish public hospital system is beneficial to the sustainable development of the system mechanism.Corporate governance mechanism accelerate,friendship/Chaoyang hospital are establish council,Create new dean executive team.The future hospital authority will establish the board of supervisors,To the hospital accredited supervisors,Appointed the chief accountant,Form the hospital corporate governance structure.At the same time to hospital internal reform of the operating mechanism,Establish a public welfare as the core of performance appraisal system,Establishment and public welfare performance evaluation results hook salary dynamic adjustment and salary distribution system.

　　医保付费调节机制包括总额预付和按病种分组付费。北京科学确定医保定额指标，明确超出费用由医保基金和医院按比例分担。今年上半年，总额预付试点医院门诊次均费用同比下降3.8%，住院次均费用下降8.3%。

Medical insurance pay adjustment mechanism including total advance and press disease to pay packet.Beijing science determine medical insurance rating index,Clear beyond the expense of medical insurance fund and hospital in proportion to share.In the first half of this year,The total advance pilot hospital outpatient service second all expenses 3.8% year-on-year drop,Hospitalization time cost were dropped by 8.3%.

　　财政价格补偿调控机制改革方面，落实财政6项补偿政策，建立与绩效考核挂钩的财政补偿机制。下一步，继续推进药品、耗材流通领域改革，建立联合招标和价格谈判机制，挤出不合理的价格水分。同时，发展现代物流配送，压缩流通费用，降低药品和耗材价格。

Financial compensation price regulation and control mechanism reform,Carry out financial 6 compensation policy,Establishment and performance evaluation hook financial compensation mechanism.The next step,To continue to push forward the drug/Material circulation field reform,A joint bidding and price negotiation mechanism,Extrusion not reasonable price moisture.At the same time,The development of modern logistics and distribution,Compression circulation cost,Lower drug prices and consumables.

　　据了解，北京明年将在市属三级医院推广医药分开，建立医疗、康复、护理相衔接的医疗服务链，推进大医院带社区，鼓励社会办医，吸引国际顶级医疗资源进京。(记者王明浩)

It is understood,Beijing next year will be under the tertiary hospital promotion medicine apart,Establish the medical/rehabilitation/Nursing the coherent medical service chain,Promote large hospital with community,Encourage social do medical,To attract top international medical resources goes to the capital.(Reporter WangMingHao)