广东16县市率先为全省公立医院改革探路。广东省政府网站昨天公布的《广东省县级公立医院综合改革试点实施意见》(下称《意见》)显示，改革从本月启动，有望2015年在全省县级公立医院中铺开。

Guangdong 16 counties take the lead in the whole province for public hospital reform units.Guangdong government website published yesterday[At or above the county level in guangdong province public hospital comprehensive reform pilot implementation opinions](said[opinion])display,Reform from start this month,In 2015 is expected to be in the public hospital spread out at or above the county level.

　　《意见》指出，今年广东选取16个综合条件较好的县(市)开展综合改革试点，2013年11月-12月将评估总结，初步形成广东县级公立医院改革的基本路子，力争到2015年实现县级公立医院阶段性改革目标。改革试点的主要目标是，以破除“以药补医”机制为关键环节，以改革补偿机制和落实医院自主经营管理权为切入点，统筹推进管理体制、补偿机制、人事分配、价格机制、医保支付制度等综合改革，建立起维护公益性、调动积极性、保障可持续的县级医院运行新机制。通过改革，要完善监管机制，探索建立以理事会为主要形式的县级公立医院法人治理结构，落实医院经营管理自主权，探索建立现代医院管理制度，真正实现管办分开、政事分离。

[opinion]Pointed out that,This year guangdong select 16 comprehensive conditions are relatively good county(city)To carry out comprehensive reform pilot,In November 2013 - December to summary of evaluation,The initial formation of guangdong public hospital reform at or above the county level of the basic way,Strive to achieve 2015 public hospital reform goal at or above the county level stage.The pilot reform of main aim is,To break"In medicine for medical"Mechanism as the key link,To reform compensation mechanism and implement hospital independent management right as the breakthrough point,To plan as a whole propulsion management system/Compensation mechanism/Personnel distribution/Price mechanism/Medical insurance payment system, and other comprehensive reform,Establish maintenance public welfare/Arouse the enthusiasm of/Guarantee sustainable at or above the county level of the hospital operation mechanism.Through the reform,To perfect the supervision mechanism,Explore establish a board of directors as the main form at or above the county level of public hospital corporate governance structure,Implement the hospital management autonomy,Explore the establishment of a modern hospital management system,Truly achieve tube to separate/Separation of politics.

　　改革将尝试建立新的补偿机制，既保证不增加群众负担，又确保医务人员待遇水平不降低和公立医院发展不受影响。具体做法是取消药品加成，医院由此减少的收入，将通过调整医疗技术服务价格和增加政府投入等途径补偿。而调整的医疗服务收费将纳入医保支付范围。

Reform will try to establish the new compensation mechanism,Both guaranteed not to increase the burden,And to ensure that medical staff treatment level is not reduce and public hospital development is not affected.Particular way is cancelled drug addition,Hospital thus reduced income,Will through the adjustment of medical technical service price and increase government into the way such as compensation.And the adjustment of medical service charges will be included in medical insurance to pay limits.

　　《意见》指出，医改还将推行基本医疗保险支付制度改革。支付政策进一步向基层倾斜，鼓励使用中医药服务，引导群众小病到基层就诊，促进分诊制度形成。

[opinion]Pointed out that,Reform will also implement the basic medical insurance payment system reform.Pay policy further to grassroots tilt,Encouraging the use of traditional Chinese medicine service,Guide the masses ailment to see a doctor at the grass-roots level,To promote the formation of FenZhen system.

　　医改的方向是坚持公益性，但并不是要回到计划经济时期的“铁饭碗”、“大锅饭”机制。《意见》指出，要通过合理的人事分配制度设计，杜绝以往医务人员个人收入与医院的药品和检查收入挂钩的错误做法，建立符合公益性要求的激励约束机制。将建立竞争性的用人机制，实行全员聘用，竞争上岗，增强队伍活力。

The direction of the reform is to stick to public welfare,But not to return to the planned economy period"Iron rice bowl"/"mess"mechanism.[opinion]Pointed out that,Through the reasonable personnel distribution system design,Put an end to previous medical personnel individual income and the hospital drugs and check the wrong practices of income hook,Public welfare establishment conforms to requirements of incentive and constraint mechanism.Will build competitive mechanism of employing,Implement overall employment,Competition mount guard,Enhance team vitality.

　　改革还将严格医疗费用监管控制。建立相关费用控制指标考核体系和公示制度。将费用控制纳入医院等级评审、评先创优等范畴，对费用控制不好的实行“一票否决”。严禁通过不合理调整用药结构、分解处方、增加自费药品使用等方式加重患者实际费用负担。(记者夏杨)

Reform will also strict medical expenses supervision control.Establish relevant cost control index evaluation system and the system of public.Will cost control into the rank of the hospital evaluation/PingXian merit and category,The practice of bad for cost control"One ticket veto".It is strictly prohibited to through the unreasonable use structure adjustment/Decomposition prescription/Increasing use of drugs at one's own expenses way aggravating patient actual expense burden.(Reporter XiaYang)