北京市同仁医院、天坛医院、积水潭医院三家公立医院12月1日起正式启动医药分开改革。与前两批试点医药分开改革的友谊医院、朝阳医院相同，试点内容是取消15%药品加成、增收医事服务费。

The Beijing tongren hospital/The temple of heaven hospital/Ji shui tan hospital three public hospital on December 1 officially start medicine separate reform.And the first two batch of pilot reform of the medical separate friendship hospital/Chaoyang hospital the same,Pilot content is cancelled 15% drug addition/Increasing medical service charge.

　　此次列入试点范围的三家医院具有一个共同特点，即专科重点学科突出，外地患者较多，药费收入在医院总收入中占比相对较低。在这类医院中推行试点对缓解“看病难”“看病贵”将会产生什么影响？对北京市公立医院改革有何意义？三家医院的院长、北京市医改办和医院管理局相关负责人1日接受新华网《第一回应》栏目记者采访，回应网友关切。

The pilot in the scope of three hospitals have a common characteristic,Namely specialized key discipline outstanding,Foreign patients more,The drug income in the hospital revenue accounted for in than the relatively low.In this kind of hospital implementation of the pilot to alleviate"See a doctor difficult""The doctor your"What effect will produce?Reform of public hospitals in Beijing have any meaning?Three the head of the hospital/Beijing medical reform and the hospital authority to the relevant person in charge of 1 to accept xinhua net[First response]Column reporters,Response netizen concern.

增加号源缓解看病难 Increase the number source alleviate difficult to see a doctor

　　在许多网民眼里，有名的专科医院病人多，看病难，挂号更难。同仁医院眼科、耳鼻喉科，积水潭医院骨伤科、烧伤科，天坛医院神经内科在全国影响较大，“一号难求”的现象本来就很突出。此次改革试点包括取消15%药品加成的内容，有网友关心，来就诊的病人是不是会更多，挂号难问题到底如何解决？

In the eyes of many netizens,Famous specialized subject hospital patients,See a doctor difficult,Registered more difficult.Tongren hospital eye/ent,Ji shui tan hospital bone traumatology department/acute,The temple of heaven hospital neurology department in national great influence,"It is difficult to find a number"The phenomenon was very outstanding.The pilot reform including cancellation 15% drug addition content,Netizens care,See a doctor to the patient is more,Registered difficult problem exactly how to solve?

　　同仁医院院长伍冀湘告诉记者：“作为试点工作的一部分，我们首先考虑的是增加号源。医院眼科、耳鼻喉头颈外科等重点科室，普通号增加420个号源，同比翻一番。其中眼科普通号由原来的每日500个号增加至700个，增加40%，专家号增加20%，部分专业的专家每次出诊增加10个号源。”

Tongren hospital dean WuJiXiang told reporters:"As a pilot part of the job,We first consider is increasing number source.Ophthalmic hospital/Ent head and neck surgery such key departments,Ordinary number increase 420 number source,Up double.The eye ordinary number by original daily 500 number increased to 700,Increased by 40%,ZhuanGuHao increased by 20%,Part of the professional experts each home visit increase 10 number source."

　　12月1日上午10点多，记者在同仁医院一楼门诊大厅看到，挂号处的患者比往日少了一多半，试点首日未见人多拥挤状况。

On December 1, more than 10 o 'clock in the morning,Reporter in tongren hospital outpatient service hall on the first floor to see,Registration office of the patients than the little more than half,The first pilot did not see many congestion.

　　伍冀湘介绍，同仁医院平时最高门诊量超过11100人次，周末门诊量平均为几百人。12月1日的门急诊量预计在1000至2000人次左右。本周末实行所有号源全部放号的措施。此外，同仁医院还在普外科、骨科、中医科等7个科室开放普通号，专家号增加号源440个，总量达到740个号源。另外，同仁医院眼科中心推行晚间门诊常态化，下午5点至8点主要为眼底、眼肌、青光眼3个供求矛盾突出的科室开设晚间门诊，有2至3位专家出诊，增加近百个号源。耳鼻喉科室也增加了晚间门诊，增设日间手术。

WuJiXiang introduced,Tongren hospital at ordinary times the highest MenZhenLiang over 11100 people,The weekend MenZhenLiang average for hundreds of people.On December 1, 1000 to curves door is expected to around 2000 people.This weekend, implement all source all FangHao measures.In addition,Tongren hospital in general surgery/orthopaedic/Traditional Chinese medicine department 7 departments open ordinary number,ZhuanGuHao increase number source 440,Total 740 number source.In addition,Tongren hospital ophthalmic center implementation of the evening outpatient normalization,5 PM to 8 point mainly for the fundus/lema/Glaucoma three prominent contradictions between the supply and demand of open evening outpatient department,Have 2 to 3 experts home visit,Increase nearly number source.Ent department also increases the evening outpatient service,Add ambulatory surgery.

　　同仁医院眼科副主任卢海告诉新华网记者：“增加号源是缓解看病难的一种方法。到眼科就医的患者80%都来自外地，就医需求是刚性的。另外眼科在就医流程方面也尽量采取优化措施，患者在普通门诊就诊后如需向专家问诊，不必再重新挂号，只要医务人员通过信息平台查询就可直接向专家预约，减少患者等待和转诊次数。”

Tongren hospital, deputy director of the eye LuHai told xinhua reporter:"Increase the number source is to alleviate the difficulties in getting a method.To the ophthalmic patients go to a doctor 80% comes from the field,Medical demand is rigid.Another eye in the medical process also try to take measures,Patients in general outpatient clinic if you need to expert interrogation,Don't need to register again,As long as the medical personnel through the information platform can be directly inquires to expert appointment,To reduce the number of patients waiting and referral."

　　据了解，三家医院此次试点计划分别汲取了此前友谊医院与朝阳医院的试点经验，为避免可能出现的普通号紧张，天坛与积水潭医院也分别扩充号源并调度相关科室医生，应对有可能出现患者增多的现象。

It is understood,Three hospitals in the pilot program respectively after absorbing the friendship hospital and chaoyang hospital pilot experience,To avoid possible ordinary number nervous,The temple of heaven and ji shui tan hospital also separately expansion, source and scheduling related department doctor,Deal with may appear the phenomenon of patients is on the rise.

　　扩充号源显然增加了医生的工作量，如何保证医生为患者看病的质量呢？同仁医院客服部主任曾多对此回应：“医院对医生医疗质量有严格管理，有行政职务的医生出诊时间因为行政工作而耽搁的，将有其助手先检查患者病历，非行政科室医生上班时间必须按时出诊，医院随时进行把控。”

Expansion number source obviously increase the doctor's workload,How to guarantee the quality of doctor for patients to see a doctor?Tongren hospital customer service department director had to respond to more:"The hospital medical quality to the doctor have strict management,Administrative duty doctor home visit time because of the delay and administrative work,Will have the assistant check patients medical records,FeiHangZheng department doctors work time must on time home visit,The hospital at any time be in progress to control."

　　同时又有网友提出，取消药品加成后，医生收入是否会降低？记者了解到，增收40元、60元、80元、100元不等医事服务费后，同仁医院与积水潭医院将医事服务费的60%分配给医务人员。同仁医院院长伍冀湘认为，医药分开改革，增收医事服务费是医生收入的一种增量，在一定程度上可以调动医生积极性，鼓励医生多为患者服务。

At the same time and have netizens put forward,Cancel after drug addition,The doctor whether income will be reduced?The reporter understands,'income 40 yuan/60 yuan/80 yuan/100 dollars after medical service charge,Tongren hospital and ji shui tan hospital will be 60% of the medical service assigned to the medical staff.Tongren hospital dean WuJiXiang think,Medicine separate reform,Increasing medical service charge is a doctor income of a kind of increment,To a certain extent can mobilize the enthusiasm,Encourage doctors to more for patient services.

设置处方金额上限确保合理用药 The prescription set maximum amount to ensure the rational drug use

　　大处方、过度医疗是深受网民诟病的医疗不良现象。在这一阶段的改革试点中，如何实现合理用药、避免过度医疗的医改目标？

DaChuFang/Excessive medical treatment is deeply for Internet users medical unhealthy phenomenon.In this one phase of the pilot reform,How to realize the rational drug use/Avoid excessive medical reform of the target?

　　记者了解到，天坛医院试点推出电子病历和设置协议处方的措施，由院方对处方及时点评。天坛医院副院长周建新告诉记者：“协议处方将常见病的常用药以固定方式组合，患者到门诊就医时，可自愿选择建立电子病历。协议处方和电子病历的实施有助于监测诊断与病历描述是否相符，用药与诊断是否相符，用药与指南规范是否相符的原则。”

The reporter understands,The temple of heaven hospital pilot out of electronic medical records and set protocol prescription measures,By the hospital in time to prescription comment on.The temple of heaven, vice President of the hospital ZhouJianXin told reporters:"Agreement prescription will be common with five fixed combinations,Patients to outpatient when go to a doctor,May voluntarily choose to build electronic medical records.Agreement prescription and electronic medical records to the implementation of the monitoring and diagnosis and medical records whether conform to describe,Medicine and diagnosis are in accord,Drug use and guide standard is in conformity with the principles of."

　　在同仁医院与积水潭医院的用药管理措施中，都提出对单张处方超过金额400元以及使用抗菌药物采取处方点评制度。每月对销售金额、销售数量排序前20位的药品进行动态监控及超长预警。对销售金额排名前10位的医师处方进行专项点评。

In tongren hospital and ji shui tan hospital medicine management measures,All put forward more than single prescription for the amount of 400 yuan and use of antimicrobial agents take prescription comment on system.Monthly sales amount/Sales volume ranking top 20 drugs for dynamic monitoring and early warning long.The amount of sales top ten physicians prescription, make a special campaign to comment on.

　　那么，实施处方金额上限规定及处方点评后，会否出现医生开药不够的情况呢？积水潭医院副院长蒋协远说：“对处方点评目的不在于医生开了多少钱的处方，而是处方本身是否合理，是否有利于患者用药安全。”

so,Implementation of prescription maximum amount rules and prescriptions to review after,There will be no doctor prescribe not enough? Situation?Ji shui tan hospital, vice President of the JiangXie far said:"The prescription of comment on purpose is not how much money a doctor prescription,But whether reasonable prescription itself,Whether it helps patients medication safety."

　　蒋协远介绍，积水潭医院将不断加强高值耗材管理，对使用高值耗材病例进行抽查，组织专家论证使用是否合理，并制定了相应的奖罚制度。

JiangXie far introduced,Ji shui tan hospital will continue to strengthen the high value consumables management,To use high value consumables spot check cases,Organizations use on the expert's demonstration is reasonable,And formulate the corresponding rules for reward system.

医药分开改革提速 Medicine separate speed reform

　　专科特色突出的综合医院医药分开改革试点推开后，意味着北京医药分开改革又往前迈进一步。北京市医院管理局局长封国生介绍，这三家专科特色突出医院在全国影响力较大，药占比少，药品让利空间相对较小，因此控费的难度、改革的压力都大于前两批试点医院。

Specialized subject features outstanding comprehensive hospital medicine separated after the pilot reform of push,Means that Beijing medicine separate reform and one step forward.Beijing hospital authority born seal countries is introduced,The three prominent characteristic specialized subject hospital in the greater influence,Medicine accounted for less than,Drug profit space is relatively small,So the difficulty of the cost control/The pressure of the reform are greater than the first two batch of pilot hospital.

　　“试点过程是发现问题的过程，希望通过这三家专科特色突出医院的试点能总结出这类医院医药分开的经验。”北京市医改办主任韩晓芳说，北京市医药分开改革试点正在提速，如果顺利，2013年将把改革试点范围扩大到北京市市属医院。此外，央属公立医院的改革也在跟进研究中。

"Pilot process is found that the problem of the process,Hope that through this three outstanding characteristics of specialized subject hospital pilot can be summed up this kind of hospital medicine separate experience."Beijing medical director do HanXiaoFang said,Beijing medicine pilot reform are separate speed,If all goes well,2013 will the reform pilot expanded to the Beijing municipal hospital.In addition,Central belong to public hospital reform is in the follow-up study.

　　那么当前试点医院的各项配套措施推行情况如何，财政补偿能否到位呢？韩晓芳说：“北京市医药分开改革的配套措施正根据改革情况一步步跟进，价格、医保、财政、编制实施政策联动。比如，财政补偿办法是‘突出花钱买机制’，医药分开后财政补偿由过去按照医院亏损额进行补偿，改为按照医院医务人员绩效考核、工作量、工作效率等进行补偿；财政投入方向给予服务模式、一些服务设备购买等补偿。”(记者 李莹)

Then the current pilot hospital each supporting measures implementation,Financial compensation? Can reach the designated position?HanXiaoFang said:"Beijing medicine separate reform supporting measures are according to the reform in follow up step by step,price/Medical insurance/financial/Implementation of the policy establishment linkage.For example,Financial compensation method is‘Outstanding buy mechanism’,Medicine after separate financial compensation from the past, in accordance with the hospital loss compensation,According to the hospital instead of medical staff performance evaluation/workload/The working efficiency of compensation;Financial investment direction given service mode/Some service equipment purchase and compensation."(Reporter LiYing)