热点聚焦 Hot focus

　　患者感叹 来一次医院太难了 Patients plaint to a hospital is too difficult

　　12月10日，周一的早晨异常寒冷，但在北京天坛医院里，却人头攒动，排队缴费和等待拿药的多条队伍已经排起了长龙。

On December 10,Monday morning very cold,But in the temple of heaven in Beijing hospital,But crowded at,Queue pay cost and waiting for the team may or may not prescribe medicine for more than have to line up the long dragon.

　　记者随机询问了几位正在排队的患者，发现这其中大多是只抓药不看病的“慢性病号”，而且老人家居多。不少老人一手拿着医保就诊册，一手拉着装药的小车，不少人还带着小凳和茶杯，“准备打持久战”。

Reporter random asked several are lining up to patients,Found the most of which are not only their doctor"Chronic disease,",And the old man's house is in the majority.A lot of the old man with a medical insurance medical books,A la dress medicine car,Many people still take a small stool and cups,"Ready to fight a protracted war".

　　“医院虽然给我们开了合适的药，我这都是几十年的老毛病了，天天不能离开药，所以只能每个星期都来。”正在排队的76岁的林老先生向记者抱怨道，“我患有高血压、糖尿病、前列腺增生、慢性支气管炎、骨质疏松等多种疾病，治疗前列腺增生的来一趟能配两盒，可服用三个星期，但控制高血压的‘波立维’较贵，一次一般只能配一两盒，只够几天的药量，糖尿病更是要天天服药，没办法，只好隔几天就来一趟，坐公交车要一个多小时，非常不方便。我只是拿药又不是看病，不好意思总麻烦孩子，来一次医院太难了。”

"Hospital although we have the right medicine,I this is one that accompanies the decades,Every day can't leave medicine,So can each week to all."Are lining up to 76 - year - old old man Lin to reporters complained,"I have high blood pressure/diabetes/Prostatic hyperplasia/Chronic bronchitis/Osteoporosis and so on the many kinds of disease,The treatment of prostate hyperplasia to a trip to go with two boxes,Can take three weeks,But control of high blood pressure‘Wave set d’More expensive,A general with only one or two box,Only a few days of enough quantity,Diabetes is to need to take medicine every day,Can't,Every few days will come to a trip,Take the bus to more than an hour,Very inconvenient.I just medicine is not a doctor,Sorry always trouble child,To a hospital is too difficult."

　　“大夫，我不看病就是拿点药，您受累帮我都开了行吗？”看着老人家疲惫的样子，大夫沉默了一下还是“无情”地拒绝了：“医院有规定，不能跨科开药，我就是给您开了，您也取不出来。您还是去相应的科室吧。”

"The doctor,I don't see a doctor is to take some medicine,Be you help me out ok?"Look at old man tired appearance,The doctor was silent for a moment"heartless"To refuse the:"Hospital has a regulation,Can't cross section prescribe,I just give you away,You also take not to come out.You still go to the corresponding department it."

　　作为第三批试点医药分开的医院，天坛医院医改后“西医科室不可跨科开药”。林老先生只能分别在神经内科、内分泌科、泌尿科、呼吸内科以及骨科排队、开药，再排队缴费、拿药。整整一个上午，老人家说累得腰都疼了。

As the third batch of pilot medical separate hospital,The temple of heaven hospital after reform"Western medicine department do not cross section prescribe".The old man can only Lin respectively in neurology department/endocrinology/urology/Respiratory medicine and orthopaedic queue/prescribe,To line up pay cost/May or may not prescribe medicine for.A whole morning,Old man was too tired to say with the pain.

　　

医生建议 The doctor advised

　　更多疾病可纳入按月开药 More diseases can be brought into monthly prescribe

　　让老人们不得不每周来医院开药的原因，既有卫生部“急三慢七、行动不便两周量”的门诊开药量规定，也有新医改中的“西医科室不可跨科开药”的要求。

Let old people have to come to the hospital a week prescribe reason,Both the ministry of health"Quick three slow seven/Action inconvenience quantity of two weeks"Open the clinic drug regulation,Also has the new medical reform"Western medicine department do not cross section prescribe"requirements.

　　2005年12月，北京市劳动和社会保障局下发《关于调整参保职工门诊开药量的通知》。《通知》要求，为方便慢性病患者治疗，从2006年1月1日起，参保职工患高血压、糖尿病等十类慢性病，且病情稳定需要长期服用同一类药物的，定点医疗机构门诊开药量可放宽到一个月量。这十类慢性病包括：高血压、糖尿病、冠心病、慢性肝炎、肝硬化、结核病、精神病、癌症、脑血管病、前列腺肥大疾病。

In December of 2005,Beijing labor and social security bureau issued[Concerning the adjustment of the ginseng protect a worker to open the notice of outpatient drug].[notice]requirements,For the convenience of chronic disease patients,From January 1, 2006,Ginseng protect a worker to suffer from high blood pressure/Diabetes ten kind of chronic disease,And in stable condition need long-term use of the same kind of drug,Nod medical establishment outpatient service to open to the drug can relax a month quantity.The ten kind of chronic diseases including:hypertension/diabetes/Coronary heart disease/Chronic hepatitis/cirrhosis/tuberculosis/psychosis/cancer/Cerebrovascular disease/Hypertrophy of the prostate disease.

　　但是其他疾病的门诊开药量5年以来一直未做调整，仍然执行卫生部及市医保中心的规定：急诊3日量，慢性病7日量，行动不便2周量。

But other disease outpatient drug open five years has not to change,The ministry of health and medical insurance still implement the provisions of the city center:Emergency 3rd quantity,Chronic 7 quantity,Action inconvenience quantity of 2 weeks.

　　宣武医院功能神经外科咨询室工作人员认为，像帕金森病，需要患者终生服药，不能停药，而且患者年龄大、行动不便，但是按照相关规定医生只能给患者开半个月的药。

Xuanwu hospital functional neurosurgery many workers thought,Like Parkinson's disease,Need the lifelong medication,Can't stop drug,And older patients/Action inconvenience,But according to relevant regulations the doctor can only give patients open half a month of medicine.

　　

社区医院 Community hospital

　　很多慢性病药“配不了” A lot of chronic drug"Don't match"

　　既然每周去大医院配药既费时又费力，那么慢性病患者为何不选择去离家近又不去排队的社区医院配药呢？记者了解到，让众多慢性病患者不得不“舍近求远”的原因，是很多慢性病用药在社区根本无法配到。

Since every week go to large hospital pharmacy was slow and arduous,So why not choose to chronic illness near home and don't line up of the community hospital pharmacy?The reporter understands,Let many chronic diseases patients had to"cooperate"reason,Is a chronic disease in community medicine cannot match at all.

　　“我一直服用‘波立维’，安贞医院说这个效果好，你们这儿为什么成自费的了？”家住亚运村社区的高大爷因为患有脑卒中，看病后拿着处方到社区医院开药，才知道社区医院这种药是自费的。“不是我们不想开，而是我国用药有规定，不同级别的医院用的药物不一样。不同医疗机构使用不同的限级药品是为了保障百姓的用药安全，一些专业性较强或用量较少的药品，只限于大医院有相关病症诊疗经验的医生具有处方权。所以，社区一般只配备疗效明确的少部分慢性病用药。”亚运村社区医院的医生解释说，现在到社区医院来的，绝大多数是来开药的慢性病患者，尤其以高血压、糖尿病、咳喘、关节炎患者居多，但是这类药物在社区医院配备的种类很少，不是没有就是患者不常吃的品牌，所以这些病人还是需要社区和大医院两头跑。这位医生还告诉记者，还有一些慢性病人到社区开一些新药、进口药，这些药社区医院也是没有的，即使有也是自费。

"I have been taking‘Wave set d’,Anzhen hospital said the effect is good,Why do you here into at one's own expense?"Asian games village community in the high because the big ye with cerebral stroke,After the doctor with a prescription to community hospital prescribe,Just know community hospital this medicine is of at one's own expenses."Not that we don't want to open,But our country medicine has a regulation,Different levels of hospitals of different drugs.Different medical institutions use different limit level drug is to ensure medication safety of the people,Some professional stronger or less dosage of the drug,Only big hospitals have related disease diagnosis and treatment experience of doctors has ChuFangQuan.so,Community usually equipped with curative effect definite a few medicine chronic diseases."Asian games village community hospital doctor explained,Now to the community hospital,The vast majority of patients with chronic disease is to prescribe,Especially in high blood pressure/diabetes/Cough asthma/Arthritis is in the majority,But this kind of drugs in community hospitals equipped with few species,Is not without is patients do not often eat brand,So the patient still need community and hospital two head run.The doctor also told reporters,There are some chronic patients to community open some new drugs/JinKouYao,These medicine community hospital is not,Although have, also be at one's own expense.

　　对此，不少在社区医院看病的患者都表示，希望社区药品能再多点、再全点，这样就可以不必再到大医院排队受苦了。

this,Many in the community hospital patients have said,Hope that the community can drugs again more/Then the whole point,This is no longer necessary to big hospital queue suffered.

　　

人保部门 Insurer department

　　就放宽开药量问题进行调研 The drug is relaxed open problems in research

　　既然开药量受限给慢性病患者带来诸多不便，那么开药量是否会放开？可开一个月药量的病种是否会进一步“扩容”？对此，北京市人力社保局表示，已经注意到患者在这些方面的反映，将会同医保处、医保中心，征求医生意见，加快进行调研。

Since open quantity restricted to patients with chronic diseases to bring a lot of inconvenience,Then open the drug will let go?Can open a month of the drug diseases will further"flash"?this,Beijing human social security bureau said,Attention has been paid to the patients in these aspects reflect,Will be in health care/Health care center,Seek medical advice,To speed up the research.

　　北京市人力社保局相关负责人表示，所谓的“急三慢七、行动不便两周量”是卫生部门的规定，之所以人力社保局发文将癌症等10种病的开药量放宽到一个月，正是出于对患者的特殊照顾。

Beijing human social security bureau officials say,The so-called"Quick three slow seven/Action inconvenience quantity of two weeks"Is the provisions of the department of health,The number of human social security bureau to cancer, and other 10 kinds of disease open dose to relax a month,It is out of the special care to patients.

　　该负责人还指出，10种病开药量放宽到一个月，都是经过专家认证的，选取的是一些病情比较稳定、需要长期服药，且服用同类药品不会出现安全问题、不会造成药品浪费的慢性病。而对于同样需要长期服药，但病情具有不确定性的病种，还是应该定期就医，以免病情出现转变。像类风湿病就容易引起心脏病等并发症。

The official also pointed out,Ten kinds of disease open dose to relax a month,Have been experts certification,Select some condition is stable/Need long-term medication,And taking drugs won't appear the same security issues/Won't cause chronic drug waste.And for the same need medicine for a long time,But the condition is uncertain of the disease,Should go to a doctor regularly,In order to avoid illness appear transformation.Like a kind of rheumatism is easy to cause complications such as heart disease.

　　另外，北京市卫生局也表示，将对社区医院基本药物目录进行调整。届时，市民反映的一些药品在社区买不到的问题将有望得到解决，今后，老百姓在家门口的社区医院就能够开到治疗老年病、慢性病的药。

In addition,The municipal bureau of health also said,To community hospital essential drugs list to adjust.the,Citizens reflect some of the drug in the community can't buy will be expected to be solved,In the future,People in the doorway community hospitals can open to treat senile diseases/Chronic medicine.

　　

官方表态 The official said

　　患者适应“急三慢七”需要时间 Patients to adapt to"Quick three slow seven"Need time

　　“医药分开改革就是要对医生的诊疗和用药行为进行规范。”北京市医改办主任韩晓芳指出，过去，个别医生一次给患者开很多药的做法是错误的。医生应遵守“急三慢七”的原则，即急诊药物开三天的量，慢性病药物开七天的量。

"Medical reform is to separate to the doctor's diagnosis and treatment and medication's behavior."Medical director of the Beijing do HanXiaoFang pointed out,In the past,Individual doctors a give patients a lot of drugs it is wrong.The doctor should abide by the"Quick three slow seven"principle,Emergency medicine is open three days of quantity,Chronic drug open the amount of seven days.

　　“由于改革后，患者不能像过去那样一次开很多药，因此需要一定时间来适应。”封国生表示，前两家试点医院已经取得了阶段性的成效。首先是患者负担减轻了。两家医院的门诊药占比、次均费用、次均药费和住院患者例均费用等指标均得到了不同程度的下降，其中次均药费下降17%左右，且趋势平稳、效果持续。其次，患者满意度提高，就医得到有效引导。

"Because after the reform,Patients can't like they did in the past, a a lot of drugs,Therefore requires some time to adapt."Seal countries said born,Former two pilot hospital has made staggered results.The first is the burden of patients with ease.Two hospital outpatient service of medicine than/Second all cost/Second all expenses for medicine and inpatient cases all expenses index were given different degree of decline,The second all expenses for medicine by about 17%,And stable trend/Effect lasts.secondly,Improve patient satisfaction,Doctor effectively guide.

　　据悉，两家医院通过问卷调查，结果显示85%以上的患者能接受医事服务费的价格，82%以上的患者对医生的服务能力满意，并认为看病沟通时间比以前长了。改革后，一部分常见病患者被有效引导到了普通门诊就诊，专家号难挂问题得到了一定缓解。

It is reported,Two hospitals through the questionnaire survey,Results showed that more than 85% of the patients can accept the price of medical service,More than 82% of the patients to the services of a doctor with ability,And that the doctor communication time than ever before long.After the reform,Part of the common disease patients were effectively guide the general outpatient clinic,ZhuanGuHao difficult problems are hanging a certain ease.

　　此外，医务人员的劳动价值得到体现，医院收益得到了提高。友谊医院和朝阳医院都按照医药分开整体方案和北京市医管局绩效考核的要求，建立了新的绩效考核体系，贯彻多劳多得、优劳优得的原则，两家医院的医务人员绩效工资较改革前均将增长30%以上。（记者 李颖）

In addition,Medical staff labor value be reflected,The hospital income improved.Friendship hospital and chaoyang hospital in separate medicine overall plan and the Beijing hospital authority performance evaluation requirements,To establish a new performance evaluation system,Implement more pay for more work/The principle of optimal pains to optimal,Two hospital medical staff performance salary reform are more before will increase by more than 30%.(Reporter kit-tai)