历经3年努力，中国医药卫生体制改革步入“深水区”。而在医改涵盖的各方面中，公立医院改革因牵涉各方利益格局的调整，被喻为最难啃的“硬骨头”。2012年，公立医院改革打响“攻坚战”。

After 3 years hard,Chinese medicine and health system reform enters"Deep water area".And in covering all aspects of medical reform,Public hospital reform of structure adjustment of the interests of all parties involved,Be as one of the most difficult"stubborn".In 2012,,Public hospital reform"Tough sell".

　　公立医院是我国医疗服务体系的主体，也是医改的重点和难点。破解公立医院改革难题，解决看病难、看病贵，一方面需要破除“以药补医”的关键问题，进行利益格局调整；另一方面，医疗卫生行业存在的“不协调、不平衡和不适应”问题，需要以资源配置和人才培养为重点，完善宏观资源配置体制。

Public hospital is the main body of the medical service system in our country,Is also the key and difficult points of the reform.Crack problem reform of public hospitals,Solve the difficulty in to see the doctor/High cost,On the one hand to break"In medicine for healing"The key problem,Adjust their interests;On the other hand,The health care industry"Not harmonious/Imbalances and does not adapt"The problem,Need to be focusing on talent cultivation and the allocation of resources,Improve the system of macroscopic allocation of resources.

　　从2010年起，我国在17个国家联系试点城市和37个省级试点地区开展公立医院改革试点，在完善服务体系、创新体制机制、加强内部管理、加快形成多元化办医格局等方面取得积极进展。

Since 2010,In 17 countries contact pilot cities and 37 provincial regions to carry out the pilot reform of public hospitals,In a perfect service system/The innovation system mechanism/To strengthen the internal management/Speed up the formation of diverse do positive progress in medical pattern, etc.

　　2012年6月，国务院出台《关于县级公立医院综合改革试点的意见》，加快公立医院改革步伐。

In June 2012,The state council issued[The opinions of the comprehensive reform of public hospitals at the county level],To speed up the pace of reform of public hospitals.

　　6月26日，卫生部发布通知，确定全国311个县(市)作为县级公立医院改革试点县。

On June 26,The ministry of health issued a notice,Determine the nation's 311 counties(The city)As 试点县 reform of public hospitals at the county level.

　　——在云南，原有国家确定的12个县级公立医院综合改革试点县增加至30个，通过全面调查，合理调整医药价格，群众医药费用负担得到减轻。按照“总量控制、结构调整”的原则，云南在县级公立医院改革中实行“三降一消一升”，即降低药品价格、降低大型设备检查治疗价格、降低高值医用耗材价格，取消药品加成，提高医疗服务技术价格。

- in yunnan,Original state of 12 at the county level comprehensive reform of public hospitals 试点县 increased to 30,Through the comprehensive investigation,Reasonable medicine price adjustment,The medical expenses burden lessen.In accordance with the"Total amount control/Structural adjustment"The principle of,Yunnan province in the county in the reform of public hospitals"Three drop one away",The lower drug prices/Lowering the price of large equipment inspection treatment/Reduce the high value of medical consumables prices,Cancel the drug addition,Improved medical services price.

　　——在西安，阎良区开展县级医院与乡镇卫生院一体化管理改革，把区属乡镇卫生院整体纳入县级医院管理，以提高基层医疗卫生服务水平为重点，促进城乡医疗卫生服务资源共享、优势互补。

-- in xi 'an,Integrated YanLiangOu in county hospital and township health hospital management reform,The whole of rural hospitals in county hospital management,In order to improve the basic medical and health service level as the key,Promote urban and rural medical and health services resources sharing/Complementary advantages.

　　——在湖北，南漳县作为全省38个贫困县之一，针对高素质人才匮乏、优质医疗资源供应不足的实际，南漳县创造性地建立了县内互助式的医疗协作机制，帮扶带动全县基层医疗卫生机构医务人员能力和素质提升，有效促进了全县整体医疗服务能力的提高。

- in hubei,NaZhangXian as the province and one of the counties,In view of the lack of high-quality talents/The practice of high quality medical resources are in short supply,NaZhangXian creatively set up the solutions in the county medical cooperation mechanism,Help drive the whole basic medical and health institutions medical staff ability and quality,Effectively promote the county as a whole the ability of medical service.

　　根据《中国的医疗卫生事业》白皮书，目前我国已有18个省(区、市)的600多个县参与县级公立医院改革试点。

According to the[China's medical and health services]The white paper,At present our country has 18 provinces(area/The city)Of more than 600 counties to participate in the pilot reform of public hospitals at the county level.

　　县级公立医院改革试点如火如荼，各大城市公立医院改革也已拉开序幕。

At the county level public hospital reform,Major cities public hospital reform has also started.

　　7月1日，北京和深圳同时在公立医疗机构启动医药分开试点，破除“以药养医”机制。

On July 1,,Beijing and shenzhen public medical institutions at the same time start medicine pilot separately,break"Medicine to support medical"mechanism.

　　——在北京，友谊医院成为第一个“吃螃蟹”的医院。他们取消药品加成，设立“医事服务费”，同步推动医保支付方式改革。试点几周，院内系统运行平稳，出现了“三降三升”。即门诊次均费用、次均药费、医保自付费用下降，百姓满意度、服务质量、医院收入提升。

- in Beijing,Be the first friendship hospital"To eat crab"In the hospital.They cancel the drug addition,To set up"Medical service.",Promote the reform of the medical insurance payment simultaneously.Pilot a few weeks,Hospital system run smoothly,appeared"Three came up".The outpatient service times are costs/All expenses for medicine/Medical insurance expense,People satisfaction/The quality of service/Hospital income ascension.

　　——在深圳，药品加成的取消彻底打断了公立医院业务收入与用药数量、药品价格直接挂钩的利益链条。数周来，公立医院运行平稳，门诊次均费用、次均药费、医保自付费用下降，群众得到了实惠。

- in shenzhen,Drug addition of cancel completely interrupted public hospital business income and the amount/Drug prices directly link the interests of the chain.For weeks,Public hospital smooth operation,Outpatient service times are costs/All expenses for medicine/Medical insurance expense,The benefits are obtained.

　　“预计公立医院一年可直接减轻参保人自付费用2.09亿元，社区医疗机构也可一年减轻市民医药费用1.17亿元。”深圳市卫生人口计生委副主任罗乐宣说。

"Public hospital is expected to pay one year can directly reduce ginseng protect people from costs 209 million yuan,Community medical institutions can also reduce public medical costs $117 million a year."Shenzhen health population LuoLeXuan, deputy director of the commission said.

　　据统计，北京友谊医院和深圳市药品收入占业务收入的比重分别比改革前下降12.9%和4.1%。深圳市公立医院门诊患者抗菌药物处方比例下降到13.7%，低于20%的国家标准。

According to statistics,Beijing friendship hospital and shenzhen drug income accounted for the proportion of income than before reform fell by 12.9% and 12.9%, respectively.Shenzhen public hospital outpatient patients antimicrobial prescription rate down to 13.7%,Less than 20% of the national standards.

　　2012，公立医院改革在“深水区”的进程亮点频现；而展望未来，仍有漫长的道路需要改革的进一步深化和推进。

2012,In the reform of public hospitals"Deep water area"The process of window frequency;And looking forward to the future,There is still a long way need to reform the further deepening and promote.

　　“公立医院改革涉及整个医疗服务提供体系的变革。如果没有公立医院改革的成功，很难想象高端医院和社区卫生能够扮演各自本来应该扮演的角色。”北京大学光华管理学院教授、北京大学中国卫生经济研究中心主任刘国恩说，突围公立医院改革“深水区”还需妥善解决计划经济遗留的人事、编制、行政干预过度等矛盾。(记者胡浩、吕诺）

"Public hospital reform involves the transformation of the medical service system.If you don't have the success of the reform of public hospitals,It's hard to imagine the high-end hospitals and community health can should play their respective role."Peking University guanghua school of management professor/Beijing university, director of the China center for health economic research, LiuGuoEn said,Breakthrough public hospital reform"Deep water area"Still need to properly solve the personnel from the planned economy/prepare/Administrative intervention excessiveness, etc.(The reporter HuHao/LvNuo)