公立医院改革效果如何？医药分开能否降低群众医药费用负担？医患矛盾该如何缓解？患者“滞留”大医院急诊的难题如何破解……去年以来，医疗领域的一系列民生问题引发关注。昨日，两位政协委员对这些问题进行了对话与探讨。

Public hospital reform effect how?The medicine can reduce the separate the medical expense burden?How to alleviate the doctor-patient contradiction?patients"retention"Big hospital emergency problem how to crack...Since last year,A series of the livelihood of the people in the medical field caused concern.yesterday,The two political consultative conference (CPPCC) of the problems and discusses the dialogue.

　　

医药分开改革 还需财政支持 Medical separate reform still need financial support

　　李刚：北京正在推广公立医院医药分开改革，这能从根本上解决“看病贵”吗？

Li gang:Beijing is promotion of public hospital reform medical separate,This can be fundamentally solved"The doctor your"??

　　王杉：医药分开，是取消了药品加成，平移为医事服务费。对绝大多数北京居民来说，医事服务费有医保报销，每人次40元，费用还是会稍降。对外地患者来说，费用负担变化可能不明显。

WangSha:Medicine separate,Is cancelled drug addition,Translation for medical service charge.For the vast majority of for Beijing residents,Medical service have medical insurance reimbursement,Forty yuan each time,Cost or will be slightly down.For patients with foreign land,Expense burden change may not obvious.

　　我专门写了个提案，建议政府尽快把新农合纳入城镇居民医保，首先让北京市民无论城乡，在医保上享受平等的普惠。另外，医药分开改革除了取消药品加成，还应有合理的诊疗模式和诊疗规范，才能避免过度医疗。

I specially write a proposal,Suggest the government as soon as possible into the new agriculture close medical insurance for urban residents,First let Beijing residents in urban and rural areas no matter,In the medical insurance enjoy equal pratt &whitney.In addition,Medical reform in addition to separate cancel drug addition,Shall also have the reasonable mode of diagnosis and treatment and diagnosis and treatment to specification,To avoid excessive medical treatment.

　　我认为，医药分开改革是否可持续，关键是看财政支持力度，另外还需要服务模式等一系列配套改革。否则很难实现患者有序就医。

I think,Medical separate reform is sustainable,The key is to see the financial support,In addition also need to service mode and a series of coordinated reforms.It is hard to realize patients go to a doctor ordered.

　　不过，医事服务费至少提高了医生的技术性劳动薪酬，起码对医生才能是一种肯定和体现。

but,Medical service charge at least improve the doctor's technical labor compensation,At least for the doctor to is a kind of affirmation and reflect.

　　但是很多患者对医生预期过高，认为大医院就得“包治百病”，这加剧了医患矛盾。你遇过吗？

But many patients to the doctor too high expectations,Think big hospitals have to"cures",This intensifies the doctor-patient contradiction.You met??

　　前不久就遇过。我们ICU收治了一位老人，出现术后谵妄症，怀疑有人要害他。家属只相信他父亲的话，指责医护人员。我们年轻的护士长解释了半天也没用，就抛出一句“那你们调录像好了”。结果，就老人床头的录像坏了。家属不干了，一定要医院给个说法。

Not long ago is met.We were ICU for an old man,Appear postoperative delirium disease,Doubt someone wait for him.Family members only believe his father's words,Accused medical staff.Our young head nurse explanations are useless,Will throw a"That you adjustable video well".The results,Is the old man bedside video is broken.Family quit,The hospital must give a statement.

　　这是没有沟通好。如果沟通到位，我遇到的绝大多数患者及其家属都是通情达理的。但从另外一个层面来说，医院、卫生行政部门能否强硬一些，推动政府拿出行之有力的措施，防止医闹和伤害医生的案件发生？

This is not a good communication.If communication in place,I met the vast majority of patients and their families are reasonable.But from another level,hospital/The public health administrative department can be tougher,To promote the government take effective measures of travel,To prevent the medical trouble and damage the doctor's case occurrence?

　　在医患纠纷发生后，医院有时确实很弱势。作为政协委员，第三方调解制度我们呼吁了好几年，现在终于初步建立起来，但与宁波、天津等城市相比，还很不完善。希望今后卫生部门能够加强针对医患纠纷的第三方调解力度，不要让所有的问题和矛盾，都集中在医院。

In the doctor-patient dispute occurs,The hospital sometimes really weak.As a political consultative conference (CPPCC),The third party mediation system we are calling for several years,Now finally preliminary established,But and ningbo/Compared to the city of tianjin, etc,Are not perfect.Hope in the future to strengthen health department for medical dispute mediation efforts to a third party,Don't let all the problems and contradictions,Are concentrated in the hospital.

　

　急诊老大难 应尽快解决 Some emergency should be settled as soon as possible

　　急诊(患者)滞留也是多年来三甲综合医院的一个老大难问题。北大人民医院想必也很严重，你们是如何解决的？

emergency(patients)Detention is also for many years one of the top general hospital some long-standing problems.Peking University people's hospital will be very serious,You are how to solve?

　　确实矛盾很多。这是一个诊疗服务整体架构要调整的问题。虽然确实很多专科科室不愿收复杂慢性病患者；但更深层次的，是总量不足的问题，专科病房也有限。所以不能把解决问题的责任，全部推给一家医院去内部调整、解决。

Indeed many contradictions.This is a medical services overall structure need to be adjusted in the problem.Although really many specialized department is not willing to accept complicated chronic disease patients;But the deeper,Is the problem of insufficient amount,Specialist ward is also limited.So can't solve the problem of responsibility,All on a hospital internal adjustment/solve.

　　如何让患者在急性恢复期，或老年病慢性病患者，放心地从大医院到基层医院去，享受同质的医疗服务，是卫生行政部门应该尽快去考虑、规划的问题。大医院自身，也要争取主动。

How to make the patients in acute recovery,Patients with chronic diseases or senile diseases,Safely from the hospital to a primary hospital,Enjoy the homogeneity of medical service,The administrative department of public health is should consider to go as soon as possible/Planning problem.Big hospital itself,Also to take the initiative.

　　我听说北大人民医院一直在探索“医疗共同体”，对二级医院、社区医院做技术支持和双向转诊。现在有什么新突破吗？

I heard that the people's hospital of Peking University, has been grappling with"Medical community",Secondary hospital/Community hospitals do technical support and two-way referral.Now there's new breakthrough?

　　我们正在跟隆福医院谈，已经初步达成了合作意向，就是今后人民医院的手术后患者度过急性康复期后，就可以转至隆福医院，接受后续的康复护理服务。隆福医院本身是二级医院，目前转型为东城区的老年病医院。

We are talking about with LongFu hospital,Has reached a preliminary cooperation intention,In the future is the people's hospital of surgery patients after acute rehabilitation period spent,You can turn to LongFu hospital,Subsequent rehabilitation nursing service.LongFu hospital itself is secondary hospital,At present for the transformation of dongcheng district hospital senile diseases.

　　北京去年底也开始在朝阳医院等11家医院试点首个医疗联盟。

Beijing chaoyang hospital is beginning to the end of 11 hospitals pilot first medical alliance.

　　是的。今后，三甲医院腾出床位和精力，做疑难病诊治；部分二级医院转型为康复护理专业医院。二者之间建立通畅的转诊渠道。但是如果没有政府规划和行政命令，医院之间没有主动性，这个事很难落实。

yes.In the future,Make 3 armour hospital beds and energy,Do abilities in diagnosis and treatment;Part of the secondary hospital transformation for rehabilitation nursing professional hospital.Set up between the referral channel unobstructed.But if no government planning and administrative orders,Between the hospital no initiative,This is a difficult thing to implement.

　　中日友好医院也在做“医疗共同体”，参与举办基层社区医院，做紧密型共同体，效果怎样？

The sino-japanese friendship hospital and doing"Medical community",Held in grass-roots community hospitals,Do close community,Effect how?

　　只能说目前在部分区域内做了一些尝试，效果还不错。起码这个小范围内的利益共同体和责任共同体，促进了优质医疗资源重新分配，让社区居民看专家更便捷。但医联体这个模式最终能否引导患者有序就医，还有很多有待探讨和解决的问题。

Can only say that at present in some areas made some try,Effect is good.At least the little within the scope of the community of interests and responsibilities community,To promote the quality of medical resource redistribution,Let the community residents see experts more convenient.But medical conjoined this mode can eventually lead patients go to a doctor ordered,Still have a lot to discuss and solve the problem.

　

　●谈医药分开 - talk about medicine apart

　　医药分开改革除了取消药品加成，还应有合理的诊疗模式和诊疗规范，才能避免过度医疗。

Medical reform in addition to separate cancel drug addition,Shall also have the reasonable mode of diagnosis and treatment and diagnosis and treatment to specification,To avoid excessive medical treatment.

　　——李刚

- li gang

　　

●谈医患关系 - about the doctor-patient relationship

　　希望今后卫生部门能够加强针对医患纠纷的第三方调解力度，不要让所有的问题和矛盾，都集中在医院。

Hope in the future to strengthen health department for medical dispute mediation efforts to a third party,Don't let all the problems and contradictions,Are concentrated in the hospital.

　　——王杉

- WangSha

　

　●谈医疗联盟 - talk about medical alliance

　　如何让患者在急性恢复期放心地从大医院到基层医院去，享受同质的医疗服务，是卫生行政部门应该尽快去考虑、规划的问题。

How to make the patients in acute convalescence safely from the hospital to base to go to the hospital,Enjoy the homogeneity of medical service,The administrative department of public health is should consider to go as soon as possible/Planning problem.

　　——王杉(记者 魏铭言记者 浦峰)

- WangSha(Reporters wei MingYan reporter PuFeng)