全面推“先看病后付费”没戏了 Comprehensive push"After the first doctor pay"no

卫生部否认年内全国推广，倡导有条件地区进行试点 The ministry of health deny years national promotion,Advocate conditional pilot area

　　19日，针对媒体有关卫生部要全面推广“先看病后付费”制度的报道，卫生部相关负责人接受本报记者采访时表示，虽然卫生部在积极推广，但只是倡导有条件的地区进行试点，没要求全面推行。

19,According to the ministry of health to the media comprehensive promotion"After the first doctor pay"System reports,The relevant person in charge of the ministry of health to accept our newspaper reporter to interview said,Although the ministry of health in the positive promotion,But only advocates have conditions of the pilot area,Not asking for the full implementation of the.

　　18日，有媒体报道，今年卫生部将全面推行“先看病后付费”制度。推行这一模式，意味着以后患者住院无需交押金，到出院时只需交纳个人承担费用即可。消息一出立即引起了公众的广泛关注。

And,,Media reports,This year, the full implementation of the sanitation department"After the first doctor pay"system.To implement this model,Means that the patient in the future without a deposit,To the hospital need to hand in individual to assume a fee.The news immediately brought to public attention.

　　就此消息，记者19日电话采访了卫生部医政司医疗管理处相关人员。一位陈姓负责人表示，卫生部虽然一直致力于推广“先看病后付费”，但是短期内无法全国推广，也从未提出过“全面推行”的要求。“卫生部门是倡导有条件的地区先行试点。”

In this news,Reporter 19 telephone interviews with the ministry of health YiZhengSi medical management personnel.A person in charge, surnamed Chen said,Although the ministry of health has been committed to the promotion"After the first doctor pay",But in the short term can't national promotion,Never raised"The full implementation of the"requirements."Department of health is the initiative conditional area first pilot."

　　该负责人坦承，要全面推广“先看病后付费”模式面临许多困难。首先推行这一模式不仅需要卫生部门推动，还需要其他相关部门政策配套。此外，信息化水平、医保报销水平也限制了这一模式的推广。“尤其像大医院，医保报销少，许多病号是慕名而来的，控制恶意逃费较难。”(记者 李钢)

The official admits,To the comprehensive promotion"After the first doctor pay"Mode faces many difficulties.The first implementation of this model not only need to promote the health department,Still need to other related department policy supporting.In addition,Informatization level/Medical insurance reimbursement level also limits the model of promotion."Especially as a hospital,Medical insurance reimbursement less,Many patient over the is,Control malicious escape fee more difficult."(Reporter LiGang)

新闻延伸 2500家医院试点 俩月逃费120人 News extension 2500 hospitals pilot two month fled fee of 120 people

　　在过去，大病或者急病的患者需要住院，往往都要先交几千元甚至上万元的押金，不少经济困难的患者耽误了治疗。而现在他们只要和医院签一份《住院治疗费用结算协议书》就可以了。出院的时候，患者只需要支付个人医保报销以外的部分，其余的都由医保部门直接支付给医院。

In the past,A serious illness or acute disease of the patients need to be hospitalized,Tend to want to make thousands of yuan even tens of thousands of yuan deposit,A lot of economic difficulties of the patients delayed treatment.And now they just and hospital sign a[Hospitalization cost settlement agreement]Can the.hospital,Patients only need to pay personal medical insurance reimbursement outside of the part,The rest are made by health care providers direct payment to the hospital.

　　按照试点规定，享受“先看病，后付费”政策的患者包括：参加医保、新农合的病人，无姓名、无陪护人、无地址的“三无”病人，以及病情急重急需抢救的病人等。从试点模式上，支付和保障配套措施也在进一步完善。

In accordance with the provisions of the pilot,enjoy"First the doctor,for"The policy of the patients including:medicare/New farmers joint of the patients,No name/Without accompanying people/No address of"neutral"The patient,And condition urgent heavy need rescue of patients, etc.From the pilot model,Payment and security measures are also further improve.

　　据统计，山东省2500家公立医院推行这项试点两个月以来，有120名患者逃费跑单，占所有“先住院，后付费”患者的万分之一左右。针对这种情况，目前卫生行政部门正在搭建全国居民医疗信息共享平台，将医疗消费纳入个人征信系统，让恶意逃费者“一朝失信，寸步难行”。为了减轻医院替病人垫付医药费的压力，确保“先看病，后付费”试点的推行，今年江苏、吉林等地为贫困患者设立医疗救助基金，实施总额预付制度，年初就把15%的钱先预付给医院，让患者和医院双方都放了心。

According to the statistics,Shandong province 2500 public hospital implementation of the pilot two months,There are 120 patients escape fee run single,Accounted for all"In the first,for"About one over ten thousand of the patients.In view of this situation,At present the public health administrative department is building country residents medical information sharing platform,Medical consumption is put into the personal credit registry system,Let the malicious fled the fee"Once break faith,stuck".In order to reduce hospital for the patient's medical advances pressure,Ensure that"First the doctor,for"Pilot implementation,Jiangsu this year/Jilin, etc to poor patients set up medical relief fund,The total advance system implementation,At the beginning of the first 15% of the money in advance to the hospital,Let patients and hospital both put their heart.

　　目前，全国已有山东、河南、青海等21个省份试点“先住院，后付费”制度，试点成功后，将逐步在全国公立医院全面推行。(据央视《新闻联播》)

At present,The country had been shandong/henan/Qinghai 21 provinces pilot"In the first,for"system,Pilot after the success,Will gradually in the full implementation of public hospital.(According to CCTV[News broadcast])

我省现状 县乡医院全部推行 省市级“掉队” Present situation in our province of county and township government hospital implementation all became laureates"Left behind"

　　我省是最早推广“先看病后付费”诊疗模式的省份之一。按照省卫生厅的要求，2012年6月1日起，各市要在县及县以下医疗机构全面推行该模式。同时，鼓励三级综合医院、中医医院、专科医院等积极参与。但现实中很少有三级医院推行。

Our province is the first promotion"After the first doctor pay"Diagnosis and treatment mode is one of the provinces.According to the provincial health department requirements,2012 June 1,Various cities in the county and the full implementation of the model of medical institutions.At the same time,Encourage tertiary general hospital/Hospital of traditional Chinese medicine/Specialized subject hospital and actively participate in.But in reality there are few tertiary hospital implementation.

　　目前，虽然我省已有个别市级医院试点“先看病后付费”，但绝大部分省市级大医院都没推行这一模式。

At present,Although our province for individual municipal hospital pilot"After the first doctor pay",But most of the large hospital became laureates didn't implement the model.

　　省城一家三级综合医院的相关负责人表示，在济宁市推广“先看病后付费”时，该院曾组织专家去考察，但该院最终并没有推行。“我们医院和县医院差别太大，一是省级医院新农合报销比例低，二是病人来自全省甚至全国各地，而且病情复杂，费用高，很难控制逃费。”

Provincial capital a tertiary general hospital officials say,In jining city promotion"After the first doctor pay"when,The hospital had organization experts to explore,But its final and no implementation."Our hospital and county hospital the difference is too big,One is the provincial hospital new farming close reimbursement ratio is low,The second is the patient from the province and even all over the country,And is difficult to,The high cost of,It is difficult to control fled fee."

　　“医保报销比例是推行这一政策的基础。”作为三级医院的济宁市中医院之所以能推行这一模式，中医报销比例较高是一个重要基础。目前新农合在乡镇医院报销90%左右，在县级医院报销75%，而在市级医院报销仅50%左右，在省级医院报销则更低。这成为阻碍省市大医院推行“先看病后付费”的重大障碍。

"Medical insurance reimbursement ratio is to implement the policy foundation."As a tertiary hospital of jining city hospital of traditional Chinese medicine can implement the model,The doctor of traditional Chinese medicine higher reimbursement ratio is an important foundation.The present new farming together in township hospital to submit an expense account about 90%,In the hospital at or above the county level shall submit an expense account 75%,And in the municipal hospital to submit an expense account only 50% or so,In the provincial hospital to submit an expense account is more low.This be the big hospital implementation of provinces and cities"After the first doctor pay"Major obstacles.

　　除了这些障碍，大医院自身也缺乏推行这一模式的主动性。“大医院的床位利用率本身就很高，没有必要再推行先看病后付费。”一位三级医院的相关负责人说。(记者 李钢)

In addition to these obstacles,Large hospital itself is also a lack of initiative to implement this mode."Large hospital bed utilization itself is very high,There is no need to see a doctor for carrying out first."A tertiary hospital related person in charge said.(Reporter LiGang)