调查 survey

　　对于于莺微博所称医院对医保患者定额诊疗费，昨日，北京多家医院医生表示“确有耳闻”，有的医生还表示年初医院已给一线医生“吹风”，“要把医生的奖金和医保使用额度直接挂钩，花超会被扣奖金。”

For the warbler weibo fixed fee referred to in the hospital for health care patients,yesterday,Beijing hospital doctor said"Definitely have heard",Some doctors also said at the beginning of hospitals has given a glimmer of a doctor"blowing","To the doctor's bonuses tied directly and healthcare use credits,Cost will be deduct bonus."

“医保使用额挂钩医生奖金” "Health care use hook doctors bonuses"

　　多家医院的医生称，北京医保实行总额预付制，北京市人社局会根据各医院往年的诊疗量，给各家医院分配本年度的医保金份额。这些份额虽然每年按比例递增，但实际上还是不够使用。按照规定，超出8%以内，医院支付5%，医保金总库支付3%，再超过的部分则由医院自行负担。

Many hospital doctors said,Beijing health care system of the total amount shall be paid in advance,Beijing people club bureau can according to each hospital ZhenLiaoLiang from previous years,Assign hospitals a share this year's insurance premiums.Although these share in proportion to increase every year,But in fact are not enough use.In accordance with the regulations,Beyond 8%,Hospital pays 5%,Insurance premiums pay 3% stronger,More than part shall be burden by the hospital again.

　　“去年10月，我们医院的医保额度已花了全年的近90%，后面这几个月，医院一直要求各科室和医生减药减诊。”东城一家二甲医院的医生说。

"In October last year,Our hospital's coverage has spent nearly 90% of all the year round,This a few months later,Hospitals have been requires all hospitals and doctor of medicine and clinical reduction."Dongcheng a dimethyl hospital doctor said.

　　“我们医院已给医生吹过风。”昨日，东城另一家二甲医院医生周林(化名)说，去年开始，医院规定花超医保的各科室医生，不再给予评优评先进资格。今年年初，医院通知各科室传达给医生，“要把医生的奖金和医保使用额度直接挂钩，花超会被扣奖金。”

"Our hospital has been to the doctor blowing wind."yesterday,Dongcheng, another dimethyl hospital doctor zhou Lin(Not his real name)said,The last year,Hospital regulations take care each department doctor,No longer give assessment evaluation of advanced qualifications.At the beginning of the year,Inform all departments to doctors hospital,"To the doctor's bonuses tied directly and healthcare use credits,Cost will be deduct bonus."

　“挂钩”多发生二级医院 "hook"Tend to occur secondary hospital

　　记者调查发现，“吹风”的多是中小医院。

Journalist survey found that,"blowing"Is small and medium-sized hospitals.

　　“医院对医保患者定额诊疗费，在中小型医院早有耳闻。”昨日，西城一家大型三甲医院医师孟祥州(化名)说，去年底已有医院为不花超医保额度，向医生下达减药减诊指令。

"Hospital patients with health care fixed fee,In the small and medium-sized hospital have heard earlier."yesterday,Meng Xiangzhou west side, a big 3 armour hospital physicians(Not his real name)said,At the end of last year has spent over coverage is not for hospital,To the doctor of medicine and clinical reduction instructions.

　　孟祥州透露，除医保份额不够外，取消药品加成也是一个原因。

Meng Xiangzhou revealed,In addition to the health care share is not enough,Cancel the drug addition is also a reason.

　　去年，北京一些大医院试点取消药品加成，“有风声说取消药品加成将逐步推广，若中小型医院也实行，对收入的冲击要比大医院严重得多。”孟祥州说，大医院门诊爆满，医疗检查预约排队，取消药品加成对医院收入并未造成严重影响，“但中小型医院却不一样。”

Last year,,Some of Beijing's big hospital pilot cancellation of drug addition,"Have a wind that cancel the drug addition will gradually popularized,If small and medium-sized hospitals also,The impact on the income is much more serious than big hospital."Meng Xiangzhou said,Big hospital outpatient service,Medical check reservation line up,Cancel the drug addition to hospital income did not cause severe influence,"But is not the same as small and medium-sized hospitals."

　　东城一家二甲医院的医生称，二级医院门诊、检查量远不如三级医院，药品加成占到医院总体收入的三分之一以上。有药品加成时，超额的医保患者对医院收入是有“贡献”的，若取消药品加成，超额的医保患者将成为医院的负担。“药品加成取消是大势所趋，这部分收入没了，医院只能卡医生，尽量缩减医保额度使用。”

Dongcheng a dimethyl hospital doctors said,The secondary hospital outpatient/Check the amount is much less than the tertiary hospitals,Drug addition accounts for more than a third of total revenue to the hospital.Drug addition,Income is excess of medicare patients to hospital"Contribution to the"the,If cancel the drug addition,The excess of medicare patients will become the burden of hospitals."Is drug addition to cancel the trend of The Times,This part have no income,Hospital doctors only card,Used to reduce coverage."

　医院有“政策” 医生有对策 Hospital has"policy" Doctors have countermeasures

　　医院将医保额度与医生奖金挂钩，医生也开始想对策。

Hospitals will coverage bonuses tied to a doctor,The doctor also began to countermeasures.

　　东城区一家二甲医院医生周林说，为控制医保消费额度，他们科室最常用的做法是少开药，“慢性病患者，原来来一次都是开半个月的，现在顶多开一周的。”

The dongcheng district a dimethyl hospital doctor zhou Lin said,To control health care spending limit,Their department is the most commonly used approach is less prescriptions,"Patients with chronic disease,Originally a are open to half a month,Now open a week at most."

　　挑病人，也是医生控制医保额的一招。

Pick the patient,Is also a doctor control insurance amount.

　　周林透露，各科室对医保患者都有收治标准，“年纪大的病人不愿收，有多种病的老病号不愿收，这些患者都容易造成医保超标。”

Zhou Lin said,Each department has admitted patients with health care standards,"Older patients are reluctant to accept,There are a number of diseases of the old and the sick are reluctant to accept,These patients are likely to cause health standard."

　　如果病人情况达不到医生的“标准”，医生会“婉言”拒绝收治，“我们会跟患者家属说，患者的病情我们没把握，家属会另找医院。”

If the patient is not a doctor"standard",The doctor will"politely"helped,"We will talk to family members of patients,We not sure the patient,Families will find another hospital."

科室控医保 患者住院难 Department accused of medicare patients in hospital

　　防止压床是病房医生控制医保额的手段。

To prevent press is ward doctor control means of the amount of health care.

　　通常情况下，医保患者住院时间越长，花费就越高，会影响科室的医保花费额度。各科室大都有个原则，不收可能会造成压床的医保患者。

Is often the case,Medicare patients in the hospital longer,The higher the cost,Will affect the department of health care cost limit.Most of all hospitals have a principle,Don't accept may cause press of medicare patients.

　　周林说，对于容易压床的患者，呼吸科来看了看，会说患者也有泌尿系统疾病，建议家属往泌尿科住院治疗，“不少病人都是有多种疾病的，各科室推来推去，谁都不愿意收。”

Zhou Lin said,In patients with easy to press,An take a look,Patients also had urinary system disease,Suggest family members to the urology hospitalized,"Many patients are a variety of diseases,Each department pushed around,Who are not willing to accept."

　　有时候科室医保额度快超标了，医生会隔三岔五催患者出院，“当然是诱导性规劝，说病人在医院没有实际性意义，可以回家静养。”

Sometimes the department coverage levels,The doctor would grill urge patients discharged from hospital,", of course, is the gateway to persuade,Said the patient in the hospital has no practical significance,Can go home rest."

　　对于这些做法，多名医生坦言很无奈，医保额超了医院就会扣医生奖金，“我们看病不说要奖励，起码不能被扣钱。”

For these practices,Doctors said very helpless,Health insurance amount exceeds the hospital doctor will buckle bonuses,"Are we going to reward the doctor don't say,At least could not be buckles money."

　■ 链接 S a link

　　外地曾出现拒收医保患者 Nonlocal appeared refused medicare patients

　　事实上，一些地方试行医保总额预付制，出现部分医院推诿病人的现象。

In fact,,Some places for total health care system in advance,In part of the hospital shuffle phenomenon of the patient.

　　据报道2012年，上海医保总额预付制试点的第三年，因为医保定额的压力，上海市民秦岭癌症晚期的父亲遭多家医院拒收，他就此给上海市委书记俞正声写信，反映此事。

It is reported that in 2012,Shanghai total health-care system pilot in the third year in advance,Because medicare fixed pressure,Shanghai residents qinling cancer late father hospitals refused,He is writing a letter to Shanghai party secretary yu zhengsheng,Reflect this matter.

　　2012年4月，新京报记者调查，河北保定实施医保总额预付制，出现市医保中心给医院定指标，医院给科室定指标，医生限收职工医保病人，“医保花超，医生被扣奖金”的现象，导致部分公办医院限收职工医保病人。报道后，卫生部要求河北省卫生行政部门调查了解此事，并根据实际情况提出解决问题的有效措施。保定市人社局表示，对于公办医院拒收医保病人一事，连续约谈重点医院主要负责人，要求必须保证医保患者正常就医。

In April 2012,The Beijing news reporter investigation,Hebei baoding implement total health care system in advance,A health care center to set target hospital,Hospital to the department indicators,The doctor XianShou worker health care of the patient,"Health-care spending is super,Doctors were buckle bonuses"The phenomenon of,In some public hospitals XianShou worker health care of the patient.After the report,The request of the ministry of health administrative department of health survey in hebei province know about the matter,And put forward the effective measures to solve the problem according to the actual situation.Baoding city people club bureau said,For public hospitals refused of medicare patients,Continuous questioning key hospital chief,Requirements must ensure that the normal medical treatment health care patients.