看病难“药方”怎么开(热点深一度) The doctor is difficult"The prescription"How to open(Hot spot deep once)

　　

钟南山代表：做强全科医生，让家庭医生触角伸向每户家庭，对村医给“身份”、保养老 Zhong nanshan on behalf of:And stronger gp,Let the family doctor into every family,The village doctor to"identity"/Insurance pension

　　

吴明江委员：筑牢基层“网底”，增加优质医疗资源，建设医疗联合体，推进分级诊疗 Wu Mingjiang member:Build a grassroots"The population",Increase high quality medical resources,Construction of medical association,Promote grading diagnosis and treatment

　　

1.看病难为何势头不减？ 1. Medical care why momentum has not lost?

　　

优质医疗资源不均衡。要打破“土围子”，建医疗联合体 High quality medical resources is not balanced.To break the"castles",Build medical association

　　

析 analysis

　　医改3年，不少人还是感觉看病难。比如，北京的大医院依然人满为患，专家门诊总是爆棚，去年一年各大医院“专家号”不到200万个，但需求者高达1.2亿人。全市门诊总量中，大医院占比2/3，基层医疗机构只占1/3。

Health care for 3 years,Many people still feel difficult.Such as the,Big hospital in Beijing is still packed,Expert outpatient service is always empty,Each big hospital in the last year"visit"Less than 2 million,But the demanders of up to 120 million people.The city's outpatient amount,Big hospitals accounted for more than 2/3,Grassroots medical institutions only accounts for a third.

　　“医改是一个渐进过程，不可能一蹴而就。”中国工程院院士钟南山代表表示，3年医改还是取得了明显成效，北京基层医院门诊量已经提升。但大医院看病难，源于医疗资源配置不均衡，基层卫生服务长期“短板”，未能形成分级诊疗。

"Health reform is a gradual process,Will not happen overnight."Chinese academy of engineering academician zhong nanshan representatives said,3 years health reform has achieved obvious results,Beijing basic-level hospitals MenZhenLiang has increased.But the big hospital,Is the result of medical resource allocation imbalance,Basic health services for a long time"The short board",Failed to form a hierarchical diagnosis and treatment.

　　全国政协委员、中华医学会副会长吴明江介绍，目前，我国医疗服务存在以下问题：一是医疗资源总量不足，优质医疗资源匮缺。二是整体医疗服务能力不高。三是优质医疗资源主要集中在北京、上海、广州等大的中心城市。这些因素羁绊着分级诊疗的脚步。

The CPPCC national committee/The Chinese medical association, vice President of Wu Mingjiang is introduced,At present,Medical service in our country exist the following problems:One is the insufficient medical resources,High quality medical resources are necessities.Secondly, the whole medical service capability is not high.Three is the high quality medical resources mainly concentrated in Beijing/Shanghai/The center of guangzhou and other big cities.These factors by the classification and treatment steps.

　　

解 solution

　　“大医院应该多培养下面挂钩的基层医院。” 钟南山说，基层医生的水平提高了，能解决常见病、多发病，自然就会分流病人。

"Big hospital should cultivate more tied under the basic-level hospitals." Zhong said,Grass-roots doctor level increased,Can solve common diseases/Frequently-occurring disease,Will bypass patients.

　　“从今年开始，卫生部准备选择若干大中型城市，建设医疗联合体。”吴明江认为，联合体内，大医院技术支持基层医院，医生可自由流动，多点执业，既增加医疗服务量，又缓解患者集中看病，病人转诊畅通，推进分级诊疗格局的形成。

"Since the beginning of the year,The ministry of health, ready to select a number of large and medium-sized cities,Construction of medical association."Wu Mingjiang think,The joint in the body,Big hospital technical support basic-level hospitals,Doctors can flow freely,More practice,Both increase the medical services,Focus and ease patients see a doctor,The patient referral flow,Promote grading diagnosis and pattern formation.

　　“围绕缓解看病难，新医改下了很大功夫。”吴明江介绍，增加优质医疗资源，2010年11月起，中央财政将连续5年投入60亿元，启动国家临床重点专科建设，打造一批“国家队”，推动东中西部医疗服务均衡发展；筑牢基层医疗服务“网底”，加强县级医院建设，推进公立医院改革，力争使县域内就诊率提高到90%左右，基本实现大病不出县。

"Alleviate medical care,Under the new health care reform have a lot of work."Wu Mingjiang introduction,Increase high quality medical resources,Since November 2010,The central government will allocate 6 billion yuan for five consecutive years,Start the national clinical key subject construction,Make a batch"The national team",Promote balanced development of east central and western medical services;Build a grassroots medical services"The population",To strengthen the construction of county-level hospitals,Promote the reform of public hospitals,Strive to make local JiuZhenLv increase to around 90%,A basic implementation of a serious illness county.

　　

2.基层医疗怎么强？ 2. Primary care how strong?

　　

大力培养全科医师，触角伸向每户家庭。让乡村医生有“身份”、保养老 Training general practitioners,Toehold in households.Let the village doctor"identity"/Insurance pension

　　

析 analysis

　　“看病贵”主要是看大病贵。“为什么这么多人得大病？因为小病防治不及时。”钟南山指出。

"See a doctor expensive"Basically be to see a serious illness."Why so many people have a serious illness?Because the ailment control not in time."Zhong said.

　　“解决看病难，关键是让全科医生‘强’起来，现在的全科医生还不‘全’。”钟南山说，“知道什么病人往哪科转，并不简单。现在大医院的医生其实面很窄，我现在也不敢开治疗糖尿病的药。而呼吸系统的病，1/3是由别的病引起的。因此，需要知识结构宽泛的全科医师。”

"Solve the difficult,The key is to get the GPS‘strong’up,Gp is not now‘all’."Zhong said,"Know what the patient families turn to,Is not simple.Now the doctor of the hospital actually very narrow,Now I can't open the treatment of diabetes drugs.And respiratory system disease,A third is caused by other diseases.so,Requires broad knowledge structure of general practitioners."

　　吴明江也这样认为，目前我国全科医生不足6万人，而需求为12万—18万，缺口一半以上。

Wu Mingjiang think so too,At present, the general practitioner of less than 60000 people,The demand for 120000-180000,More than half of gap.

　　缓解看病难，农村不能成为被遗忘的角落。“乡村医生的保障还不到位。”钟南山说，全国650万乡村医生大都处于“三无”状态：无职称晋级，无教育培训，无养老保障。许多村医生活困难，时常“放下针头，拿起锄头”，村医队伍面临人员老化、后继乏人的局面。

Alleviate medical care,Rural can not become the corner that is forgotten."The guarantee of rural doctors is not in place."Zhong said,The country's 6.5 million rural doctors in mostly"3 without"state:No title promotion,Without the education and training,No old-age security.Many village doctor life difficult,From time to time"Put down the needle,Picked up a hoe",Village doctor forces face aging/Dried up.

　　

解 solution

　　钟南山说，社区家庭医生的触角可伸向每户家庭，及时发现疾病苗头，早防早诊早治，这样百姓就会不得病、少得病、晚得病，小病就不会酿成大病。

Zhong said,Reach out to each family to community family doctor,Discover the disease symptom,Early prevent early detection treated early,So the people will not get sick/Little sick/Later got sick,Ailment will not lead to a serious illness.

　　吴明江说，给家庭医生强筋健骨，解决基层医院“庙小没菩萨”，应该进一步做好以下工作：一是鼓励大医院对口支援社区；二是建立全科医师培训制度；三是全科医师转岗培训。

Wu Mingjiang said,To the family doctor JianGu strong muscles,Solve the basic-level hospitals"Little not bodhisattva temple",Should further increase the following work:One is to encourage big hospital counterpart support community;Second is to build a general practitioner training system;Three is the general practitioner job-transfer training.

　　钟南山说，村卫生所是离农民最近的医疗单位，乡村医生是农民的“健康守门人”。有了他们，不仅避免小病拖成大病，减少看病开支，还可以减轻城市医院的压力，有效缓解农民看病难、看病贵问题。

Zhong said,Village health clinic is nearest farmers medical units,Of rural doctors is a farmer"Health the gatekeeper".It is thanks to them,Not only to avoid the ailment pulls a serious illness,To reduce spending on to see the doctor,Also can reduce the pressure of the city hospital,Effectively relieve farmers' medical care/To see a doctor expensive problem.

　　钟南山建议，有关部门完善乡村医生的政策，一是给“身份”，将他们纳入乡村医务人员管理；二是保养老。调研了解到，广东罗岗镇30名村医中，一半人超过60岁，他们迫切希望，政府补贴能直接发到他们手上。

Zhong suggested that,Related departments to perfect the policy of rural doctors,One is to"identity",They should be brought into the country medical staff management;2 is the endowment.Research to know,Guangdong Luo Gang 30 village doctor in the town,Half of people over 60 years old,They are eager to,Government subsidies can directly to their hands.

　　

3.如何破解看病贵？ 3. How to decipher expensive?

　　

加快公立医院改革，提高保障标准，给大病保障“扩容” Speed up the reform of public hospitals,Improve security standards,To a serious illness protection"capacity"

　　

析 analysis

　　看病贵不贵，首先看自费。近10年来，我国个人卫生支出占卫生总费用比重，由50%下降到35%左右。为什么百姓感受不明显？

Is it expensive to see a doctor,First of all look at his own expense.For nearly a decade,The proportion of personal health spending accounts for the total health expenses in our country,Fell from 50% to 35%.Why do the people feel not clear?

　　吴明江分析，一方面是医疗费用增长。随着城市化、老龄化进程提速，糖尿病、高血压等慢性病“井喷”式增长，长期治疗、终身服药，花费不菲。同时，医学技术进步使人们享受高科技的同时，也带来高额费用。当然，还有部分过度医疗，加重患者负担。

Wu Mingjiang analysis,On the one hand is the growth in medical costs.Along with the urbanization/Accelerated the aging process,diabetes/Chronic diseases such as hypertension"blowout"Type growth,Long-term treatment/Lifelong medication,costly.At the same time,Medical technology advance enables people to enjoy high-tech at the same time,Also lead to high cost.Of course,,Some excessive medical care,Burden of aggravating patient.

　　另一方面，医保水平相对较低。当前城镇居民医保和新农合的筹资水平和报销水平偏低，医疗救助制度和商业医疗保险起步较晚，医疗保障体系尚不健全。

On the other hand,Health care level is relatively low.The current urban residents medical insurance and new farming low financing level and reimbursement,Medical assistance system started relatively late and the commercial medical insurance,Medical security system is not sound.

　　医改3年，基本药物价格平均下降1/3。钟南山说，“我现在担心的是，不少药品低于成本价中标，会导致缺斤短两甚至假劣现象。”

Health care for 3 years,Essential drugs price average drop by one-third.Zhong said,"I worry about now is,Many drug is lower than cost price bidding,Can lead to QueJinDuanLiang even JiaLie phenomenon."

　　

解 solution

　　“解决‘看病贵’，一方面需要提升保障标准，一方面要加快公立医院改革，实行医药分开。”吴明江表示，实际上，我国也正在朝这些方向努力。2012年，全国1000多个县级公立医院试点取消以药补医，基本药物制度覆盖全国74.6%的村卫生室，20种重大疾病实际报销比达到66%。今年，政府工作报告中提出，全面开展儿童白血病等20种重大疾病保障试点工作。

"To solve‘See a doctor expensive’,On the one hand want to improve security standards,On the one hand to speed up the reform of public hospitals,Practice medicine separately."Wu Mingjiang said,In fact,Is also working in the direction of our country.In 2012,,The pilot to cancel more than 1000 public hospitals at the county level to medicine cure,The basic drug system covering the 74.6% village clinics in the country,20 kinds of major diseases actual reimbursement ratio reaches 66%.This year,The government work report,Overall childhood leukemia and kinds of major diseases and 20 pilot work.

　　钟南山表示，这对保障百姓健康，缓解因病致贫、因病返贫，无疑是好消息。但目前，单病种病死率排位第二的慢性阻塞性肺病，尚未入列。

Zhong said,To safeguard people's health,Alleviate poverty due to illness/Chinese because of illness,Is the good news.But at the moment,Single diseases mortality in second position in chronic obstructive pulmonary disease (copd),Has not yet been loaded.

　　钟南山认为，原因在于这种病还没有被认识。希望大病保障进一步“扩容”，能纳入慢性阻塞性肺病和脑中风等疾病，减轻百姓看病负担。(记者 李晓宏)

Zhong think,The reason is that this disease has not been known.Hope serious security further"capacity",In diseases such as chronic obstructive pulmonary disease (copd) and stroke,Reduce the financial burden on the people to see the doctor.(The reporter Li Xiaohong)