Changshu: health care to guide the masses at the grass-roots level to see the

traditional Chinese medicine

Time: 2016-04-29

Source: China's traditional Chinese medicine

Author: chestnut)

Moderate open to different levels of medical institutions of the medical insurance fund pay pay line and reimbursement ratio, through the leverage of health policy guide the masses at the grass-roots level to see the doctor of traditional Chinese medicine --

"Hierarchical diagnosis is currently promoting national health policy, also is one of the focuses of our work this year." When it comes to grading diagnosis and treatment, hospital of changshu city, jiangsu province, dean of Tang Jian stand for it. "We have done some work hospital, including and institutes to establish medical conjoined at the grassroots level to improve two-way referral channels, and hope to see more people stay at grass-roots doctor of traditional Chinese medicine." His temper, "in the process of working towards this goal, form a complete set of health policy has played a large role."

For compensation policies at the local level

"In terms of policy, the grassroots medical institutions must be quite a tilt." Changshu city human resources and social security bureau deputy director of the social insurance fund management center brinton introduces to the reporter, to give full play to the health care policy leverage, guide the orderly grading diagnosis, changshu formulated a series of grassroots oriented compensation policy.

In changshu city, town and village level 3 outpatient medical institutions, medical expenses at 5% ~ 5% difference increased step by step. Grassroots medical institutions outpatient cost of essential drugs on the basis of original increased by 10%, reimbursement ratio of TCM appropriate technologies all incorporated into the scope of reimbursement. In hospital, outside the hospital in the city, the city level 2 and above hospitals, basic-level hospitals, community health service centers of hospital starting line according to the 1000 yuan, 500 yuan and 300 yuan of decreasing step by step, reimbursement of medical expense proportion to the difference of 10% ~ 15% increase step by step. In the absence of specification for referral to the city outside the designated hospital, and on the basis of the original reimbursement ratio by 30% ~ 50%.

Through health policy guidance, the grassroots medical and health services utilization in changshu people increased significantly. 2015, town or village two levels of medical institutions outpatient service people accounted for 79.91%, the city, the town of two levels of medical institutions in hospital visitors accounted for 94.32%, outside the hospital accounted for 5.68%, implement the national comprehensive reform goals and tasks put forward more than 90% of the patients stay in the county. In with the cooperation of health policy, changshu woes of couplet of institutes form close medical hospital and the sea, help them enhance medical service ability and management level. "On the one hand, through the health guidance, on the other hand, improve service capacity at the local level. Health care and human social departments closely, both, left the patient at the grass-roots level." Tang Jian smiled and said, "look at the grassroots level of traditional Chinese medicine, all fee paid by the medical insurance fund, more and more people choose to see Chinese medicine at the grassroots level."

Payment reform regulating medical behavior

Hierarchical diagnosis and treatment of promoting continuously need health policy in coordination with, the stability of the medical insurance fund is particularly important. In a long period of time, however, changshu implement according to the project charge and norm appraisal way of health care management, medical costs rising faster, annual increase of more than 10%, and there is a big risk of investment fund pressure. In 2011, changshu is identified as the national new farming in the supplier payment reform project counties. Take this opportunity to since 2012, changshu began to hospital outpatient amount shall be paid in advance, according to bed day paid to give priority to, according to macro-reforms mixed payment system, aims to further standardize the medical service behavior, optimize the management, provide more stable support for grading diagnosis and treatment. Under the new payment policy, changshu hospital bed days paid standard and the first people's hospital, the second people's hospital.

For four years, changshu medical insurance payment reform effect is remarkable, the fund risk pressure is reduced, fee structure more reasonable, and drug expenses proportion dropped from 52.78% in 2011 to 38.86% in 2015. Health and family planning commission of jiangsu province, deputy director of the bureau of traditional Chinese medicine Chen Yijiang said, through to distinguish the level of traditional Chinese medicine hospital in jiangsu, category, characteristics and the medical services provided by the quantity and quality indicators, such as reasonable distribution of the annual hospitalization cost total control index of traditional Chinese and this is the successful experience of reform in jiangsu province. "Score for disease to pay, traditional Chinese and western medicine at the general hospital in practice the same disease score conversion coefficient. In the basic medical insurance according to the project payment, reimbursement ratio appropriate improve TCM service."

Payment Tang Jian feel that health care reform should be more accurately guide the classification diagnosis and treatment, "what are the common types of suits in primary diagnosis and treatment, what are the basic medicine well received at the grassroots level, which is suitable for technology in the grass-roots, health policy can be more detailed, more specific to let the people enjoy the benefits of hierarchical diagnosis."