ZiChangXian 3 years in order to

explore: hospital decided to

China at the county level medical

success or failure

Chinese businessman nets-HuaShangBao

Summary: three years ago, a drug price mechanism in government subsidies for core, supplemented by health reform ZiChangXian quietly in development. The data shows, in the last three years, the county hospital clinic patients increased by 15.8%, 37.5% lower costs, increase of 31.5% in the number of hospital, cost 31.8%; In addition, after cure of implementation, the county public hospital drug prices fell 40%.

Three years ago, a drug price mechanism in government subsidies for core, supplemented by health reform ZiChangXian quietly in development. The data shows, in the last three years, the county hospital clinic patients increased by 15.8%, 37.5% lower costs, increase of 31.5% in the number of hospital, cost 31.8%; In addition, after cure of implementation, the county public hospital drug prices fell 40%.

Prior to the national 10 months on the introduction of the cure of smaller, because of its happened in is underdeveloped economy in the west of the county and cause for concern. However, cure of smaller and not a mould, still kept the exploration, still has that limit the development of the bottleneck problem or.

"Cure of smaller pattern, the outside world to the cure of a misreading, we have no pattern, just in exploring a return to the public that the hospital." Smaller county wei secretary XueHaiTao said, smaller just hospital in the market economy of public welfare regression.

The government procurement and distribution, unified drugs through "" to reduce the intermediate link profits, the comment by the outside world for" planned economy "cure changes mode, XueHaiTao said believe in deng xiaoping to the interests of the service" for a cat, as long as it catches mice are good cat "the idea, he said:" don't simply deny the past."

June 1, 2008, cure of smaller was formally implemented after wood, the government office, and the valley of shaanxi province "three medical and model". Three years later, cure of smaller has become the most shining cure in shaanxi a piece of calling card, secretary of health BuDangZu ZhangMaoCeng three pretend to cure: "visit long cure, do not need other mode, smaller model line!"

And the real mode only just outside smaller considers "through the drug group buying, and greatly reduce drug cost more than 30% of" simple reproduction? Its disguises a smaller management for China's huge medical dream.

A county wei secretary of choice

In smaller folk filed, a cure is not open around the character is ZiChangXian county wei secretary XueHaiTao.

In fact, the county party committee of the communist party of China's in office was extended, deputy secretary of the county magistrate, is XueHaiTao during initiation of the thought of cure. In July 2006 when he entered office ZiChangXian county wei secretary, began to research for the cure of smaller pathway. "After investigation, we found that at the county level, for medical treatment for difficulty and high cost problems actually is a doctor your problem, because the county so many, the population doctor does not exist on the problem of team not line, and we also know that the drug may not so expensive!" In XueHaiTao this, it seems, is a simple logical problems.

Therefore, in the CPC, at the price of drugs to a mechanism for the core, government subsidies as the auxiliary medical reform carried out in ZiChangXian quietly. The data shows, in the last three years, the hospital clinic patients increased by 15.8%, 37.5% lower costs, increase of 31.5% in the number of hospital, cost reduced by 31.8%.

According to the county and the standing committee of the county party committee propaganda department minister MeiFang trail, cure of policies introduced smaller than countries spent the whole time as early as 10 months later, and the country has issued the order policy, smaller and cure completely.

XueHaiTao think, compared with the rest of the two big model-in shaanxi province government, smaller and the valley of ancient medical caught in the past "main medicine" key contradictions raise medical dot, and really touched the system. He said: "after the reform and opening policy, the government put the hospital to the market, although at the time are necessary, but now it seems that the hospital of the economic market roads have gone too far!"

Drug group buying big reduce the price by 40%

Medicine is the most expensive ZiChangXian management major point. ZiChangXian LanMengYan county commissioner said in a speech: "the government's investment is not in place, and hospitals to the salary, the normal operation, public welfare hospital seems to naturally became the for-profit hospitals, 'to raise medical" medicine negative effects, the great difficulty and high cost problem more and more outstanding."

He said one example: "a gallstone surgery patients cost will be as high as 5000 yuan, which in turn will account for more than 50%." LanMengYan introduction, to the end of 2007 county hospital business income is as high as 29 million yuan only, a drug income up to 15 million yuan, accounting for 51% of total revenue.

To this, ZiChangXian leadership after many studies, from anhui, Inner Mongolia and other places for the experience, through the bidding select the stronger medicine enterprises, centralized procurement, unified to county, township and village level 3 distribution, cut off to a medical representative for the interests of the intermediary in exchange for bulk order, large amount of chain drug low price, all pharmaceutical realized pricing homogeneous.

LanMengYan said, the county public hospital drug prices fell 40%, of which 1942 species of basic drugs price was reduced by 36.67%, 1044 kinds of commonly used drug prices are down 40.39%, 116 kinds of key bargaining drug prices decreased 48.41%. Only drug centralized purchasing this a year and can reduce the burden of the 8 million yuan.

Drug profits exactly have so big? A question that smaller, folk sound reform, but it doesn't actually seem luxuriant ensure pharmaceutical quality, shoddy, fake drugs is also the same exists?

Facing the question, ZiChangXian people's hospital WuJianJun dean told reporters, a drug centralized purchasing unified distribution, a medical representative and the doctor between benefit chain is cut off, and used to have a medical representative grey income, not now take the money, almost no middle circulation, reduce the price of drugs so is a matter of necessity. "At the same time, domestic distribution enterprise is very powerful drug company, through open tender reached cooperation relations, drug quality absolutely, and at the same time, the doctor can ensure in a line of drug quality inspection." WuJianJun said.

In addition to the drugs, in government each year more than 2000 yuan to the support of the funds, the hospital has gradually realized by nonprofit public welfare to the regression. WuJianJun introduction, ZiChangXian also for hospital medical equipment investment has increased, invested 500 yuan for county hospital purchase Siemens double row helical CT and Hitachi 8500 color dopplar ultrasound and other equipment, but asked hospitals only at cost HeShou inspection fee. Now CT examination cost from 170 yuan to 120 yuan, magnetic resonance imaging (mri) fell by 15%, pa examination expenses. A year come down, the examination of the hospital charges reduced 880000 yuan.

The reporter understands, in the order after carrying out, now a gallstones cost of surgery patients has been lowered to 3000 yuan or so, less than before the reform for 2000 yuan.

A mother's crying

The cure of smaller "painting bread" looks good, and got the management at all levels must, but for ordinary individuals, they actually have to get specific benefits?

July 26, ZiChangXian in early morning, reporters outpatient asked DuoWei patients to come round to see a doctor, the majority of patients is the first time to county hospital, for them, the drug is cheap is still a mystery. But in the yard in a huge set drug price list caught the news of note, the reporter in see above price of 46.4 yuan: in the past, archie LeiSu needle, now sell only 7.8 yuan, the original price nearly $25 cephalosporins latter piece, only now, price of 3.8 yuan, the original price $20 cimetidine, present price only $0.85...

Zhang wang is 3 days ago from xian a 3 armour hospital turned back to ZiChangXian hospital, 75 days ago, at the age of 19, he for a car accident and lead to the skull, still injured were in a coma, and became a vegetable. Mother HuangCuiPing introduces, they live in ZiChangXian LiuGuPing village, people who depend on farming, family conditions were poor, it happened son with an accident. "He was the yenan to learn the cook, didn't come back this year Spring Festival, was also expected to do farm work to home, but just suddenly so." HuangCuiPing said.

She introduces, the accident compensation responsibility of the 90000 yuan, however in xian big hospital courtyard is 72 days spent, the hospital also let hand over 50000 yuan, and they cannot afford the, therefore the son had to turn back to the county hospital. "Give children a tooth brush to 40 yuan, cut fingernail also to 40 yuan, every day fancy nurse cost down almost have to light 800 yuan, we really can't afford! No money immediately make hospital discharge, the hospital is not save us?" HuangCuiPing said.

County hospital of drug prices is the most HuangCuiPing cheap feeling: "the same medicine in xian, the big hospital a day in here every day thousands of dollars, only spend 300 DuoYuan." The reporter of the drug use in zhang wang on the list, except for the cost of drugs to see outside, zhang wang of every day care costs only $15, and nurses every 15 minutes and almost on a ward has tour.

The hospital a ZhangXing doctors give reporters calculate a bill: "with zhang wang for example, because we cure drug prices and service after fare is very low, he in our county hospital treatment costs almost even xian 3 armour hospital head all less than zero, but also can enjoy new farming and bring 75% of the submit an expense account, if is extremely needy, and may medicine is free of charge."

The doctor more pure than before

And HuangCuiPing have the same feeling of patients still has a lot of, but the cure of smaller, patients were to benefit is the ultimate goal, but the success or failure of medical doctor is. At the beginning of the reform, county wei secretary XueHaiTao most worry about: no gray income, if earn less and the enthusiasm of the doctors from any security?

WuJianJun told the reporter, after cure for the doctor the biggest change before the reform, a 70% pay rely on appropriations, need to earn 30%, and now into the pay sum, means that the doctor can appropriated without pressure mount guard. At the same time, is now on a prescription for a dollar money, the doctor prescribed by way of examination is adjusted for the number of prescription, work, the doctor does not open DaChuFang also don't open your medicine.

A family medical doctor well embellish is 1994 to Christine county hospital of the work. Just a cure, she because their wages will worry about drops, also and some "conservatives" whisper in private. But soon, she found herself not only reduce the salary, but because they are a business backbone, every month increased by 1000 DuoYuan.

After understanding, well run was just know the hospital staff incentive mechanism, medical level, see a patient quantity, service attitude, directly and salary hook, published are rewarded, won the title of honor also are rewarded, various kinds of incentive mechanism that let employees enthusiasm.

Well accept our reporter on embellish interview: "see a doctor now more than ever, as long as the pure business, do more natural, salary can go up." And she is the goal of the impact this year end, "560 thousand comments may be."

Well for the biggest medical Christine embellish feeling is: "patient many, before a dozen men lived in the ward, is quick to 40, but the corresponding also means more pressure."

WuWei doctor also have the same feeling, as outside general two of vice director of division, the attending physician, after cure a month can get 6000 yuan of above, more than it used to about 2000 yuan. And because he is the backbone of surgeons, almost every two years and you have a go to large hospital study opportunity: "other hospital is further to a basic salary during our hospitals, even the salary is a advanced eat a hospital are to bag."

According to President WuJianJun introduction, the government gave 1 million yuan each year of talent award special funds for reward business backbone, and at the same time each year on September also will be the backbone, the backbone is mount guard holder can get very good treatment.

Private hospital tend to be difficult situation

County people's hospital medical success, but it doesn't mean that the cure of smaller success. July 27, afternoon, the reporter and to the WaYaoBao site next door of ZiChangXian hospital of traditional Chinese medicine to cure changes, the situation of a baseline. "We continuously improving hospital, size and the number of personnel can't and county hospital." compared The director of the YuanBan ZanZhi to introduce. Reporters in the traditional medicine hospital, the hospital is located in the old town, see three buildings, built in the 70 s, a narrow corridor, at around 5 PM can hardly see the shadow of patients.

The vice President of the li told reporters, as the second big hospital, ZiChangXian cure of the equipment, personnel before behind erosion, many staff are BanTuoChan half to work, no organization, no discipline at the hospital January would be less than $10000. Gross

"It is for us to cure a good policy in the past no one came to the hospital, the doctor, now public hospitals are cheap, especially what the hospital to submit an expense account in the original standard on the basis of increased 10%, the doctor also would more up." Li said. Executes salary financial full funding, employee's salary has been protected, "January a ordinary doctor can get 5000 yuan, this in the past may not!"

And reporters in the americans visit in shanbei region, that is the traditional Chinese medicine cure, many patients want to go to hospital treatment, but in the past, the traditional medicine hospital doctors are just lazy, also not on time to and from work, which cause the sick patients to the door QiuZhi phenomenon.

It is reported, a smaller cure for three years, the hospital income has from 2007 in 180000 to 1.87 million yuan RMB leap. Nancy dean introduction, because the hospital is located in the revolution and the construction site WaYaoBao limited space, the county government are investing in about 24 million yuan for the traditional medicine hospital swap the new site, about 2014 years can be constructed and put into use.

Chairman, medical director of cppcc.in do more of the development of the Chinese JinXiaoHong good prospect: "now they hospital only more than 20 beds, advanced equipment and the government bought all have no place to put, and other new hospital built two public hospitals, probably can have 500 beds for our county, number of people, enough to satisfy the demand for......."

JinXiaoHong also mentioned the ZiChangXian private hospital, he says, ZiChangXian now have three private hospital, after cure for a doctor expensive private hospital formed the larger impact, they have to follow your price, but private hospital reputation is not high, the government's strategy is to not let go of never limited, but through the order, two public hospitals after the mature will squeeze them.

The biggest problem is not at the county level and medical personnel

Since the cure of smaller, this mode of the onlookers caused all over the country. ZiChangXian do medical staff, told reporters that by the end of July, to visit the cure of smaller all government departments have as many as 150 or so, and as journalists in smaller interview, Inner Mongolia investigation delegation also has just arrived at the.

But the mode of cure of smaller is perfect? It can in the other provincial and municipal reproduction? County people's hospital, said the current WuJianJun cure many problems also existed, and the biggest problem is the recruit less than talents.

"Earlier this year I posted a a recruitment, want to recruit 20 posts DuoGe doctor, but finally a register of all have no." WuJianJun some frustration. WuJianJun goal is to be ZiChangXian hospital, national aaaaa county hospital, but the serious lack talents, making the hospital without the brand department, no more in the area of academic leaders, which let his dream slightly feeling far away. "With talent to attract patients each year, we come out the cost of medical treatment in patients with more than 5000 ten thousand yuan, and it can put patients keep healthy to succeed." WuJianJun said.

And the doctor well embellish was also have their own confusion: "drug centralized purchasing, but in order to get very low price and the director, but often they sometimes special medicine group of down slower, and for health care workers, the use of drug of medicine is very deadly when the purchasing department. And often don't understand a kind of medicine for a patient's value, they might not be professional, a little dilettante management adept meaning."

Wells was suggested, embellish shall be given some autonomy, and the current President and no property in his hand, nor can buy medicine, the independent long hospital is not a good thing. WuWei doctors agree well embellish the views on, he said: "the hospital income and expenses two line and the director what hand power all have no, beating a bonus you have to report for examination and approval, the bureau and what to the administrator, so hold on to the administrator feelings? There will always be problems."

WuWei said, the hospital now management mode is to restrict the clinical and administrative, a line to complicate matters, not the power to, the director can't lead the hospital development. Great For example, he said the hospital medical disputes, and patients often have argy-bargy often direct run to dean's office to, but not the power of the President and solve, up and down a mess, it is in the hospital medical staff and patients themselves are a kind of damage.

3 armour hospital cure is the biggest bottleneck

"Although the past for three years, but do not deny, cure of smaller is still in the stage of exploration." ZiChangXian, chairman of the Chinese people's political consultative medical director for JinXiaoHong says to the reporter, he thinks, at present the biggest problem is not smaller cure changes in their own, 3 armour hospital reform, the county hospital not reform will inevitably encounter bottleneck.

JinXiaoHong logic based on a set of data: the current medical insurance policy, 3 armour hospital up newspaper can submit an expense account point point (is 5500 yuan, dimethyl hospital is 4500 yuan, and the smaller the hospital is at the county level is 300 yuan, including, 3 armour hospital to submit an expense account proportion is 40%-45%, and the county hospital between reimbursement ratio is 75%, but there is always of 3 armour hospital patients with high expectations, caused a serious illness is not also go to see the doctor, 3 armour hospital to submit an expense account must spend is in 5500 yuan of above.

The reporter understands, in xian XiJing hospital, tang all hospitals and other 3 armour hospital, often have patients from 5 o 'clock in the morning began to line up more than, huge stream has also become the hospital burden. And in ZiChangXian hospital, 8 a.m. to 30 points, the doctor line up of the patients do not more than 50 people.

JinXiaoHong question: "3 armour, dimethyl hospital can see what disease? We county hospital and can see what disease? Smaller every year there are 56000 ten thousand yuan RMB to 3 armour hospital, excellent talent also flow 3 armour hospital, they are expensive, they far we cheap we close, but it is difficult to rob to hospital at the county level 3 armour hospital patients, go on like this, how could cure of success?"

JinXiaoHong said, the county level shall be hospital is the most basic medical institutions because it not only to see a doctor for the work, but they also bear the local area of anti-epidemic, maternity and child care, etc. After medical hospital, in the county is almost ten years ago, but the price of medical condition is greatly enhanced, need not put patients burden, general of a serious illness can through the county hospital medical insurance cost to solve, patients don't need to go to a doctor, the doctor 3 armour hospital your doctor the difficult question natural is solved.

But, he thought that the smaller order to want to get nationwide success, must let 3 armour hospital at the county level to hospital for more fully supporting: "now executes is loose, occasionally please experts will aid in a day or two, but lecture, the meaning is not big. 3 armour hospital should be sent 90% of doctors at the county level in the hospital, in the county hospital patient's problems are solved, and this is an huimin."

For recruitment problem, JinXiaoHong think can't let fresh graduates directly into 3 armour hospital, but to allow to grassroots exercise, but also to the grassroots bring a lot of talent. "And the question now is, 3 armour hospital think they equipment high, health care providers, treatment is good, why want to reform?" JinXiaoHong said, see the environment, to solve the problems of China's overall cure: "3 armour hospital not reform, the county hospital difficult to break!"

JinXiaoHong said, he has put these ideas combining medical report for the smaller group, looking forward to cure the central can attach importance to 3 armour hospital reform proposal, and from the function at the county level and the ability to improve hospital. "Well, to the hospital at the county level of the Chinese medical was successful!" JinXiaoHong said. Cure of smaller as a first TanLuZhe, it has not only affects 110000 people at the county level of medical, and among them, have already embraced the great dream of China medical.