Focus on Zhejiang's new medical reform: citizens pay less for medical treatment

It is difficult and expensive to see a doctor, which are the two problems that people have criticized most about medical services for many years. The main reason behind this is the uneven distribution of medical resources: residents in big cities seek experts when they see a cold, while people in rural areas delay when they have a serious illness, because it is too difficult to hang up the name of a famous doctor in a provincial hospital.

In Zhejiang, the new medical reform has made a drastic cut to the difficult problem. Qianjiang evening news reporter recently learned from the small-scale notification of the new medical reform of the Provincial Health Department that what are the new medical reforms in Zhejiang Province? Three changes? : is it difficult to see a doctor? Medical resources are sinking, so that provincial and municipal experts can go to county hospitals and community hospitals to see everyone; The health service industry has expanded diversified medical services, giving residents more choices in seeing a doctor; Expensive to see a doctor? There is no price difference between drugs, and buying drugs in hospitals is the same price as buying drugs in cheap pharmacies, or even cheaper.

for the nationwide medical reform? Zhejiang phenomenon? At the beginning of the clue.

Mao Qunan, director of the Propaganda Department of the National Health and Family Planning Commission, spoke highly of the medical reform in Zhejiang. The experience of Zhejiang should be said to give us great confidence in promoting the reform of public hospitals. ?

Mei Junjie, a researcher at Shanghai Academy of Social Sciences, believes that medical reform now also plays a role in relieving patients' expensive medical treatment. ? At present, a large part of the high cost of seeing a doctor is that drugs are more expensive. Now, the zero difference rate of drugs is also obvious to patients. ?

Zhejiang, which is at the forefront of the country, is there really any case to follow? In the new medical reform? Zhejiang phenomenon? How did you do? For Zhejiang people, what changes have these reforms brought to our medical treatment? Has it really become more convenient and cheaper to see a doctor? Qianjiang evening news will launch? Zhejiang phenomenon of medical reform? A series of reports will explain in detail the health benefits brought by Zhejiang medical reform to the people.

ease the difficulty of seeing a doctor?

One of the phenomena in Zhejiang: 47 county hospitals have provincial doctors at work

When they get sick, they have to go to the hospital. The first reaction in everyone's mind is always the large hospitals around them.

In big hospitals, it has long been common for people to be overcrowded and scalpers to grab the number. In community hospitals, the scene of being empty and empty is also staged almost every day. While complaining about the long queues and difficulties in seeing a doctor in large hospitals, we turned a blind eye to the community hospitals around us.

The reason behind this is nothing more than distrust of the level of doctors in community hospitals, and I always hope that the most experienced experts can make the most professional diagnosis for myself.

So where do the good doctors at home come from?

At the beginning, Zhejiang began to implement the sinking action of urban high-quality medical resources step by step. By the end of June, there were 28 county-level hospitals with close cooperation with provincial hospitals and 19 county-level hospitals with close cooperation with municipal hospitals.

This means that in 47 county-level hospitals, you can see experts from provincial hospitals and enjoy medical technology from provincial hospitals. However, the payment of medical expenses is much less than going to provincial hospitals, because the proportion of reimbursement in county hospitals is much higher.

reporter qianjiang evening news interviewed in the First People's Hospital of Chun 'an County. Since July 19th last year, a piece has been added to the hospital? Chun 'an Branch of Zhejiang Provincial People's Hospital? Brand, this is the beginning of the provincial people's hospital and county hospital hosting cooperation.

The dean, vice-president and finance chief of the county hospital are all appointed by the provincial people's hospital. Last year, 21 people worked here for a long time, and 18 of them had the title of associate senior or above.

They cover general surgery, neurosurgery, thoracic surgery, gynecology, urology, orthopedics, anorectum, otorhinolaryngology, ophthalmology and cardiovascular medicine, intensive care unit, neurology, nephrology, infectious diseases, dermatology, rehabilitation, radiology, ultrasound and other specialties in county hospitals, among which 11 are department directors and department heads.

Li Dabo, a native of Chun 'an, is a patient with chronic kidney disease. In the past, he had to wait in line for hemodialysis in Hangzhou for two and a half hours, but now he stays in the county hospital for treatment. According to his words? Convenient and reassuring. ?

　? In the past, children had to go to Hangzhou for bone age measurement, but now they can go directly to the county hospital. ? Another Ms. Xu from Qiandao Lake Town said.

In addition to outpatient service and operation, most patients also stayed in the local area. ? The urologist of the Provincial People's Hospital has seen it. Because I am over 7 years old this year, the operation needs to be done as soon as possible, so I should be prepared for the operation. ? Lao Yu, who has suffered from prostate disease for many years, said that in the past, his family would definitely take him to Hangzhou for surgery, but the doctor in Hangzhou was in Chun' an, which was much more convenient. He didn't have to travel far, and his family could take care of him more conveniently.

how many local people have enjoyed high-quality medical care in the county hospital at their doorstep? This set of figures can reflect the problem very well: < P > Compared with the city hospitals, the total business income of county hospitals increased by 78.69%, the number of outpatient and emergency visits increased by 5.35%, the number of discharged patients increased by 9.14%, and the number of operating tables increased by 35.23%.

with more patients, the efficiency of hospital medical service has also improved: the proportion of drugs has decreased by 29.63%, the average length of stay in hospital has decreased by 6.94%, and the balance of income and expenditure has increased by 5.45%. County hospitals are more capable, more efficient and have more stamina for development.

give patients more choices?

Phenomenon 2 in Zhejiang: Good private hospitals can compete with provincial hospitals

? By 22, the total scale of health service industry will reach more than 8 trillion yuan. ? Last October, the State Council issued "Several Opinions on Promoting the Development of Health Service Industry". Private capital entered this industry, and private hospitals were a very important link.

Both private hospitals and public hospitals serve the same people who are sick. For ordinary people, whether it is a private hospital or a public hospital, the hospital with convenient medical treatment and good curative effect is their first choice. Similarly, in the medical market, public hospitals seem to be natural? Born orthodox? Identity, but this identity in the development of private hospitals over the years, has become increasingly unimportant.

according to the data of Hangzhou health bureau, by the end of last year, there were 1,228 private medical institutions in Hangzhou, including 132 private hospitals with 4,764 approved beds, accounting for 13.28% of the total approved beds in the city? This proportion is roughly equivalent to that of Zhejiang province.

Qianbao reporter learned that in the specific professional fields of Chinese medicine, stomatology and medical beauty, the strength of private hospitals in Zhejiang is not weaker than that of public hospitals. Compared with the long queue of public hospitals, many people will trust these private hospitals with unique professional characteristics and convenient treatment. At the same time, the corresponding departments of public hospitals are constantly introducing new equipment and new treatments under competitive pressure.

　? Private hospitals and public hospitals are not competing with each other, but promoting each other. ? Ma Weihang, deputy director of the Provincial Health Planning Commission, said: Wenzhou Kangning Hospital, a private third-class hospital and Jinhua Guangfu Hospital, has a high level of tumor treatment. Many private hospitals are run by excellent doctors in public hospitals. The overall level of private hospitals in our province ranks among the top medical care, which is rare in the country. ?

at the end of may this year, the provincial general office issued the "implementation opinions of the people's government of Zhejiang province on promoting the development of health service industry", which is described in the opinions? Strictly control the expansion scale of public hospitals in the central city, and governments at all levels will no longer set up new urban public general hospitals in principle. ? Encourage enterprises, charities, foundations, commercial insurance institutions and natural persons to set up various medical institutions. ?

It can be seen from this that the development momentum of private hospitals in Zhejiang will be stronger in the future. With better equipment investment and personnel participation, patients rushing to public hospitals will have more diversion.

　? The reform of public hospitals is advancing, so we hope that more private capital will come in and expand the supply of medical services, which will also produce the catfish effect, and some new models will be born. ? A staff member of the Municipal Health Bureau told the reporter.

is it expensive to see a doctor?

the third phenomenon in Zhejiang: the zero price difference of drugs is fully implemented in the municipal hospitals in Hangzhou province

From April 1st this year, Zhejiang province canceled the 15% bonus of drug sales in public hospitals, which was the first in China to break the hospital operation mode that has been used for more than half a century. This kind of reform is the first in the country. Such a change has enabled Zhejiang people to enjoy the benefits of nearly five months.

In the outpatient pharmacy of the First Hospital of Zhejiang University, it is obvious that Ms. Zhang's prescription for liver disease is compared before and after. In her prescription, two boxes of oral lamivudine and two boxes of oral adefovir dipivoxil tablets are 81.74 yuan. She looked through the previous documents, and the price of the prescription before April 1 was 862.2 yuan, which saved 6.46 yuan this time.

　? Zero difference rate? Hospitals involve the reduction of drug prices and the increase of medical service fees, but for patients, the proportion of out-of-pocket expenses has decreased. For patients with chronic diseases like Ms. Zhang, the reduction of medical expenses after the reform is obvious, while for surgical patients, even if the medical expenses are raised, the proportion of self-funded expenses is reduced.

Yesterday, the staff of the finance department of the provincial Tongde Hospital came to the orthopedic ward to settle accounts for a retired employee, Aunt Chen. She had an operation and was hospitalized for half a month because of a broken finger and phalanx.

Compared with before the reform on April 1st, although her total expenses have increased, Aunt Chen actually paid less.

Qianbao reporter saw on this list of discharge expenses that the total cost was 1,391.78 yuan, of which 2,457 yuan was paid by himself and 7,934 yuan was borne by medical insurance. If the time is a few months earlier, the total cost may be 1192.3 yuan, but Aunt Chen will pay 2559 yuan herself and the medical insurance will bear 7633.3 yuan. Obviously, although Aunt Chen's total medical expenses increased by 199.48 yuan, Aunt Chen saved 12 yuan by paying herself.

it is becoming more and more convenient for Zhejiang medical reform to enjoy the treatment of provincial hospitals.

Dr. Ye, I will come to your place for surgery next week. ? Ye Ke, the attending physician of neurosurgery in the First Hospital of Zhejiang University, received a telephone appointment from the patient Lao Wu the day before yesterday. On March 31st this year, Ye Ke and 15 other colleagues were selected by the First Hospital of Zhejiang University and went to Sanmen County People's Hospital as resident doctors to treat local people. This county hospital has become the Sanmen branch of the First Hospital of Zhejiang University, and Lao Wu is the patient of Yeke in Sanmen.

Now, after a four-month residency, Ye Ke returned to the First Hospital of Zhejiang University, and another group of colleagues rushed to Sanmen. Because of the convenience of the referral system, Lao Wu will go to the First Hospital of Zhejiang University for skull repair surgery next week.

For patients like Lao Wu, when provincial medical resources come to county hospitals, they can enjoy upgraded medical services at home. More importantly, he can be referred to the First Hospital of Zhejiang University more conveniently than in the past.

the most unobstructed referral?

after filing in the county, it will be sent directly to provincial hospitals

? Lao Wu suffered from brain injury caused by a car accident, and the operation was done by me. However, he had diabetes insipidus after the operation, and he was upset. In Sanmen Branch, there were few drugs for treating diabetes insipidus, and the most ideal way was to refer him to a big hospital. ? Ye Ke told qianjiang evening news reporter, but before the sinking of medical resources started, it was not easy for Lao Wu to think of seeing a doctor in the First Hospital of Zhejiang University.

Like any patient from other places, first of all, Lao Wu has to take a three-and-a-half-hour bus ride from Sanmen to Hangzhou. After arriving at the big hospital, he has to register at the outpatient clinic and show his case, relevant instructions and films to the neurosurgeon. If he wants to have surgery on such symptoms, he has to wait for a bed. It will take at least a week. ?

Because of the close medical cooperation between the two hospitals, it is not so troublesome to refer Lao Wu now. Lao Wu at least saved the time of queuing for registration, and he could inform him as soon as he had a bed. ? Ye Ke said.

at the beginning, the standing Committee of Zhejiang provincial party Committee studied and promoted it? Urban quality medical resources sink? By the end of June, there were 28 county-level hospitals with close cooperation with provincial hospitals and 19 county-level hospitals with close cooperation with municipal hospitals.

With such a large hospital opening a branch in the county, people living in the county have saved a lot of troubles in seeing a doctor, and everyone trusts the county hospital much more than in the past. Compared with Belgium, the total business income of county hospitals cooperating with big city hospitals increased by 78.69%, the number of outpatient and emergency visits increased by 5.35%, the number of discharge visits increased by 9.14%, and the number of operating tables increased by 35.23%.

the luckiest patient?

The dangerous tumor was treated in the county hospital

If the luckiest beneficiary of the sinking of medical resources is judged, it may be Wang Shunhe, 55, from huaqiao town, Sanmen County.

In June this year, Wang Shunhe suffered a car accident and was rushed to Sanmen County People's Hospital by 12 ambulances. Because the brain was injured by a collision, the hospital conducted a brain CT examination. Who would have thought of this investigation and actually found another big problem?

　? He is in good health and has never had any problems, so he has never had a physical examination before. ? Wang Shunhe's son said that his father didn't take the physical examination seriously because of his good physical condition, and this time, the CT examination caused by the car accident found that there was a shadow in his brain, which was very worrying.

　? This patient was injured by a car accident, and the brain injury caused by the car accident was not serious, but we found that he had a space occupation in the saddle area. ? Ma Yuehui, the doctor who examined him, was the chief doctor of neurosurgery in the First Hospital of Zhejiang University. At that time, he was giving technical guidance for three months in Sanmen County People's Hospital.

After consultation in the hospital, Ma Yuehui concluded that the shadow of Wang Shunhe's head is a pituitary tumor. Although it belongs to benign tumor, the tumor has been surprisingly large due to the long onset time.

　? This lump has reached 1.3 cm, and more than one cm is a large linear tumor, which is already close to the optic nerve. ? Ma Yuehui said that if the tumor is not removed, it will become bigger and bigger. At that time, the vision will be damaged, the eyes will not see anything, and insomnia will occur. ? At that time, it will be too late to operate again. ?

If this test had happened one month earlier, Wang Shunhe might not have had such a smooth test and subsequent surgery. Now, not only a dangerous tumor has been found, but more importantly, such an operation can also be completed in the county hospital because of the presence of doctors from the First Hospital of Zhejiang University.

Shortly before Wang Shunhe was sent to the hospital, the county hospital just bought an operation microscope. In the neurosurgery of the First Hospital of Zhejiang University, the operating microscope is a standard, but Sanmen County Hospital is the first one. ? Experienced Ma Yuehui performed surgery for Wang Shun.

　? In the past, the tumor in his position was made from above the forehead of the head, and the operation was very slow. Now it is entered through the nose, which is very close. The nose reaches here, and then the bone is bitten open, and the tumor is dug up. ? Wang Duanbu, deputy chief physician of Sanmen County People's Hospital, said that he understood that the new equipment and the doctors in the First Hospital of Zhejiang University had brought completely different surgical procedures to the county hospital.

After an hour and 2 minutes of operation, Wang Shunhe's brain tumor was removed by the way.