The state expressly stipulates that comprehensive reforms will be launched before September 30, 2017, all drug additions (except for Chinese herbal medicines) will be abolished, medical treatment mechanisms will be broken, public welfare will be established, and modern hospital management systems will be accelerated.
After the zero-defect price of medicines was fully implemented, some public hospitals had a strange phenomenon of inspection fees and consumables fees. In order to avoid the "pick-up of the gourd", it is an inevitable trend to implement the zero price difference of consumables.
On November 10th, the National Development and Reform Commission issued the "Opinions on Comprehensively Deepening the Reform of the Price Mechanism". The opinion puts forward that it should "consolidate the results of the elimination of drug additions and further abolish the medical consumables." After the consumption of the consumables is scattered in several places, the zero price difference of consumables will be implemented nationwide.
In other words, 2017 is a good year for us to say goodbye to drug addiction and to see goodbye for consumables. After facing the no-drug and consumables profit, how to operate, reform and adjust the layout of the hospital will be a very difficult problem. The pharmaceutical industry will also see a series of major changes.
First, the days of public hospitals are sad.
Drugs and consumables can be described as the two major profitable lifelines of public hospitals. After the implementation of zero price difference, how to survive in public hospitals is a major problem faced by the government and hospitals today.
Even with the financial support of the government and the help of other means of income and other means, it is undeniable that the days of public hospitals have not been better.
After the drug add-on was cancelled, the hospital’s income was significantly reduced. On the occasion of the Dean’s Summit on different occasions, the most heard was the dean’s economic account. Some face is full of sadness, and all the income reduction is painful; some generously replied, and strive to ease the pressure by adjusting the internal mechanisms and projects of the hospital.
After the zero-plus of consumables is gradually implemented, it is equivalent to cutting off another profitable hand in public hospitals. "After the zero rate, it is a problem for the hospital to make up for the reduced income, so at the hospital level or facing A lot of pressure, the government may give a certain subsidy," said Guo Rongfu, a senior researcher at Sinopharm. However, in any case, the public hospitals have taken the knives of consumables.
Second, the medical staff service fee increased
There will be an increase if there is a decrease. At the same time as the elimination of medicines and consumables, the medical service fees, such as medical technology fees, surgery fees, nursing expenses, medical expenses, and other medical service items, have been raised, which can better reflect the value of medical staff's technical services and enable medical staff to obtain The decent income of the sun and the full space for career development.
Hospitals and medical staff must also increase the choice of patients and increase the source of profits by improving the techniques of diagnosis and treatment.
Third, a skilled, branded doctor is more popular
The implementation of zero price difference between medicines and consumables, together with the introduction of a series of documents, changed the situation of doctors who used to open expensive medicines, used more consumables, and who had more papers, so that those with technology and personal brands The doctors will get more benefits, so that the doctor's focus will be on the patient, and the improvement of the efficacy and the patient experience will increase the patient's satisfaction and thus enhance their brand value and income level.
Fourth, the number of public hospitals reduced the number of hospitals in primary hospitals
With the sudden drop in bonuses, public hospitals can only change the way they used to expand extensively. For less operating costs, public hospitals have to scale down. And from the policies of recent years, the government also advocates controlling the disorderly expansion of the scale of tertiary hospitals.
With the reduction of the scale of public hospitals and the in-depth advancement of grading medical treatment, the government will subsidize and strengthen the doctors' strength of primary medical institutions (high-level hospital physicians regularly attend clinics, community physicians regularly go to high-level hospitals for further study, family doctors signing plans, etc.) Guide patients to primary health care institutions, strengthen the comprehensive strength of primary hospitals, and ease the pressure of hospital visits.
Fifth, according to the era of disease payment
The implementation of zero price difference forced the hospital to change the interest conversion mode. In order to improve the medical insurance payment mechanism and interest control mechanism, implement refined management, stimulate medical institutions to regulate behavior, control costs, rationally treat and refer patients for endogenous motivation, and guide medical treatment. Reasonable allocation of resources and orderly medical treatment for patients. This year, the state issued the "Guiding Opinions on Further Deepening the Reform of Basic Medical Insurance Payment Methods", and the medical insurance payment method ushered in major reforms.
It is clear that the prepayment of the total amount, the disease type, the service unit, and the prepaid method are used to replace the post-payment method according to the project; the clinical path is combined with the reform of the payment system, and the payment system reform and cancellation are complemented by the medicine supplement. Taking the reform of medical insurance payment as an entry point means that the control of medical insurance funds is the core and the reform of public hospitals is strongly promoted.
At the same time, the payment according to the disease will gradually tilt to the grassroots level. There are already many places in the country to issue payment documents according to the disease type, and the payment according to the disease will be forced to be pushed away in the country.
Six, a large number of hospital pharmacy hosting
The zero price difference between drugs forced the separation of medicines. The hospital did not have the profit of medicines. The varieties on the basic medicine list were difficult to make money. The self-paid medicines were important profits of hospital pharmacies. As a result, pharmacy hosting has become a way for hospitals to digest losses.
The definition of pharmacy trust is: under the premise that the ownership of the hospital pharmacy does not change, the hospital will hand over the pharmacy to a third-party enterprise to operate and manage. In other words, the hospital did not sell the pharmacy, but instead handed the pharmacy to the drug company or the drug distribution company.
However, the prospect of pharmacy trusteeship, the role of pharmacy in the hospital and pharmaceutical companies, remains to be seen, but it is certain that hospital pharmacies and pharmacy pharmacy staff will bid farewell to the past identity, re-adapt to the new Way of survival.
Seven, public hospitals turn to refined management
In the new situation and new environment, the decline in inspection fees, drug charges, and consumables fees is a big trend. The income from technical services has increased. The extensive income growth model of hospitals relying on over-medication, over-examination, and over-treatment has come to an end, forcing the hospital to go fine. It is the general trend of the medical quality of the medical service to connotate the quality of the road and to achieve the improvement of the refined management ability. It is true that it is necessary to adapt in advance.
The "pain of the reform" is inevitable, but after the pain is an orderly, reasonable and healthy growth, the effect of zero price difference on the optimization of the medical market environment and the reform of the medical institution's management strategy is irreplaceable, so that the price tends to Rationality, returning to the natural attributes of medical treatment, is the most correct choice for achieving health care.
The improvement of medical treatment into the deep water area has affected and changed not only these points, but also all aspects of society and life, the redistribution of interests in all aspects, the medical resources being newly planned, and the good days of large hospitals are about to pass, fully complying with the laws of the medical market. Under the premise, respecting the labor value of medical care, letting medical care return to its original intention, and creating a healthy, sunny and reasonable medical environment is the real goal of reform.
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