The old mechanism of “using drugs to support doctors” has been broken

October 5, 2024  Source: drugdu 109

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Recently, the State Council Information Office held a series of press conferences on "Promoting High-quality Development". The leadership of the National Health Commission answered many questions in the field of domestic medicine and health at the meeting.  

When introducing the basic situation, Lei Haichao, director of the National Health Commission, said that the National Health Commission adheres to the public welfare and works with relevant departments to deepen the medical reform. Over the past decade, especially since the 18th National Congress of the Communist Party of China, the old operating mechanism of using drugs to support doctors and consumables to support doctors has been historically broken, and a new operating mechanism dominated by medical services has been initially established. The income of public medical institutions has changed from the original three channels to two channels of government financial subsidies and medical service charges.

"The old mechanism of relying on drugs and consumables to compensate for medical services no longer exists", and the public welfare has been further strengthened, which has also played a good role in promoting the better role of public hospitals.

At the same time, in the process of promoting medical reform, Sanming, Fujian has created a lot of fresh experience, which has been learned and promoted in many places across the country. At the same time, some practices of Sanming, Fujian have also been elevated to national policies, forming a good implementation and implementation, as well as a work situation of re-creation and re-innovation.

Improving the salary system of public hospitals is a reform task clearly defined by the Third Plenary Session of the 18th CPC Central Committee. The reform of the salary system can be simply summarized as "two permissions" and "three structural adjustments".

"Two permissions" means that when the relevant departments determine the performance wages of public medical institutions, they must approve the total amount and make dynamic adjustments to synchronize the performance wages of medical personnel with the changes in the economic, social and price levels, reflect the labor value of doctors, and encourage good work and good pay, and more work and more pay.

"Three structural adjustments", the first structural adjustment, public medical institutions should insist on taking public welfare as the basic starting point and foothold, and gradually narrow the performance wage level gap between public first-, second- and third-level medical institutions.

The second structural adjustment is to adhere to the requirements of public welfare, gradually narrow the salary gap between different specialties and departments within medical institutions, and improve the income and treatment of relatively weak professional medical personnel in pediatrics, pathology, mental health, anesthesia, general practice, obstetrics, etc.

The last structural adjustment is to gradually increase the proportion of fixed income in the performance salary of medical personnel in accordance with the requirements of public welfare, and appropriately adjust the proportion of flexible income bonus to make it more in line with the public welfare positioning, and encourage medical and health professionals to study technology more and provide more good services, rather than simply linking personal income with income-generating ability.

Lei Haichao emphasized at the meeting that in order to maintain public welfare, it is also necessary to strengthen comprehensive supervision, strictly control the unreasonable growth of medical expenses, and make medical insurance funds more stable, safe and sustainable. The National Health Commission has established systems such as hospital inspections, prescription reviews, and traditional Chinese medicine syndrome differentiation and treatment.

In addition, it is necessary to strengthen the application of information technology, monitor and analyze whether the diagnosis and treatment service behaviors meet the relevant standards and specifications, and guide medical services to be more quality and efficient, and save more resources and costs.

At the end of last year, the National Health Commission and 10 other departments jointly issued a document to comprehensively promote the construction of close-knit county-level medical communities. Local governments attached great importance to it and promoted it rapidly. By the end of August this year, the number of close-knit county-level medical communities had grown to 2,171. Lei Haichao, director of the National Health Commission, said that "this work is expected to achieve our expected goals ahead of schedule."

According to the work plan, by the end of next year, more than 90% of counties will establish county-level medical communities, and the degree of closeness must be improved, that is, the coordination between the upper and lower institutions will be better, information will be more integrated, and personnel exchanges will be more frequent, so that the grassroots service capabilities and levels will be continuously improved and improved.

At present, many places adopt grassroots inspections and superior diagnosis, and the results are mutually recognized. According to the monitoring of the National Health Commission, this method has covered 2/3 of township health centers, so that the grassroots diagnosis level has been better improved and guaranteed.

In 2023, there will be 93,000 traditional Chinese medical institutions nationwide, and the total number of visits will reach 1.54 billion, an increase of 29.2% in the number of institutions and 67.4% in the total number of visits compared with 2020.

Yu Yanhong, director of the State Administration of Traditional Chinese Medicine, mentioned that of the 15 major development indicators in the "14th Five-Year Plan" for the high-quality development of traditional Chinese medicine, three have been completed ahead of schedule, and the rest are all in line with expectations.

During this period, 130 prefecture-level traditional Chinese medicine hospitals built key hospitals with traditional Chinese medicine characteristics, and more than 1,000 county-level traditional Chinese medicine hospitals built "two specialties and one center", basically achieving full coverage of community health service centers and township health centers.

In terms of innovation, 7 national key laboratories and 2 national clinical medicine centers have been built in the field of traditional Chinese medicine, and 46 national traditional Chinese medicine inheritance and innovation centers have been laid out. The China Center for Evidence-Based Traditional Chinese Medicine has become the World Health Organization's first-level registration platform for international traditional medicine clinical trials, and has released a number of traditional Chinese medicine varieties with unique therapeutic effects and suitable technologies for traditional Chinese medicine.

In addition, the collaborative system and mechanism of traditional Chinese and Western medicine and the collaborative service capabilities are also constantly strengthening.

It is reported that more than 90% of public general hospitals at or above the second level have opened clinical departments of traditional Chinese medicine. For the first time in the country, 62 "flagship" hospitals and 559 "flagship" departments of traditional Chinese and Western medicine collaboration have been selected to create a demonstration benchmark for traditional Chinese and Western medicine collaboration. A large number of well-known hospitals such as Peking Union Medical College Hospital, West China Hospital of Sichuan University, and Peking University First Hospital are leading and promoting it.

The project focuses on diseases such as severe pancreatitis, chronic stable coronary heart disease, and tumors, and conducts collaborative research between traditional Chinese and Western medicine. According to Yu Yanhong, "So far, we have promoted the release of the first batch of 52 clinical diagnosis and treatment plans combining traditional Chinese and Western medicine, newly selected more than 150 clinical collaboration projects between traditional Chinese and Western medicine for major and difficult diseases, and actively explored new ideas, methods, and models for the prevention and treatment of diseases combining traditional Chinese and Western medicine."

Source: https://mp.weixin.qq.com

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