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in Shandong Province, a number of county hospitals have carried out comprehensive reform pilot. (Qilu Evening News and Qilu one point reporter Li Gang) recently, the Ji'nan municipal government issued a "notice on the implementation of the comprehensive reform of public hospitals in Ji'nan" (hereinafter referred to as "the program"). In the program, it was pointed out that by the end of 2016, there were not less than 100 diseases to be paid in accordance with the disease. The health care reform measures can be continuously calculated from the date of hospitalization of the first medical institution. So what benefits and benefits will Ji'nan citizens get from this reform? to realize the grading diagnosis and treatment, we should increase the reform scheme of the reimbursement gap, and point out that we should promote the system of grading diagnosis and treatment, construct the service system of the misplacement of the function of the regional medical center and the basic medical institutions and the cooperative development of the business, and promote the shift of the center of medical and health work and the sinking of the resources, and guide the residents to take a reasonable medical treatment. By the end of 2016, the proportion of appointments transferred to public hospitals had increased to more than 20%.
, Xu Lingzhong, a professor of public health at the Shandong University, pointed out that "classification diagnosis and treatment can not be separated from the cooperation and support of medical insurance policy. In addition to the program, the medical insurance starting and payment line can be continuously calculated, and the difference between medical insurance reimbursement at different levels of medical institutions should be increased, and the leverage of medical insurance should be fully played. The man. " Hierarchical diagnosis and treatment should avoid letting primary medical institutions end up being simply referral procedures for patients. Xu Lingzhong said, "if you do not want to improve the diagnosis and treatment of medical institutions at the grass-roots level, let patients truly believe the level of grass-roots medical institutions, only through compulsory policy diversion may increase the contradiction." In order to retain high level doctors, primary medical institutions also need policy tilt, appropriately raise their income level, and ensure that all kinds of drugs are well equipped.
"complete classification of diagnosis and treatment can not be realized overnight, just as it is difficult to change the way of life completely, and the change of medical habits will also take time." Therefore, Xu Lingzhong believes that the improvement of grading treatment and appointment referral needs a long-term process.
health card, hospital sharing information "program" proposed to further improve the public health card function, and medical insurance cards, UnionPay cards and a variety of carrier information butt, to promote full card medical treatment and credit card pay, online payment.
"from the perspective of Shandong Province, the medical insurance system between the 17 cities is independent of each other, and the provincial health insurance is independent." Xu Lingzhong said, "in addition to medical insurance, the medical cards between hospitals are independent, to different hospitals to do different cards, which causes the fragmentation of medical information, can not achieve information sharing, also is not conducive to the implementation of the appointment and referral." Xu Lingzhong said that if the hospital systems can be shared in real time, only a "health card" can go to different hospitals, which can bring great convenience to the patient. "Now many elderly people go to see a doctor with a medicine box, if the doctor can clearly see all the diagnosis and treatment of the patient." Record, it will be more convenient to visit. " It is clear that Ji'nan will build the "Ji'nan residents medical network" and the APP application system in the program to improve the appointment and consultation of residents. The results of the self-service appointment registration, payment and inquiry inspection, and the personal health archives "on the hand" will be realized, and the referral, telemedicine, health management and medical cooperation will be formed. "One Netcom".
corresponds to the current information fragmentation, and the appointment of a doctor now needs to log in to the official website of the different hospitals or the mobile client, if there is a unified one-stop platform that is more conducive to the patient's medical treatment.
Xu Lingzhong said, building such an information system requires huge financial input. Many developed countries and regions in Hongkong and the United States have realized this information sharing. "As early as 1999, I went to Hongkong to investigate the patient information in any hospital system, and all the medical records of the patient could be recorded. Show it. " The patients with chronic diseases had better fixed one doctor "plan" to set up a medical and nursing service team in the three level hospitals and specialized hospitals as a unit for providing disease diagnosis and nursing service and carrying out team service. It is necessary to reform the mode of direct appointment of patients, change the appointment of medical teams or departments to patients, and arrange reasonable patients' visit by hospitals.
at present, the appointment is almost all the appointment to the specific doctor name, "because the well-known expert appointment limited number, the patient may be difficult to make a successful appointment, if a centralized reservation to the Department, it increases the chances of a successful appointment." Experts from the second hospital of Shandong University explained that "the Department can be assigned to the corresponding level of doctors according to the patient's specific condition, and the general condition is accepted by the general doctor, so that the real patient can see the expert." "The number of famous experts can not be seen too much. After the patients are shunted, they can appropriately reduce their burden and focus on the difficult problems; the young doctors also have the opportunity to take more patients to speed up their own growth." The expert said that the change in the way of appointment is of great benefit to both patients and doctors.
, however, it is worth noting that "a lot of chronic chronic disease patients are best fixed at the same doctor's name each time, helping the doctor to master the condition in an all-round way and make a more suitable treatment plan for the patient." Even with the same disease, different doctors will have different treatment plans, and frequent replacement of doctors is not appropriate.