Source: Economic Reference News
Since 2017, Beijing has launched a comprehensive reform of medicine separation and a comprehensive reform of medical consumption linkage. In the past three years, the comprehensive reform has been generally smooth and orderly, the cost of medicine has been continuously controlled, the construction of a graded diagnosis and treatment system has been effective, and a good trend of outpatient services being diverted to primary institutions has emerged.
Up to now, the increase in the number of emergency outpatient clinics in Beijing has been higher than that of secondary and tertiary hospitals for 43 consecutive months; inpatient services have been concentrated in tertiary hospitals, and the hospitalization days in tertiary hospitals have been shortened and the efficiency has been improved. In this regard, the reporter recently interviewed a number of relevant departments and responsible persons and made a field visit.
The person in charge of the Beijing Municipal Health and Wellness Commission said that the comprehensive reform of the separation of medicine in Beijing and the comprehensive reform of the medical consumption linkage has made the participating medical institutions say goodbye to the history of compensating the running costs with drugs and consumables, and the compensation for skilled labor plays a greater role, and the new compensation mechanism effectively supports the smooth operation and development of medical institutions.
The reporter learned that since the implementation of medical reform, the effect of graded diagnosis and treatment has continued to emerge, the service structure of tertiary medical institutions has changed significantly, with an increase in difficult and critical patients and a decrease in common and slow patients; the increase in the number of primary outpatient clinics has been higher than that of secondary and tertiary hospitals for 43 consecutive months.
The data show that from January to October 2020, the share of primary care visits in Beijing rose by about 8 percentage points compared to the same period in 2015. Excluding patients visiting Beijing, the share of primary care volume reached 51.2%, reaching a record high in recent years.
The data show that from January to October 2020, the share of primary care visits in Beijing rose by about 8 percentage points compared to the same period in 2015. Excluding patients visiting Beijing, the share of primary care volume reached 51.2%, reaching a record high in recent years.
Zhang Jinbao, secretary of the Party Committee of Beijing Chaoyang Hospital, said that in the first year of reform, the total number of outpatient and emergency visits to Chaoyang Hospital decreased by 3.39% year-on-year; among them, the number of outpatient visits decreased by 3.84% year-on-year, and the number of general outpatient visits decreased by 7.13% year-on-year; in the second year of reform, the number of general outpatient visits decreased by 2.69% year-on-year compared with that before the reform, and the number of specialist outpatient visits increased by 15.57% year-on-year; the capacity of inpatient services improved year by year. In the first year of reform, the number of hospital discharges increased by 3.47% year-on-year, and the average hospitalization day decreased by 0.19 days; in the second year of reform, the number of hospital discharges increased by 9.33% year-on-year, and the average hospitalization day decreased by 0.62 days compared with the pre-reform period.
Data show that after the comprehensive reform of medicine separation in Beijing in 2017, the annual increase in medicine costs was controlled at about 8%; after the implementation of the comprehensive reform of medical consumption linkage in June 2019, the medicine costs in 2019 increased by only 6.8% compared with the same period in 2018. The relevant person in charge of the Beijing Municipal Health and Wellness Commission said that since the medical reform, the coordination between the growth rate of medical costs and economic and social development in Beijing has been further improved.
In April 2017, Beijing implemented a comprehensive reform of the separation of medicine, abolished the medical institutions drug markup, implemented zero-rate sales, set up medical service fees, abolished registration fees and consultation fees, implemented sunshine procurement of drugs, standardized and adjusted the prices of 435 medical service items, and implemented comprehensive reform measures to improve medical services; in June 2019, Beijing implemented a comprehensive reform of medical consumption linkage, abolished the medical supplies markup, standardized and adjusted the prices of 6,621 medical service items, carried out joint procurement of medical supplies in Beijing, Tianjin and Hebei, implemented a national pilot centralized procurement and use of drugs, improved medical services and increased medical security reform efforts.
The reporter learned that Beijing has continued to deepen the reform of medical service prices, since 2017, the successive standardization and adjustment of more than 7,000 medical service price items, and the implementation of dynamic adjustment of more than 200 price items. Steady implementation of drug sunshine procurement, national drug centralized procurement “4 + 7” pilot and the second and third batch of national drug centralized procurement, the implementation of Beijing, Tianjin and Hebei six categories of medical supplies joint procurement, effectively reducing the cost of drugs and supplies.
As a cardiovascular specialty hospital, for example, Fu Wai Hospital has increased transparency in the use of high-value consumables through full lifecycle management of high-value consumables. from 2014 to 2019, Fu Wai Hospital achieved a steady decline in the average balloon and average number of stents in the face of increasing clinical workload. The proportion of domestic stent use increased from 51% to 58%, and the proportion of high-end biological valve use decreased from 72% to 45%. (Mank)
