The antibiotic consumption of per person of our country is 10 times in U.S.A. " new medical reform " Meet the new problem

The antibiotic consumption of per person of our country is 10 times in U.S.A. " new medical reform " Meet the new problem
The antibiotic consumption of per person of our country is 10 times in U.S.A. " new medical reform " Meet the new problem
Hole leaf of reporter intern Wu Jing of the newspaper today " new medical reform " Since the scheme is started, what is the difficult problem met? What are direction and focal point of the public hospital reform of our province? Yesterday morning, Henan Province promoted new medical reform and five major engineering construction seminars to be held in province people's assembly hall ceremoniously. It is participating in the conference leader, expert and every city relevant for hospital person in charge on " Promote new medical reform and five major engineering construction " Wait for the focus problem to discuss. [" new medical reform " Meet the new problem ] " small disease enters the community " ,But patient's cold still runs to the large hospital Zhengzhou " The medical reform " Some questions met in the process are very representative. It is introduced, Zhengzhou has jurisdiction over nine districts, six counties (market) ,Urban area permanent resident population more than 3 million. Over the past ten years, sponsor through the public hospitals of provinces, cities and autonomous regions, hospitals of enterprises and institutions, inner health clinics in towns and townships of urban area transform, make the transition and to multiple channels such as the social competitive bidding,etc., build up 45 community health Centers, 135 community health stations together, serve 2,615,000 of population. Zhengzhou will take the lead in putting out in 2008 " Slice cures responsibility system " This new community hygiene service mode, but relevant persons in charge of the place of society of woman of Zhengzhou Municipal Health Bureau say, according to gists of a document such as the province and city " Opinions on Implementing developing urban community's hygiene service ",etc., community's hygiene serves the policy support lacking relevant related files such as relevant house using, talent introduction, fund subsidizing, medical insurance,etc. even at present. Community examine, make, implement yet for the first time, " whether small disease, in community, serious disease go to the hospital " Pattern take shape really yet,patient go to a doctor concentrate on by general hospitals large-scale still, the ones that cause the relativity " It is difficult to see the doctor " ,The development of community's hygiene service is restricted too. " advise the government to issue the relevant policy, in order to give full play to the advantage of the hygiene service organization of the community " . Complete medical talents lack it according to the relevant instructions of the State Council, every 10,000 residents should allocate 2~3 complete doctors, but the complete doctor's quantity of the hygiene service organization of community of Zhengzhou has certain disparity. Because most community hygiene service organizations make the transition from the hospital at the basic level or the hospital of higher level sets up an office, staff members were all clinicians with stronger professional lines in the past, lacked complete medical knowledge. In addition, community's hygiene staff members compare with large hospital doctor, is respected the intensity is relatively low, train examine, evaluation of professional titles policy form a complete set still, lack, attract outstanding talent enter community, effective incentive mechanism to take root community, restrain the intersection of community and hygiene from serve key link of development still. "Propose having and grouping into and determining a post the hygiene service organization of the community, personnel include salary in the finance and supply. " Woman of Zhengzhou Municipal Health Bureau the intersection of society and relevant person in charge of propose, issue corresponding policy put up, favorable to the intersection of business and platform of development for attendants, hygiene of community. The community sees the doctor and can not submit an expense account smoothly on one hand, the hygiene service organization of the community is non-profit-making public beneficial medical organizations, and threshold fee and daily maintenance expense that apply to join medical insurance have been used high, make some community hygiene service organizations inspire awe even from distance to the medical insurance. In addition, the examination and approval of the hygiene service organization of the community is carried on at any time according to planning and construction, and the intersection of examination and approval and one year only one time of medical insurance, this make some the intersection of hygiene and service organization unable to join medical insurance in time newly constructed community of examination and approval. Woman of Zhengzhou Municipal Health Bureau the intersection of society and relevant director of propose, department examines and approves the medical insurance at any time, so as to ensure community residents can enjoy the medical insurance service in the hygiene service organization of the community in time. Setting up to medical dispute third party and mediating the mechanism at present, the medical dispute mainly has mediating and three kinds of routes of lawsuit of doctors and patients' consulting, administration to solve, but it is difficult to get the result of there should be to meet a great deal of questions in practice ing. According to 12 above- second -class hospital incomplete statistics city owned to Zhengzhou, had certain scale and dispute of doctors and patients on influence to reach 210 in 2006, 2007, 3 of 2008. " in the first half of 2009, more than 10 malignant incidents caused by medical dispute have already happened in Zhengzhou " . So, medicine of Zhengzhou Municipal Health Bureau corrects the relevant persons in charge to propose in the report, the Ministry of Health organizes the medical organization to pay and cure the responsibility to the safety unit dangerously according to the regulation; The bureau of justice takes the lead in establishing the medical dispute people's mediation committee, accept the dispute and mediate free; If the medical organization has fault that is compensated by insurance company, open up third party's just, fair, high-efficient and free new route of mediation for the patient; Hygiene, judicial department set up expert's storehouse together, third party's mediation committees organize the investigation, adjust the place in accordance with the law, meanwhile, the public security department should carry out government's order strictly too, get involved etc. fast. [Public hospital medical reform direction ] The public hospital expenses will be by the government " It is single to bury " "The public hospital reform needs to carry on the reform around system, mechanism, three major respects of structure. " The department of public health of Henan Province cures the beautiful report that has made " public hospital reform and management under the new medical reform situation " at the meeting of Tian Chang, division chief of of policy. He says, because the reform of the public hospital involves the coordination questions of a plurality of departments such as development and reform committee, ensuring, medicine supervising, hygiene, finance of working, so the public hospital is a difficult point in all reforms, it is the theme of the medical reform at the same time. While mentioning the government put into the question, he says, already clear in the relevant policies which the country issued: As to the professional public health organ, the government guarantees the budget in full. And at the same time, the country allows social forces to establish the hospital, undertake public health task, " very clear, two words ' buy ' " . According to the national regulation, it is subsidized that the government can take and buy way of serving etc. to authorize. And will be arranged to the basic construction expenditure that the medical organization at the basic level needs by the government, this is including operating expenses such as fee, strength,etc., after examining the performance, the government examines and mends cores according to the performance. In addition, questions such as personnel training,etc. will be subsidized rationally by the financial department. As to the public hospital, capital construction,etc. that is involved at first is put into listing in the special report by the relevant department too, the government will arrange progressively, " though bring the hope too progressively " . In addition, to the expenses happening when the incident of meeting an urgent need happen suddenly, will be subsidized specially by the government. The hospital works out the need " Lighten restrictions on " As to the establishment question of the public hospital, it is a content of reform too. Tian ChangJun mentions, the establishment system of the public hospital has not basically changed enough for over 20 years. Nowadays, the medical organization wants to enter a graduate student, need multistage leader to carry on research too, " want to retain staff, must go on ' lightens restrictions on ' in working out the question " . Meanwhile, the medical organization can also introduce " council " , " board of directors " The intersection of operation and structural mode of framework, beautiful to say central authorities plan to launch a pilot project first Chang Tian, then popularize progressively. And professor of government of Peking University management college Gu Xin refers to while mentioning " new tendency of new medical reform ", the public hospital can introduce the social capital and open the branch too, or introduce the social capital to open The clinic, the public hospital merge the public or private community medical organizations, let doctor of hospital this in clinic that oneself invest " Some operation more " . And throw to the supplier into the pluralistic hospital, can provide service to different crowds. For example, field that social capital enters may launch high side serve, face the high income crowd. But the general hospital that the pure government puts into faces ordinary common people. While connecting and still needing to coordinate the public hospital reform with the medical insurance policy, the medical insurance policy needs connecting too. Beautiful to say many patient of hospital need, add bed, live, enter at present Chang Tian, some department number go beyond in hospital berth far, it has another more 10%~20% to be fairly relatively more normal in hospital, some even many 50%. This is actually very unfavorable to medical treatment safely. And this relates to arrangement of some medical insurance systems. " some projects could submit an expense account in hospital " . He is for example, the artificial crystal that cataract is done plants and starts with the skill, in some hospitals in Hong Kong, can go home directly after the operation, does not need to be in hospital, but stipulate on the present medical insurance policy inside the province, can't not submit an expense account in hospital. And this demand, shorten in hospital day, simplify procedure, accelerate the intersection of berth and turnover come on, reduce the intersection of patient and the intersection of expense and the intersection of looks and contradiction with medical organization. " this has caused the wasting greatly of medical resources too " . In addition, he thinks, while the public hospital reforms, needs the question stressed emphatically, the rational administration remains the key. He lift one data in antibiotic, according to investigation, of our country the intersection of per person and annual volume of consumption in 138 gram about, and this figure is 10 times that of U.S.A., the first in the world. And really need the number of people of disease which use antibiotic to be less than 20%, more than 80% abuse antibiotic. This problem has already become the factor influencing people's health seriously at present. For this reason, he mentions, the system, the system of strengthening clinicians and making the rounds of the wards that our province should implement the rational administration and is trained.


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