10月9日,国务院总理李克强主持召开国务院常务会议,听取了公立医院综合改革和医疗联合体建设进展情况汇报,通过深化医改优化资源配置保障人民健康,部署进一步做好基本医保全国联网和异地就医直接结算工作。
China will carry out reforms at public hospitals to optimize medical care resources, according to a decision made at a State Council executive meeting chaired by Premier Li Keqiang on Monday.
国务院总理李克强10月9日主持召开的国务院常务会议指出,我国将推进公立医院改革,优化医疗保障资源。
Reforms in the pricing of medical services will continue to move toward dynamic price adjustments to better reflect the expertise of medical workers, the panel determined.
会议决定,医疗服务定价机制改革将继续推进动态价格调整,以更好地反应医务工作者的专业能力。
今年的《政府工作报告》指出,“全面推开公立医院综合改革,全部取消药品加成,协调推进医疗价格、人事薪酬、药品流通、医保支付方式等改革(We will introduce overall reform in public hospitals nationwide, abolish all markups on pharmaceuticals, and make coordinated progress in reforming health care pricing, staffing and remuneration, medicine distribution, and models of health insurance payment)。”
会议指出,到今年9月全国所有公立医院已全部开展综合改革,逐步建立了维护公益性、调动积极性、保障可持续的运行新机制(public-oriented, motivated and sustainable mechanism)。
截至目前,医改已经取得了一定的成效,取消了实行60多年的药品加成政策(drug price markups removed),医院收入的药占比(drug sales as a share of total revenue for hospitals)从2010年新一轮医改之初的46.3%降至2016年的38.1%,居民个人卫生支出占卫生总费用比重从2008年的40.4%降至2016年的30%以下,65%的二级以上公立医院开展了按病种付费的医保支付方式改革(reform of category-based insurance payment),患者就医负担持续下降。
公立医院综合改革接下来的任务包括:
一是要完善公立医院运行新机制(to improve the new mechanism of public hospital operation)。
二是用体制机制改革推进医联体建设(to speed up efforts to establish medical treatment partnerships to promote effective cooperation and coordination between different types of medical institutions)。
三是有关部门要集中力量开展疑难高发癌症治疗(treatment of difficult and high-incidence cancer)专项重点攻关,采取措施支持发展先进医疗设备和医药产业,突破提纯、质量控制等关键技术。
四是以“互联网+医疗”(Internet plus medical care)破解难题,加快推广远程医疗(telemedicine)、预约诊疗(medical service pre-registration)、日间手术(daytime surgery)等医疗服务模式,推动在医疗机构之间实现就诊卡和诊疗信息共享,深入推进家庭医生签约服务,全面推进医疗便民惠民服务。
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