公立医院改革下一步如何做?国家卫生健康委和发改委说话了

2019-01-03 佚名 基层医师公社

公立医院改革目前遇到了哪些突出的重要问题?下一步还想采取哪些步骤和做法?在鼓励社会力量办医方面,政府有什么打算?这些问题,国家卫生健康委和发改委都做了回答。近日,十三届全国人大常委会第七次会议在人民大会堂举行联组会议,围绕审议国务院关于财政医疗卫生资金分配和使用情况的报告开展专题询问。公立医院改革有哪些措施?有什么困难?下一步怎么干?这些社会普遍关注的问题被全国人大常委会委员一一提出。这些问题,卫

公立医院改革目前遇到了哪些突出的重要问题?下一步还想采取哪些步骤和做法?在鼓励社会力量办医方面,政府有什么打算?

这些问题,国家卫生健康委和发改委都做了回答。

近日,十三届全国人大常委会第七次会议在人民大会堂举行联组会议,围绕审议国务院关于财政医疗卫生资金分配和使用情况的报告开展专题询问。

公立医院改革有哪些措施?有什么困难?下一步怎么干?这些社会普遍关注的问题被全国人大常委会委员一一提出。

这些问题,卫生健康委主任马晓伟和国家发展改革委副主任连维良分别作了回答。

马晓伟:公立医院改革面临两大问题

在肯定了公立医院的改革多年取得的明显阶段性成果后,马晓伟指出我国公立医院改革目前面临两个主要问题:

第一,有四个方面要继续推进完善

1.在切断以药养医之后,价格补偿没有完全到位,有百分之十几左右的缺口;

2.国家对公立医院的投入政策在一些地区落实不到位;

3.医保的总量控制比较紧,限制了医疗的需求;

4.公立医院的分配结构还不够合理。

第二,对公立医院医疗行为的监管和对整个行业的监管需要进一步从制度层面加以完善。

下一步:加大薪酬制度改革,调动医务人员的积极性

马晓伟提出,下一步要巩固药品加成的改革成果,建立一个灵活体现成本和收入结构变化的动态的价格调整机制,科学合理地使公立医院得到补偿;

持续深化医保支付方式的改革,引导合理就医;

加大薪酬制度改革,调动医务人员的积极性;

加大建立现代医院管理制度,使我国公立医院向质量效益型和管理科学精细化转变。

关于现代医院制度建设,在前不久国家卫生健康委等六部门联合发布的《关于开展建立健全现代医院管理制度试点的通知》中,就点名了148家公立医院,作为建立健全现代医院管理制度的试点医院,依法全面推行聘用制度和岗位管理制度,实行合同管理。可见,现代医院管理制度即将在全国范围铺展开来,开启真正落地时代。

连维良:社会办医部分政策落实不到位,监管自律不到位

国家发展改革委副主任连维良介绍了有关社会办医的情况。他说,近年来社会办医取得了积极成效,民营医院的数量、软硬件能力以及诊疗人次明显提升。社会办医机制灵活,贴近群众,在一些细分的医疗领域逐渐显现出优势。

连维良同时指出,目前社会办医仍然存在许多亟待解决的问题,主要表现为一个缺乏、两个不到位。

一个缺乏是人才缺乏。

两个不到位,一是部分政策落实不到位,准入审批、土地用房、税收优惠、医保定点等政策获得感有待提高。

二是监管自律不到位,有些医院通过网络竞价排名和虚假广告误导患者,存在无证行医、欺诈骗保等不法行为。

社会办医准入重点审核医生职业能力

近年来,国家针对社会办医颁布了多项文件,一步步简化了社会办医的各种不必要程序。但这并不代表国家降低社会办医准入门槛。

连维良表示,下一步支持社会办医,重点是做到进一步放宽准入,适当放宽准入的硬件标准,重点审核软件能力,特别是医务人员的职业能力。

同时加强政策落实力度,提高融资引资、土地用房、税收优惠、医保定点等政策实施的质量;加强综合监管力度,严厉打击医疗服务领域各类违法行为,特别是加强对无证行医、欺诈骗保、虚假违法医疗广告等严重失信行为实行联合惩戒和专项治理,净化行业发展环境。

看来,虽然社会办医在程序上简单了,硬件上放宽了,但在软件上,国家相对提高了准入门槛,提高社会办医医生整体素质,是提升社会办医质量的必要手段。

公立医院改革任重道远,一系列问题和细节还有待加强和完善,但改革的决心是坚定的,目标也是明确的。随着公立医院改革越来越深入,医疗市场对优质医疗资源将更加包容,同时对不正规不合法的医疗行为也将给予更为严厉的打击,医疗格局在更为科学的机制下走向规范化时代。

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14:27:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492939, encodeId=bac9149293943, content=<a href='/topic/show?id=d98f3660e57' target=_blank style='color:#2F92EE;'>#卫生健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36607, encryptionId=d98f3660e57, topicName=卫生健康)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60488981755, createdName=wangyang7961, createdTime=Sat Jan 05 14:27:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568093, encodeId=038b1568093a4, content=<a href='/topic/show?id=85a54086193' target=_blank style='color:#2F92EE;'>#国家卫生健康委#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40861, encryptionId=85a54086193, topicName=国家卫生健康委)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sat Jan 05 14:27:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=357159, encodeId=dfbd35e1590c, content=任重道远, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86c32515959, createdName=EVA1836, createdTime=Fri Jan 04 16:10:11 CST 2019, time=2019-01-04, status=1, ipAttribution=)]
    2019-06-16 d830372
  4. 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14:27:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492939, encodeId=bac9149293943, content=<a href='/topic/show?id=d98f3660e57' target=_blank style='color:#2F92EE;'>#卫生健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36607, encryptionId=d98f3660e57, topicName=卫生健康)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60488981755, createdName=wangyang7961, createdTime=Sat Jan 05 14:27:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568093, encodeId=038b1568093a4, content=<a href='/topic/show?id=85a54086193' target=_blank style='color:#2F92EE;'>#国家卫生健康委#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40861, encryptionId=85a54086193, topicName=国家卫生健康委)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sat Jan 05 14:27:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=357159, encodeId=dfbd35e1590c, content=任重道远, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86c32515959, createdName=EVA1836, createdTime=Fri Jan 04 16:10:11 CST 2019, time=2019-01-04, status=1, ipAttribution=)]
    2019-01-10 zwjnj2

    学习学习天天向上

    0

  6. 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    2019-01-04 EVA1836

    任重道远

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