公立醫(yī)院已全部開展綜合改革

10月9日，國務院總理李克強主持召開國務院常務會議，聽取了公立醫(yī)院綜合改革和醫(yī)療聯合體建設進展情況匯報，通過深化醫(yī)改優(yōu)化資源配置保障人民健康，部署進一步做好基本醫(yī)保全國聯網和異地就醫(yī)直接結算工作。

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.

國務院總理李克強10月9日主持召開的國務院常務會議指出，我國將推進公立醫(yī)院改革，優(yōu)化醫(yī)療保障資源。

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.

會議決定，醫(yī)療服務定價機制改革將繼續(xù)推進動態(tài)價格調整，以更好地反應醫(yī)務工作者的專業(yè)能力。

今年的《政府工作報告》指出，“全面推開公立醫(yī)院綜合改革，全部取消藥品加成，協調推進醫(yī)療價格、人事薪酬、藥品流通、醫(yī)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)。”

會議指出，到今年9月全國所有公立醫(yī)院已全部開展綜合改革，逐步建立了維護公益性、調動積極性、保障可持續(xù)的運行新機制(public-oriented, motivated and sustainable mechanism)。

截至目前，醫(yī)改已經取得了一定的成效，取消了實行60多年的藥品加成政策(drug price markups removed)，醫(yī)院收入的藥占比(drug sales as a share of total revenue for hospitals)從2010年新一輪醫(yī)改之初的46.3%降至2016年的38.1%，居民個人衛(wèi)生支出占衛(wèi)生總費用比重從2008年的40.4%降至2016年的30%以下，65%的二級以上公立醫(yī)院開展了按病種付費的醫(yī)保支付方式改革(reform of category-based insurance payment)，患者就醫(yī)負擔持續(xù)下降。

公立醫(yī)院綜合改革接下來的任務包括：

一是要完善公立醫(yī)院運行新機制(to improve the new mechanism of public hospital operation)。

二是用體制機制改革推進醫(yī)聯體建設(to speed up efforts to establish medical treatment partnerships to promote effective cooperation and coordination between different types of medical institutions)。

三是有關部門要集中力量開展疑難高發(fā)癌癥治療(treatment of difficult and high-incidence cancer)專項重點攻關，采取措施支持發(fā)展先進醫(yī)療設備和醫(yī)藥產業(yè)，突破提純、質量控制等關鍵技術。

四是以“互聯網+醫(yī)療”(Internet plus medical care)破解難題，加快推廣遠程醫(yī)療(telemedicine)、預約診療(medical service pre-registration)、日間手術(daytime surgery)等醫(yī)療服務模式，推動在醫(yī)療機構之間實現就診卡和診療信息共享，深入推進家庭醫(yī)生簽約服務，全面推進醫(yī)療便民惠民服務。