Since the implementation of the comprehensive reform of Beijing medicine separation on April 8, it has attracted much attention from all walks of life. On June 9, the Beijing Municipal Health Planning Commission held a symposium on medical reform. The health sector learned from the symposium that in the past two months, the total drugs in major hospitals in Beijing accounted for 36.6%, a decrease of 6.87 percentage points compared with the same period last year. Gao Xiaojun, spokesman of the Beijing Municipal Health Planning Commission, said that there was no general decline in the income of large hospitals after the start of medical reform in Beijing. "If the medical reform makes the hospital’s income drop, then it means that the reform policy design is a failure." Gao Xiaojun said.
The total number of outpatients in medical institutions in Beijing decreased.
The medical reform made it clear that public medical institutions in Beijing canceled drug addition (excluding Chinese medicine drinks), registration fees and medical treatment fees, and set up medical service fees, with the goal of getting rid of medicine to supplement medicine. From April 8 to June 2, Beijing monitored the progress of medical reform in 373 tertiary and secondary hospitals, some first-class hospitals and community health service institutions. It shows that in the past two months, the total number of outpatient and emergency services in monitoring units has exceeded 20 million, which is 8.46% lower than the same period of last year. The total number of outpatient and emergency services in tertiary hospitals has decreased by 12.58%, that in secondary hospitals has decreased by 4.54%, and that in primary hospitals and community health service institutions has increased by 7.6% compared with the same period of last year.
The data shows that the number of visits to secondary and tertiary hospitals in Beijing has decreased correspondingly, while the number of visits to primary hospitals and community health service institutions has increased. The relevant person in charge of the Beijing Municipal Health Planning Commission said that since the reform, the situation of graded diagnosis and treatment in Beijing has gradually emerged.
Compared with the same period of last year, the number of outpatients in monitoring medical institutions decreased by 7.58%. Among them, the number of visits by deputy chief physicians decreased by 9.3%, the number of visits by chief physicians decreased by 20.8%, and the number of visits by well-known experts decreased by 14.8%. This shows that the problem of difficulty in seeing experts generally tends to be alleviated.
In terms of the number of discharged patients, the total number of discharged patients in the monitoring unit was 510,000, a decrease of 0.24% compared with the same period of last year. This data has not changed much compared with the same period of last year. Gao Xiaojun believes that the number of discharged patients has not changed much, indicating that the medical reform has not affected the diagnosis and treatment of hospitalized patients.
Drug procurement is one of the important contents in this medical reform. By June 7th, the cumulative expenditure of Beijing Pharmaceutical Sunshine Procurement was 10.27 billion yuan, saving 842 million yuan and 8.2%.
After the medical reform, has the medical expenses been effectively controlled? According to the data provided by the relevant person in charge of the Beijing Municipal Health Planning Commission, medical expenses are generally stable. Compared with the same period of last year, the average drug cost of outpatient and emergency departments in monitoring units decreased by 6.38%. Since the reform, the average drug cost of outpatient and emergency departments has shown a gradual decrease trend.
The proportion of drugs decreased by nearly 7%, and the hospital income did not drop.
This medical reform canceled the drug addition, aiming at changing the income structure of medical institutions. The data shows that in the two months after the medical reform, the proportion of drugs in monitoring units was 36.6%, a decrease of 6.87 percentage points compared with the same period last year. The proportion of drugs in tertiary hospitals was 33.84%, a decrease of 7.31 percentage points compared with the same period of last year; The proportion of drugs in secondary hospitals was 40.07%, a decrease of 7.14 percentage points compared with the same period last year. The proportion of first-class and community drugs was 72.53%, which was 4.06 percentage points lower than the same period of last year. The proportion of discharged drugs in monitoring units was 26.29%, a decrease of 6.05 percentage points compared with the same period of last year.
At the symposium, individual hospitals mentioned that the total income of hospitals decreased by nearly 20% after the reform. Gao Xiaojun believes that the reform requires medical institutions to carry out refined management, thus improving their operational capabilities. "There is no general decline in the income of large hospitals in Beijing." Gao Xiaojun stressed.
Encourage large hospitals to independently set up comprehensive outpatient clinics for geriatric diseases.
At present, major hospitals in Beijing have shut down simple prescription clinics one after another, and some patients feel that it is inconvenient to seek medical treatment.
In this regard, Liu Ying, deputy director of the Medical Administration Department of the Beijing Municipal Health Planning Commission, believes that government departments hope that the functional orientation of tertiary hospitals is to diagnose and treat difficult and severe diseases, rather than to deal with common diseases and frequently-occurring diseases. Only by strengthening the grass-roots units can patients truly appreciate the convenience of seeking medical treatment. "Large hospitals can independently set up comprehensive outpatient clinics for geriatrics according to the development of their own disciplines to provide services for patients." Liu Ying said.
"Doctors no longer work for pharmaceutical companies"
Beijing Obstetrics and Gynecology Hospital is the only third-class hospital specializing in obstetrics and gynecology in Beijing. As a hospital with a small amount of drugs, Beijing Obstetrics and Gynecology Hospital has benefited greatly from this round of medical reform. According to Chen Jing, secretary of the Party Committee of the hospital, the income of the hospital has been slightly improved by canceling the registration fee and medical treatment fee and setting up the medical service fee. Outpatient medical income increased by 9.68% from 54.14 million yuan in May 2016 to 59.38 million yuan in May 2017; In-patient medical income increased by 9.73% from 24.24 million yuan in May 2016 to 26.6 million yuan in May 2017.
It is worth mentioning that, while the income of Beijing Maternity Hospital has increased, the increase in the average outpatient expenses has slowed down, which is due to the fact that the hospital has promoted and reduced the burden on patients after canceling the drug addition.
This round of medical reform emphasizes that medical institutions should strengthen refined management. Following the "baton" of reform, Beijing Maternity Hospital adopted a new version of performance distribution scheme on June 1, improving internal performance appraisal and establishing a performance appraisal distribution mechanism suitable for medical reform.
Chen Jing said that the new performance appraisal index system includes four dimensions: work quality, work efficiency, cost control and annual special projects. "Doctors are no longer people who work for pharmaceutical companies, but earn money by trying to improve their services."
Highlights of other medical institutions
Beijing Aviation General Hospital
Two months after the implementation of the "Beijing Edition" medical reform, the drug sales of Beijing Aviation General Hospital decreased by 6.72% compared with the same period of last year, the prescription amount decreased by 14% compared with the same period of last year, the inspection income decreased by 13.25%, the total number of outpatient and emergency visits decreased by 16.31%, and the total hospital income decreased by 20%.
Third Hospital of Beijing Medical University
For two consecutive months, the number of outpatients in the Third Hospital of Beijing Medical University decreased by 10.86% year-on-year, and the number of outpatients in six departments kept increasing, while the number of outpatients in other departments decreased. Medical beauty, dermatology, cardiovascular medicine, endocrinology, Chinese medicine, general surgery, neurology and other departments have dropped significantly.
Nanmofang community health service center
Since the reform of separating medicine from medicine, the community and large hospitals have achieved unity in the variety of drugs that can be purchased. After purchasing sunshine, patients also enjoy the benefits brought by drug price reduction. For example, the use of "Gehuazhi" by patients decreased by 8.9%.