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如何控制药占比?三甲医院放大招!

2017-09-30 大鹏 医学界

对外科医生停刀,是对外科医生最大的处罚,只有这样才能产生威慑力。一定要下狠手,才能把这股歪风止住。

院长如何控制住药占比?不妨听听这位院领导的“心得”。

很多医院为控制药占比可谓是“煞费苦心”,使出浑身解数。而在前不久的一次医疗会议上,某三甲医院的副院长则向在座的众多公立医院的管理者展示了该院“漂亮”的药占比数据。他是如何做到的呢?

“绝招”就是——严管科主任的“笔”。怎么个严管?这事儿得从四年前说起。据了解,四年前,这家医院的药占比控制得并不算很好。

“四年前,一次偶然的情况,我发现我们医院每个胃癌患者的人均花费,要比同市三级医院平均花费多花一万块钱。我当时就想,为什么我们会多花一万块钱?我就想不明白。”这位院领导当时就去医务处信息科把半年以内在医院住院的所有胃癌患者病例全部调出来,一个字:查!

“一查,我发现,这多花的这一万块钱里面,其中九千块多块钱是用药。”这位院领导惊讶地表示,"既然是花在药上面,我就让药剂科临床药师全部给我去查,这九千多块钱都用了什么药。然后,我又让临床药师来评估、审核,这些药品有没有指针,是不是合理。“

结果,问题马上就发现出来了,这些多用的药品当中,大多数都是辅助用药。

“我们有些医生有时候就是喜欢乱用药,有的病人不论青红皂白,收治进来,从入院到出院,每一天都用一些可用可不用的辅助用药,没有实用价值。”这位院领导坦言。

把这些数据全部抓实以后,这位院领导立即把科室里的主任、副主任全部找过来,进行询问。于是有了下面的对话:

院领导:给我讲讲这是怎么回事?

科主任:这个,这个不关我的事。我开完刀就走了,都是下面的小医生干的。

院领导:是哪个小医生干的,你把他给我找过来!

科主任:这……

院领导:即使是小医生干的,你作为一个科室的主任,你就能推脱干净吗?我早就说过,科主任相当于科室里面的家长,小医生都是你的孩子,孩子教育不好,家长就一点责任没有吗?

科主任:这是我的疏忽,以后一定注意严查。我保证决不再发生这样的情况。

院领导:保证没用,必须要严惩,才能引以为戒!

科主任:我们服从医院的处罚,没有异议。

最后,医院对管床位的医生一次性罚款五千,带组的小组长一次性扣一万,科主任罚款一万五。

这位院领导表示,“处罚完之后,我告诉他,这次经济处罚只是一个小小的警示,我会跟踪你半年。再让我发现你这样没有指针,不合理乱用药,我不罚你钱。虽然我也不是卫生监督部门,没有资格吊销你的医师资格证,但是我作为医院的管理者,我有权让你离岗培训,我封你刀,两个月、半年,不准你开刀,不准你看门诊。让你每天到党办去学习文件,或者去医患纠纷处去接待病人投诉。这个权力我有。”

最后,这位院领导坦言:“对外科医生停刀,是对外科医生最大的处罚,只有这样才能产生威慑力。一定要下狠手,才能把这股歪风止住。”

在这样的重压之下,才有了这家三甲医院“漂亮”的数据。

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    2017-10-02 HNYYM
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    2017-10-02 陈吴1239
  4. [GetPortalCommentsPageByObjectIdResponse(id=1365917, encodeId=def9136591e68, content=<a href='/topic/show?id=468119e04db' target=_blank style='color:#2F92EE;'>#三甲医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19704, encryptionId=468119e04db, topicName=三甲医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Mon Oct 02 13:21:00 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1509747, encodeId=194a1509e4727, content=<a href='/topic/show?id=1c8e8e333cb' target=_blank style='color:#2F92EE;'>#药占比#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87333, encryptionId=1c8e8e333cb, topicName=药占比)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=762710134609, createdName=HNYYM, createdTime=Mon Oct 02 13:21:00 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552382, encodeId=0fb5155238223, content=<a href='/topic/show?id=a8d5196997c' target=_blank style='color:#2F92EE;'>#三甲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19699, encryptionId=a8d5196997c, topicName=三甲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88e914287502, createdName=陈吴1239, createdTime=Mon Oct 02 13:21:00 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249504, encodeId=f86d2495049e, content=不错的文章.值得一读., beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/20/71f908320db34f36cac4a7c807970775.jpg, createdBy=c93a2154620, createdName=平静的光芒, createdTime=Mon Oct 02 00:07:10 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249470, encodeId=ca8a2494e0bd, content=不错的文章值得一读, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Sun Oct 01 21:39:59 CST 2017, time=2017-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249372, encodeId=01b72493e224, content=不错的资讯.值得阅读与分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/20/71f908320db34f36cac4a7c807970775.jpg, createdBy=c93a2154620, createdName=平静的光芒, createdTime=Sun Oct 01 09:33:31 CST 2017, time=2017-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249218, encodeId=9fe324921821, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00501987275, createdName=130****4638, createdTime=Sat Sep 30 23:42:28 CST 2017, time=2017-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249194, encodeId=f28824919460, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Sat Sep 30 23:02:32 CST 2017, time=2017-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249187, encodeId=189524918e27, content=很多医院为控制药占比可谓是[煞费苦心".使出浑身解数.而在前不久的一次医疗会议上.某三甲医院的副院长则向在座的众多公立医院的管理者展示了该院[漂亮"的药占比数据., beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Sat Sep 30 22:49:12 CST 2017, time=2017-09-30, status=1, ipAttribution=)]
    2017-10-02 平静的光芒

    不错的文章.值得一读.

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1365917, encodeId=def9136591e68, content=<a href='/topic/show?id=468119e04db' target=_blank style='color:#2F92EE;'>#三甲医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19704, encryptionId=468119e04db, topicName=三甲医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Mon Oct 02 13:21:00 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1509747, encodeId=194a1509e4727, content=<a href='/topic/show?id=1c8e8e333cb' target=_blank style='color:#2F92EE;'>#药占比#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87333, encryptionId=1c8e8e333cb, topicName=药占比)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=762710134609, createdName=HNYYM, createdTime=Mon Oct 02 13:21:00 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552382, encodeId=0fb5155238223, content=<a href='/topic/show?id=a8d5196997c' target=_blank style='color:#2F92EE;'>#三甲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19699, encryptionId=a8d5196997c, topicName=三甲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88e914287502, createdName=陈吴1239, createdTime=Mon Oct 02 13:21:00 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249504, encodeId=f86d2495049e, content=不错的文章.值得一读., beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/20/71f908320db34f36cac4a7c807970775.jpg, createdBy=c93a2154620, createdName=平静的光芒, createdTime=Mon Oct 02 00:07:10 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249470, encodeId=ca8a2494e0bd, content=不错的文章值得一读, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Sun Oct 01 21:39:59 CST 2017, time=2017-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249372, encodeId=01b72493e224, content=不错的资讯.值得阅读与分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/20/71f908320db34f36cac4a7c807970775.jpg, createdBy=c93a2154620, createdName=平静的光芒, createdTime=Sun Oct 01 09:33:31 CST 2017, time=2017-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249218, encodeId=9fe324921821, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00501987275, createdName=130****4638, createdTime=Sat Sep 30 23:42:28 CST 2017, time=2017-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249194, encodeId=f28824919460, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Sat Sep 30 23:02:32 CST 2017, time=2017-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249187, encodeId=189524918e27, content=很多医院为控制药占比可谓是[煞费苦心".使出浑身解数.而在前不久的一次医疗会议上.某三甲医院的副院长则向在座的众多公立医院的管理者展示了该院[漂亮"的药占比数据., beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Sat Sep 30 22:49:12 CST 2017, time=2017-09-30, status=1, ipAttribution=)]
    2017-10-01 1e1b8538m79(暂无匿称)

    不错的文章值得一读

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1365917, encodeId=def9136591e68, content=<a href='/topic/show?id=468119e04db' target=_blank style='color:#2F92EE;'>#三甲医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19704, encryptionId=468119e04db, topicName=三甲医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Mon Oct 02 13:21:00 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1509747, encodeId=194a1509e4727, content=<a href='/topic/show?id=1c8e8e333cb' target=_blank style='color:#2F92EE;'>#药占比#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87333, encryptionId=1c8e8e333cb, topicName=药占比)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=762710134609, createdName=HNYYM, createdTime=Mon Oct 02 13:21:00 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552382, encodeId=0fb5155238223, content=<a href='/topic/show?id=a8d5196997c' target=_blank style='color:#2F92EE;'>#三甲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19699, encryptionId=a8d5196997c, topicName=三甲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88e914287502, createdName=陈吴1239, createdTime=Mon Oct 02 13:21:00 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249504, encodeId=f86d2495049e, content=不错的文章.值得一读., beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/20/71f908320db34f36cac4a7c807970775.jpg, createdBy=c93a2154620, createdName=平静的光芒, createdTime=Mon Oct 02 00:07:10 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249470, encodeId=ca8a2494e0bd, content=不错的文章值得一读, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Sun Oct 01 21:39:59 CST 2017, time=2017-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249372, encodeId=01b72493e224, content=不错的资讯.值得阅读与分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/20/71f908320db34f36cac4a7c807970775.jpg, createdBy=c93a2154620, createdName=平静的光芒, createdTime=Sun Oct 01 09:33:31 CST 2017, time=2017-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249218, encodeId=9fe324921821, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00501987275, createdName=130****4638, createdTime=Sat Sep 30 23:42:28 CST 2017, time=2017-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249194, encodeId=f28824919460, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Sat Sep 30 23:02:32 CST 2017, time=2017-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=249187, encodeId=189524918e27, content=很多医院为控制药占比可谓是[煞费苦心".使出浑身解数.而在前不久的一次医疗会议上.某三甲医院的副院长则向在座的众多公立医院的管理者展示了该院[漂亮"的药占比数据., beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Sat Sep 30 22:49:12 CST 2017, time=2017-09-30, status=1, ipAttribution=)]
    2017-10-01 平静的光芒

    不错的资讯.值得阅读与分享.

    0

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    2017-09-30 130****4638

    学习了受益匪浅

    0

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    2017-09-30 thlabcde

    好资料学习了!

    0

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    2017-09-30 有备才能无患

    很多医院为控制药占比可谓是[煞费苦心".使出浑身解数.而在前不久的一次医疗会议上.某三甲医院的副院长则向在座的众多公立医院的管理者展示了该院[漂亮"的药占比数据.

    0

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