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公立医院薪酬改革:部分涨薪超50%

2017-10-16 佚名 央视新闻客户端

按要求,公立医院将建立以公益性为导向的考核评价机制,做到多劳多得、优绩优酬。在岗位设置、收入分配、职称评定等方面,对编制内外人员统筹考虑。探索实行目标年薪制和协议薪酬。

按要求,公立医院将建立以公益性为导向的考核评价机制,做到多劳多得、优绩优酬。在岗位设置、收入分配、职称评定等方面,对编制内外人员统筹考虑。探索实行目标年薪制和协议薪酬。

国家卫生计生委消息,截至9月底,全国所有公立医院已全部开展综合改革,逐步建立起维护公益性、调动积极性的公立医院运行新机制,缓解群众看病贵、看病难。

我国从2010年开始在16个城市开展公立医院综合改革。改革的主要任务是:

破除以药补医,取消药品加成,降低医用耗材和大型医用设备检查检验价格,提高诊疗、手术、护理等体现医务人员技术劳务价值的项目价格;

完善公立医院管理体制,实行政事分开和管办分开,逐步取消公立医院行政级别;

建立规范高效的运行机制,建立符合医疗卫生行业特点的人事薪酬制度,做到多劳多得、优绩优酬;

建立以质量为核心、公益性为导向的医院考评机制;

控制公立医院医疗费用不合理增长。

取消药品加成遏制医院趋利行为

公立医院综合改革的重点是破除“以药补医”机制,取消实行了60多年的药品加成政策,患者就医负担持续下降,个人卫生支出占卫生总费用比重从医改前的40.4%降至2016年的30%以下。


“以药补医”政策是上世纪五十年代在政府补助不足的情况下,允许公立医院药品在进价基础上加价15%卖给患者,这在一段时期起到了积极作用,但从现阶段来看,这项政策导致公立医院严重依赖药品收入,加重了患者负担。今年4月8日,北京3700多家医疗机构在全国率先实施“医药分开综合改革”,降低药品和大型医用设备检查、检验价格,提高手术、护理等价格,改革5个月,药品价格平均降幅超过8%。

改革打破了医院靠开药、做检查获取利益的运行机制,由此减少的收入,将通过财政补偿、调整医疗服务价格等渠道解决。


甘肃省医改办主任省卫计委主任郭玉芬:通过体现你的服务价值,做好一些手术、护理等,让医生回归看病的本能。

这次价格调整,有升有降,总量平衡,不同患者会受到不同影响。如内科住院病人,因药品费用占比较高,改革后看病费用会有所下降;而外科病人因手术、护理等服务价格上涨,看病费用会有所增加。

国家卫生计生委体改司副司长姚建红:使得我们医疗费用结构得到进一步优化,也减缓了医疗费用增长的幅度。今年年底之前,我们地方的医疗费用增幅要控制在10%以下。

薪酬改革:医生收入阳光有尊严

公立医院综合改革的主要任务,还包括建立符合医疗卫生行业特点的人事薪酬制度,做到多劳多得、优绩优酬。

四川省巴中市中心医院推行同工同岗同酬制度改革,取消编制管理,打破编制内编制外不一样的薪酬待遇,实行多劳多得。

巴中市中心医院院长方明恒:将我们服务的质量、服务的数量、患者的满意度纳入到薪酬制度考核内容之中来,把待遇重点向临床一线倾斜,向业务骨干倾斜。

副主任医师魏炯是肾内科的骨干医生,按照新的绩效工资制度,门诊诊疗费的60%作为个人收入,每多收治一位住院病人,就增加大约100元的收入,魏炯的月收入由改革前的8000元涨到现在的12000元。

巴中市中心医院肾内科副主任医师魏炯:对我来说收入比以前增加了50%,大家积极性更高了。

按要求,公立医院将建立以公益性为导向的考核评价机制,做到多劳多得、优绩优酬。在岗位设置、收入分配、职称评定等方面,对编制内外人员统筹考虑。探索实行目标年薪制和协议薪酬。

国务院医改办主任王贺胜:允许医疗卫生机构突破现行事业单位工资调控水平,稳步提高医务人员的薪酬水平,切断医务人员个人收入与医院科室业务收入的利益联系,使医务人员收入阳光、体面、有尊严。

分级诊疗:构建绿色就医通道

公立医院综合改革将建立起布局合理、分工协作的医疗服务体系和分级诊疗就医格局。目前全国共有321个地级以上城市开展试点,占地级以上城市总数的94.7%。

分级诊疗是根据疾病的轻重缓急和疑难程度,不同级别的医疗机构承担不同疾病的治疗,形成基层首诊、双向转诊、急慢分治、上下联动的新型就医模式。湖北十堰太和医院与6家社区医院组建分级诊疗联合体,建立双向转诊绿色通道和网络诊断平台,影像、心电、病理等方面实现“基层检查、上级诊断”,避免漏诊、误诊。

今年71岁的王顺有老人两周前突发急性脑栓塞,被送到太和医院实施急诊手术。病情稳定后,老人被转回到家附近的社区卫生服务中心康复治疗,此前为老人看病的专家定期到社区回访。

太和医院神经外科三病区副主任胡钧涛:他后面的治疗,一个方面就是脱水药逐渐减量,二个问题就是抗生素要根据病情随时调整。


患者家属:专家今上午来查房,指导这儿的医生怎样地用药,指导我怎样伺候病人,我就觉得很放心了。

分级诊疗制度将通过多种形式的医疗联合体,促进医疗资源下沉;通过家庭医生签约服务,把常见病患者留在基层。

国家卫生计生委体改司副司长姚建红:我们大医院看一些疑难杂症,我们小医疗机构更多的是看一些基层应该看的病,使得我们大小医疗机构各归其位,也能够从某种程度上减少医疗费用的发生。

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    2018-06-08 朱睿睿
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    2017-10-18 维他命
  4. [GetPortalCommentsPageByObjectIdResponse(id=1941852, encodeId=4f3d1941852f5, content=<a href='/topic/show?id=7282884558a' target=_blank style='color:#2F92EE;'>#薪酬改革#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88455, encryptionId=7282884558a, topicName=薪酬改革)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd34186, createdName=wshxjq, createdTime=Mon Feb 12 07:08:00 CST 2018, time=2018-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1716673, encodeId=ad061e1667355, content=<a href='/topic/show?id=e7a9658e90a' target=_blank style='color:#2F92EE;'>#涨薪#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65879, encryptionId=e7a9658e90a, topicName=涨薪)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16bd32296474, createdName=朱睿睿, createdTime=Fri Jun 08 20:08:00 CST 2018, time=2018-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1553124, encodeId=61ad1553124e3, content=<a href='/topic/show?id=f983884456a' target=_blank style='color:#2F92EE;'>#薪酬#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88445, encryptionId=f983884456a, topicName=薪酬)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccd914357372, createdName=维他命, createdTime=Wed Oct 18 02:08:00 CST 2017, time=2017-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=253407, encodeId=cb8025340ed3, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/21/39b6a0099eb602e8ac1f7e10d5d440a9.jpg, createdBy=dee01724555, createdName=杨利洪, createdTime=Mon Oct 16 13:12:16 CST 2017, time=2017-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=253397, encodeId=0b9925339ed8, content=很好.值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Oct 16 11:54:59 CST 2017, time=2017-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=253387, encodeId=6aae25338e02, content=聊胜于无.但请别吹牛逼, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Mon Oct 16 11:26:01 CST 2017, time=2017-10-16, status=1, ipAttribution=)]
    2017-10-16 杨利洪

    学习了分享了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1941852, encodeId=4f3d1941852f5, content=<a href='/topic/show?id=7282884558a' target=_blank style='color:#2F92EE;'>#薪酬改革#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88455, encryptionId=7282884558a, topicName=薪酬改革)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd34186, createdName=wshxjq, createdTime=Mon Feb 12 07:08:00 CST 2018, time=2018-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1716673, encodeId=ad061e1667355, content=<a href='/topic/show?id=e7a9658e90a' target=_blank style='color:#2F92EE;'>#涨薪#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65879, encryptionId=e7a9658e90a, topicName=涨薪)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16bd32296474, createdName=朱睿睿, createdTime=Fri Jun 08 20:08:00 CST 2018, time=2018-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1553124, encodeId=61ad1553124e3, content=<a href='/topic/show?id=f983884456a' target=_blank style='color:#2F92EE;'>#薪酬#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88445, encryptionId=f983884456a, topicName=薪酬)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccd914357372, createdName=维他命, createdTime=Wed Oct 18 02:08:00 CST 2017, time=2017-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=253407, encodeId=cb8025340ed3, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/21/39b6a0099eb602e8ac1f7e10d5d440a9.jpg, createdBy=dee01724555, createdName=杨利洪, createdTime=Mon Oct 16 13:12:16 CST 2017, time=2017-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=253397, encodeId=0b9925339ed8, content=很好.值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Oct 16 11:54:59 CST 2017, time=2017-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=253387, encodeId=6aae25338e02, content=聊胜于无.但请别吹牛逼, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Mon Oct 16 11:26:01 CST 2017, time=2017-10-16, status=1, ipAttribution=)]
    2017-10-16 清风拂面

    很好.值得关注

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1941852, encodeId=4f3d1941852f5, content=<a href='/topic/show?id=7282884558a' target=_blank style='color:#2F92EE;'>#薪酬改革#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88455, encryptionId=7282884558a, topicName=薪酬改革)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd34186, createdName=wshxjq, createdTime=Mon Feb 12 07:08:00 CST 2018, time=2018-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1716673, encodeId=ad061e1667355, content=<a href='/topic/show?id=e7a9658e90a' target=_blank style='color:#2F92EE;'>#涨薪#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65879, encryptionId=e7a9658e90a, topicName=涨薪)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16bd32296474, createdName=朱睿睿, createdTime=Fri Jun 08 20:08:00 CST 2018, time=2018-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1553124, encodeId=61ad1553124e3, content=<a href='/topic/show?id=f983884456a' target=_blank style='color:#2F92EE;'>#薪酬#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88445, encryptionId=f983884456a, topicName=薪酬)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccd914357372, createdName=维他命, createdTime=Wed Oct 18 02:08:00 CST 2017, time=2017-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=253407, encodeId=cb8025340ed3, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/21/39b6a0099eb602e8ac1f7e10d5d440a9.jpg, createdBy=dee01724555, createdName=杨利洪, createdTime=Mon Oct 16 13:12:16 CST 2017, time=2017-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=253397, encodeId=0b9925339ed8, content=很好.值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Oct 16 11:54:59 CST 2017, time=2017-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=253387, encodeId=6aae25338e02, content=聊胜于无.但请别吹牛逼, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Mon Oct 16 11:26:01 CST 2017, time=2017-10-16, status=1, ipAttribution=)]
    2017-10-16 戒馋,懒,贪

    聊胜于无.但请别吹牛逼

    0

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