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国家卫健委:取消药品加成之后,争取每年调整医疗服务价格

2019-06-15 胡丹萍 澎湃新闻

6月14日,国家卫生健康委员会召开专题新闻发布会,介绍全国公立医院综合改革进展情况。记者从发布会上获悉,在深化医疗服务价格改革中,全面取消公立医院药品加成之后,各地探索建立医疗服务价格的动态调整机制,山东、广东、福建等省份明确规定每年至少调整1次价格。针对调整医疗服务价格后是否会增加百姓看病负担的问题,国家卫生健康委体改司巡视员朱洪彪在发布会上也表示,按照“腾空间、调结构、保衔接”的改革路径,保衔

6月14日,国家卫生健康委员会召开专题新闻发布会,介绍全国公立医院综合改革进展情况。记者从发布会上获悉,在深化医疗服务价格改革中,全面取消公立医院药品加成之后,各地探索建立医疗服务价格的动态调整机制,山东、广东、福建等省份明确规定每年至少调整1次价格。

针对调整医疗服务价格后是否会增加百姓看病负担的问题,国家卫生健康委体改司巡视员朱洪彪在发布会上也表示,按照“腾空间、调结构、保衔接”的改革路径,保衔接就是医保要跟上,调整医疗服务价格的项目主要纳入医保报销,总体上不增加老百姓看病负担。

2017年,我国全面推开公立医院综合改革,一个重要的标志就是取消药品加成,建立了公立医院新的补偿机制。

所谓药品加成就是指在以前的规定中,县及县以上医疗机构销售药品,以实际购进价为基础,顺加不超过15%的加价率作价,在加价率基础上的加成收入为药品加成。

药品加成没有了,公立医院如何运转?“新的补偿机制就是由过去的三个渠道变成两个渠道。”朱洪彪介绍,过去的三个补偿渠道包括药品加成,政府投入和医疗服务收费。

药品加成取消之后就变成了政府投入和医疗服务价格的补偿。朱洪彪说:“现在新的补偿机制下,政府投入应该说是一个逐步增长的过程。去年年底的时候,政府投入大概是10%左右,这就意味着还有90%左右的补偿靠医疗服务价格。”

在2017年全面取消药品加成同步调整医疗服务价格的基础上,2018年19个省份再次调整医疗服务价格,进一步完善公立医院补偿新机制。

建立公立医院的补偿机制的重点在调整医疗服务价格,深化医疗服务价格改革的方法,就是要建立价格的动态调整机制。朱洪彪表示,“动态就是在新的机制刚刚建立起来和在完善的过程中,我们希望能够最好是每年调整一次价格。”

山东、广东、福建等省份明确规定每年至少调整1次价格。朱洪彪以福建省三明市为例介绍到,三明先后6次调整4318项医疗服务价格,公立医院医疗服务收入(不含药品、耗材、检查、化验收入)占医疗收入的比重提高到42%,最高的医院达到68.6%。

“通过医疗服务价格调整,使医务人员的技术劳务价格能够体现它的价值。”朱建彪表示,调整了技术劳务价格医院的收入结构就改变了,过去药品耗材占大头,现在把技术劳务提上去后,应该是技术劳务占大头。公立医院的收入结构改变要与医务人员的薪酬制度改革要衔接。医生的收入和劳动付出相匹配,使他们的收入更阳光、体面有尊严。

作为公立医院综合改革典型地区代表,贵州省福泉市副市长曾薇在发布会上介绍了福泉市在公立医院医生薪酬制度改革上的经验,福泉市打破公立医院统一工资制度、工资政策及工资标准,对编内人员档案工资进行统一封存,全部实行岗位薪酬和绩效薪酬制,由医院自主制定分配方案,实现编内编外人员同岗同标准,按劳取酬。2018年,医务人员平均收入达12.5万元/年,同比上升15.3%。

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    2019-06-16 txqjm

    谢谢了,学习

    0

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