Mechanism's obstacle of the system remains to break through

Mechanism's obstacle of the system remains to break through
Staff reporter Zhang CanCan "The thing is difficult to experienced personally and does not know, the one that even feel and can't bear sometimes is heavy. " An officer in charge of reform pilot work of public hospital describes the feeling in the past year like this. Chen Zhu, minister of Ministry of Public Health, says frankly too, it is " really too complicated " for the public hospital to reform when two Conferences gives an interview during this time . The public hospital reform pilot project of Ministry of Public Health coordinates the relevant person in charge of office of work group to point out, the public hospital reforms how mechanism's obstacle of the system breaks through, it is the important content of pilot work of this year. In charge of doing how to separate to still need to explore government's hygiene development and management function at the same level are too scattered, coordinate the big difficulty; It is unreasonable that government's hygiene duty of level is divided, resource distribution overlaps, the whole trade and possession management are difficult to implement, it has been wide all the time and is condemned. In reforming the management system of public hospital, the pilot city has formed 4 kinds of tubes and done and separated the mode. The public hospital management organization has been established in the municipal governments of cities such as An'shan, Qitaihe River, Wuhu, Wei workshop, Ezhou, Zhuzhou, Zun Yi,etc., set up the executive body under the Ministry of Health; The public hospital management organization managed by the health bureau has been established in Luoyang, Beijing, manage the manpower, financial resources and material resources of the hospital in charge ofed in an all-round way; Trust health authorities to fulfil contributor's duty directly in Zhenjiang, Baoji; Public hospital management organization of establishment outside health authorities of Maan Mountain, Kunming, undertake to do medicine and state-run assets management function. At the seminar held in the industry many times, it is launched debating fiercely that the experts are all optimum around any management system modes. Specific pilot the intersection of city and public the intersection of hospital and the intersection of reform and pilot scheme delay, issue, block, do, separate in different department different on the understanding and different designs in charge ofing too. And monitor the situation according to the work of medical reform to reveal, already there are more than 100 public hospital reform pilot cities (district) in the whole country Having set up public hospital management organization, 60% among them are set up in health authorities. As to this, this person in charge thinks, any management system modes are optimum, need following, assessing and comparing for a long time, find that accords with the hygiene law and the modes of the national conditions of our country to popularize from it. While explaining it is separated that the tube is done, there is a word that attracts people's attention in " job placement ": " the administrative department heads of hygiene at all levels can't hold the public hospital leadership position concurrently " . Relevant experts think, this has reflected too the tube goes through the thinking separated. The rational compensation policy focuses on falling and increasing input, has been placed the great expectations by the presidents to the hospital all the time the rational compensation of science. A lot of presidents say, compensate it uncompletely, the public hospital is still funded by managing and maintaining, it is an empty verbiage to realize public beneficially. Relevant experts tell reporters, in compensation mechanism reform, the policy of the reform is supported to need further improving in environment. Though all parts have all increased input, but in general, purchase capital construction and heavy-duty equipment of public hospital, governments such as key discipline development, according with expenses of retired personnel of the national regulation and policy subsidies to make to for losses,etc. invest the policy not to totally implement, and lack and increase the mechanism steadily. In allocating funds in the government, are implemented only in some places, to 1,200 million yuan of basic construction input of public hospital such as An'shan; Beijing explores that sets up the financial compensation system based on cost accounting, medicines implement the difference and raise the price, retired personnel's funds government will give the guarantee in full through the financial allocations; The hygiene operation expense of the whole city will be always put into 3,063 million yuan in 2009 in Shenzhen, it accounts for 16.7% of gross income of public hospital for finance to subsidize. Separate the respect in medicine, only the specific pilot city has cancelled and mended and cured the mechanism with medicine, An'shan passes the public hospital of financial compensation " Five risks one gold " Way last mechanism of mending and curing,launch by medicine thing service charge pilot project at 6 city Guangdong Province. The main methods or differences of other all parts raise the price. Total value prepays, single number the reform of way of paying of paying etc. remains to further move forward. In exploring and adjusting the medical service price, only Jiangsu Province and Anhui are so as not to reach the approval of the price department, attend to the expenses standard after improving the whole province. The reporter finds, " job placement " has been already clear, the medicine thing service charge includes in basic medical treatment and ensures paying the range, but how to have clear statement to collect. Relevant expert think, should issue associated documents while being central, define the finance at all levels is put into proportion and time node, explore that dissolves the public hospital debt through financial compensation, change the past the finance is put into the situation done bit by bit, off and on, compensate the thinking clearly as soon as possible, setting up the financial input of rigidity increases the mechanism, reform the medical service price forming mechanism at the same time, arouse medical worker's enthusiasm. High-quality medical resources demand urgently " Dilatation " This person in charge thinks, except change the system mechanism, the high-quality medical resource " dilatation " Also very urgent. It is introduced, 2009, the operation (assistant) of our country The doctor is 1.75 people / a thousand people, and World Health Organization 2008 statistics show, U.S.A. reaches 3.4 people / a thousand people up to 2.6 people / a thousand people, Francing. In 2009, the registered nurse of our country is 1.39 people / a thousand people, well below 2.8 people / a thousand people's average level in the world in 2008; Of our country doctors and nurses than 10.8, well below 102.9 average level global to compare with suggestion doctors and nurses of World Bank 102 in 2008. In 2009, in national hygiene personnel, junior college and special secondary school education person account for 71%, more than of undergraduate course only accounts for 24%, there are 5% besides as high school and the following education. "It is demanded to compare that increasingly high to the health care service with the public, the medical resources of our country are insufficient in total amount, among them high-quality resource shortage questions reflect very outstandingly at the present stage, become the main obstacle further deepening the medical reform. Why did some ordinary people distrust the medical care at the basic level? Pluralistic to do the ideal pattern of medicine difficult to form why? The intersection of hospital and vacation clinic, attend to why launch while being difficult project while being high-quality? One of the important reasons even if our good doctors, good nurses have also few very much. This is that the country especially pays attention to complete doctor and main reason of the specialist standardized training during the public hospital reform too. " This person in charge says. High-quality medical resources OK " Dilatation " ? Propose in " job placement ", the system of training in standardization of implementing complete doctor and specialist, set up 100 pieces of standardized training base, recruit 10,000 people and train the standardization. It is reported, in the pilot work that has already been launched, the first batch of nearly 2000 residents in Shanghai have already entered 39 hospitals to accept training, already 1720 undergraduate courses and masters graduates have entered the standardized base of complete doctor, resident to accept training at present in Tianjin. Relevant experts tell reporters: "It needs quite long cycle to train a good doctor, in this respect, relevant pilot work can only solve the problem. Solve high-quality medical resource shortages The question, need us to take action immediately, make long-term and unremitting efforts. "

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