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国家卫计委:医改这一仗已打到长江边

2015-08-07 佚名 中国青年报

在8月6日举行的新闻例会上,国家卫计委新闻发言人宋树立引述该委主任李斌的话说:“经过了数年的艰苦攻坚,我国新一轮医改已经取得了重要的阶段性成果,这就好比医改这一仗已经打到长江边了,要一鼓作气,推进医改向纵深发展。”公立医院改革被视为医改的硬骨头,牵一发而动全身。尽管新医改已经历时6年,在医保等层面取得了世人公认的成绩,但是在公立医院改革方面却未能有所突破。今年4月,中央全面深化改革领导小组第十一次

在8月6日举行的新闻例会上,国家卫计委新闻发言人宋树立引述该委主任李斌的话说:“经过了数年的艰苦攻坚,我国新一轮医改已经取得了重要的阶段性成果,这就好比医改这一仗已经打到长江边了,要一鼓作气,推进医改向纵深发展。”

公立医院改革被视为医改的硬骨头,牵一发而动全身。尽管新医改已经历时6年,在医保等层面取得了世人公认的成绩,但是在公立医院改革方面却未能有所突破。

今年4月,中央全面深化改革领导小组第十一次会议审议了《关于城市公立医院综合改革试点的指导意见》,明确指出要坚持公立医院公益性的基本定位,将公平可及、群众受益作为改革的出发点和立足点,落实政府办医责任,破除公立医院的逐利机制,构建起布局合理、分工协作的医疗服务体系和分级诊疗新格局,并对重点工作安排了时间进度表。

按照国家卫计委的通报,截至目前,全国1463个县(市)已启动改革,占74.9%,其中13个省已经覆盖全部县(市);共有3297家县级公立医院启动改革,占78.3%,其中8个省已经全部覆盖;城市公立医院综合改革试点扩大到100个,其中61个城市已出台实施方案,764家城市公立医院已启动改革。

公立医院体制机制改革是此次改革的难点,尤其是取消药品加成更是备受关注。目前,3077家县级公立医院、446家城市公立医院取消了全部药品加成;江苏、浙江、福建、安徽、四川、陕西、宁夏已经在全部县级公立医院取消药品加成;各地通过取消药品加成、调整医疗服务价格、增加政府投入以及医院节约运行成本等综合措施,推动构建科学补偿机制。21个省份的224个地市按照“总量控制、结构调整、有升有降”的原则,对医疗服务价格进行了调整。

与此同时,安徽、广东、河南、内蒙古等省份在县级成立了政府领导牵头的县级公立医院管理委员会,合理界定政府作为出资人的举办监督职责和医院作为事业单位的自主运营管理权限。

试点城市在理顺政府和公立医院关系、构建法人治理结构、下放微观管理权限方面进行了多种形式的探索。另外,各地普遍在医保总额控制基础上,推进按病种、按人头、按服务单元、按床日等支付方式改革。

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    2015-08-09 tata95

    比喻形象,可谓水能载舟,也能覆舟!

    0

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    2015-08-09 tidiq
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