以药养医 初见成效

在毛主席“备战、备荒,为人民”的伟大战略方针指引下,我们大队发扬自力更生,艰苦奋斗的革命精神,自一九六九年以来,创办卫生所、药场、药厂“三结合”的卫生基地,积极开展中草药的采、种、制、用活动,坚持走以药养医的道路,初步解决了合作医疗基金和药源不足的问题。三年来,共采药六万多斤,种药五十多亩,制成膏、丹、丸、散、片、水、糖浆、酊、胶囊和注射液等十多种剂型,基本上满足了合作医疗用药的需要,社员经济负担逐年减轻,合作医疗基金由一九六九年每人收一元降至一九七二年八角,三年共结余现金一千三百五十多元,进一步巩固了合作医疗。     

以药养医与医药分开

医院收入主要由三个部分组成,政府财政补助、医疗收入、药品收入。随着医院进入市场经济的不断深入,政府补助越来越少,医疗收入中的医疗服务价格由政府物价部门定价,一直很低,只有药品收入是可以通过加价获取利润的,所以药品收入占总收入的比例就越来越高,就形成了大处方、开贵     

财政投入:后"以药养医"时代的改革路径

很多的时候,我们在痛批医院"以药养医"种种"罪行"而获得快感时,却往往忽视了这样一个重要的事实,那就是"今天"的尴尬困境是由"昨天"的政府财政投入的严重不足,今天的继承事实不过是长期以来卫生事业投入的严重不足积攒下的弊病,事实上,公允地说,很多医院也是其中的"受害者",是财政投入不足的"替死鬼".而一旦投入不足,用"以药养医"来提高门槛就成了医院的"不二法门".     

以药养医、大力发展合作医疗

古鄯公社范家河大队广大贫下中农在毛主席革命路线指引下,在一九七一年四月份成立了大队合作医疗站。六年来,医疗站为保障人民群众健康水平,开展农村各项卫生工作,促进农业学大寨运动的深入发展,做出了积极的贡献。范家河大队共有三个生产队,77户,503人,耕地面积1,125亩,粮食产量逐年提高,1976年粮食总产量比1975年增产百分之九点一。大队使我们跨入了大寨式大队的行列中。合作医疗的发展壮大使农村卫生面貌发生了很大变化,改变了农村缺医少药的状况,保     

新医改中关于取消"以药养医"问题的深思

分析我国新一轮的药品改革制度发展动态,发现我国药品流通体制机制仍然存在问题,并提出解决的对策.方法 采用文献法,收集我国新医改有关文件方案规划等资料,找出目前药品改革中存在的问题,并提出解决对策.结果 努力的消除"以药养医"制度,建立公平、公正的政府投入机制.建议:"十二五"期间在全系统稳妥有序地革除以药补医弊端,建立药品生产流通新秩序,全面推进药品集中采购.     

以药养医逐步变为政府买单

意见中明确政府、社会与个人的投入责任,确立政府在提供公共卫生和基本医疗服务中的主导地位。建立和完善政府卫生投入机制。中央政府和地方政府都要增加对卫生的投入,并兼顾供给方和需求方。要逐步提高政府卫生投入占卫生总费用的比重,使居民个人基本医疗卫生费用负担明显减轻;政府卫生投入增长幅度要高于经常性财政支出的增长幅度,使政府卫生投入占经常性财政支出的比重逐步提高。     

试论"以药养医"与"医药分开核算、分别管理"

“以药养医”是我国目前医疗卫生机构的主要补偿机制。这种补偿机制曾经为医院的发展做出了贡献。然而 ,在公费医疗改革后 ,这种补偿机制不仅造成了医院药价虚高 ,同时也给居民的看病就医增加了负担。要从根本上解决上述这些问题 ,必须对“以药养医”的补偿机制的进行改革 ,实行“医药分开核算、分别管理”。     

不怕挫折 坚持走以药养医道路

一九七四年下半年,我们开始抓以药养医工作,以水源山为基地,办起了一个药场。在办场过程中,我们从失败走向胜利,经历了一番艰苦的斗争。头一年,我们开了八分荒地,种上党参、白芷等药材,由于缺乏经验,护理不     

谁来终结“以药养医”

终结“以药养医”，已经成为医疗体制改革的目标之一。问题在于谁是“终结者”？     

以药养医,歧路还要彷徨多久?

"以药养医",由来已久 "以药养医"是指医疗机构通过药品价格加成收入,以弥补政府财政对医疗机构投入不足和医疗服务价格过低的缺口.     

移动医疗服务如何破冰“看病难”困局

目的 "看病难"这个与社会民生密切相关的难题,长期困扰广大民众。主要表现在看病流程复杂,挂号、候诊排队时间长,就诊指引不清晰,服务水平低。移动互联网时代,各个传统行业都在转变运营模式,医院应如何因势利导,寻求"破冰"良策。本文结合佛山市中医院的应用案例,对利用微信公众号[1]改造现有业务流程,有效解决"看病难"问题进行讨论分析。     

Health service production in the view of medical informatics

Medical informatics aims to improve the process and the result of health care delivery, both in its theoretical and practical aspects through the application of formal methods and concepts of informatics and the utilization of up-to-date information and communication technology. As part of a theoretical framework this paper deals with the factors of production, the constitutive criteria and the formal aspects of health service production in the view of medical informatics.     

"托管制"条件下医疗服务质量监控的实践

无锡市卫生局在"托管制"条件下,转变政府职能,加强医疗服务质量监控,在依法管理的基础上,严把"导、评、赛、奖"四个控制环节.     

从心理学角度探究快速高效处理医疗纠纷的方法

医疗机构每天接待不同患者,产生医疗纠纷的患者也各不相同,采取一刀切的医疗纠纷处理模式明显不符合实际。针对不同患者采用不同的方法去处理医疗纠纷是每个医疗纠纷处理人员的一项重要能力,如何处理好医疗纠纷是医院工作一直面临的难题。通过从心理学角度分析医疗纠纷发生的原因,并结合作者多年来的工作经验,针对不同患者提出不同处理医疗纠纷的方法,为更快更好地处理医疗纠纷进行有益的借鉴。     

A national model of care service for professionals dealing with Sudden Infant Death

Sudden Infant Death Syndrome (SIDS) is any death occurring in an infant or young child which is unexpected by history and in which a thorough post mortem examination fails to demonstrate an adequate cause of death. The National Sudden Infant Death Register collects information on all sudden unexpected deaths in infants and young children occurring in Ireland. In this study, a comparison was made between parent’s experience of professional services in the aftermath of their child’s death both before and after the implementation of a National Model of Care for professionals in 1995. In addition, a random sample of 105 professionals were surveyed about their knowledge of the Model of Care services. Results were grouped according to the parental experience of the emergency services, the hospital services, the community services and the bereavement support services offered to parents. Prior to the implementation of the Model of Care Service (MOC) (1992–1994), 14 per cent of families stated that they did not find the Gardai helpful. After the Model of Care, only 7 per cent of parents expressed such dissatisfaction. Prior to the MOC, only 3 per cent of Gardai provided families with an information booklet on sudden infant death but afterwards, 23 per cent of Gardai did so. After the MOC families were more likely to have been given the opportunity to hold their infant, were given more privacy and were offered more keepsakes of their infant. Only 46 per cent of families were offered momentos of their baby prior to the MOC as compared to 84 per cent after the implementation of the MOC. They were also more likely to perceive the ancillary services such as the Gardai in a more positive light, where 22 per cent of Gardai offered the family the ISIDA support booklet compared to a previous 3 per cent. Over 50 per cent of parents were provided with a special room in the hospital following the MOC as opposed to a previous 48 per cent. Twenty-one per cent of parents prior to the MOC described the conditions in the hospital as awful, poor or fair, however 31 per cent of parents stated this after the MOC. While there have been improvements in certain areas, there still remains considerable variation in the quality of service provided to all parents. Specifically, we need to address the fact that 16 per cent of parents still report a difficulty in obtaining post-mortem information. Almost 40 per cent said they had little input into how their child was dressed or laid out at this highly emotive time. Over one-third of parents stated they were concerned about how few of their primary health providers, namely general practitioners and public health nurses called to visit them in the aftermath of this tragic event.     

医学生应对"突发性公共卫生事件"能力的培养

所谓“突发性公共卫生事件”是指突然发生的，造成或可能造成社会公众健康严重损害的重大传染病疫情、群体性不明原因疾病、重大食物中毒以及其他严重影响公众健康的事件。     

从胆囊切除病人住院费用分析影响医疗费用的主要因素

为探讨支配和影响病种医疗费用变化的某些因子,控制医疗费用的不合理增长.以某三级甲等医院2002年胆囊结石伴胆囊炎行胆囊切除手术出院病案274份为样本,采用因子分析方法,对出院病例的医疗费用进行分析.结果:药物、治疗与检查因子、手术因子、ICU因子,其它费用因子是支配胆囊切除手术住院医疗费用的公共因子.结论:控制医疗费用的不合理增长应着力降低药费、治疗费和检查费.     

“和谐使命-2011”海外医疗服务药品使用分析

目的调查"和谐使命-2011"任务药品使用情况。方法根据《新编药物学》对携带药品进行分类,统计各类药品使用情况。结果共消耗药品364种,价值49.35万元。结论从实际用药情况看,应该适当减少品量,以节约经费。     

医疗机构网络舆情的应对策略

阐述了医疗机构如何建立网络舆情研判机制及责任体系,从明确投诉方法,清晰投诉流程;提高医患沟通水平,建立互信机制;注重舆论引导,营造良好氛围等方面探讨了网络舆情突发事件预防和舆论引导等问题,并对医疗机构网络舆情突发事件研判模型提出构想。