The intersection of Guangzhou and for assuare the intersection of profit and prescription limit turn on at one's own expense medicine suddenly some hospital

The intersection of Guangzhou and for assuare the intersection of profit and prescription limit, turn on at one's own expense medicine suddenly some hospital
It is reported medical insurance ordinary the intersection of clinic and the intersection of pool and the intersection of Huimin and new policies issue, join sponsor think expenses of clinic need, draw all by oneself finally. However, the new policies last two months, join sponsors to find, the proportion that oneself pays the bill exceeds 60% while seeing the doctor. Yesterday, reporters learnt from municipal Labour Insurance Bureau of Guangzhou, at present, the overall payment rate of the basic hospitalization cost of the ordinary clinic of pool money of the medical insurance was 38.3%, wipe out proportion to be on the low side.
Where to lead to the fact these kind of reason which blames the phenomenon? Reveal, since the pool of ordinary clinic was implemented, some hospitals have made more medicines at one's own expense or presumed that examine phenomenon of the prescription limit once each time according to the social insurance department, purpose to assuare profit, take tertiary hospital as examples, ordinary clinic conduct implementing method, implement at one's own expense rate only about 12% last time, the method rises to 17.8% after implementing, increasing degree is up to 48.3%.
Less than twenty percent join sponsors and participate in selecting some
It is reported, by September 30, there are 269 the whole city offers the fixed hospitals of services of ordinary clinic, ordinary clinic selects some number of people as 503,000 (573,000 persons) ,Account for, should select some effect an insurance 19.3% of number always. Among them, the tertiary hospital is 327,000 persons (account for 57.1%) ,Second hospital 118,000 people (account for 20.6%) ,The first class hospital is 120,000 persons (account for 20.9%) ,The other hospitals are 8,000 persons (account for 1.4%) .
The medical insurance Zhang XueWen, division chief of place of municipal Labour Insurance Bureau in Guangzhou says, there are nearly 500 fixed hospitals in the whole city, but because there are some fixed hospitals because of hardware, information system installation,etc., fail, launch the pool of ordinary clinic serve temporarily, department will assist to open the medical insurance as soon as possible, join sponsors and provide service for being the masses of as soon as possible. The statistics show, the new policies were implemented, the clinic amount of the fixed hospital has risen equally 20% - 30% .
"Because policy begin, implement just, so join sponsor because illness participate in, select some mostly, the healthy ginseng sponsor seeks medical advice after not selecting some voluntarily conveniently " ,XueWen Zhang say, cause less than twenty percent effect an insurance suitable person order, so with the intersection of hospital and the intersection of clinic and rising of quantity only, the specific hospital thinks that selects ginseng sponsors that clicks all " The sickly body " ,Thus anxious " Lose money " ,Have adopted some improper means.
As to this, social insurance department call upon, select health that order join sponsor for seek medical advice, select some while being convenient future because of seeking medical advice yet, in case because acute disease registers for the emergency call, will do and select some to waste time first, may delay the condition. Zhang XueWen says, according to the law of seeking medical advice, even join sponsors and only seek medical advice and select some by the way at the time, the whole Guangzhou should finish selecting some work of all ginseng sponsors within 2- 3 years too.
Submitting an expense account rate is only 38.3% wholly
Select 503,000 that order effect an insurance philtrum have 387,000 people it enjoys ordinary clinic to be 387,000 people in number in treatment, accounts for 76.9% which select some number of people. Enjoy to the ordinary clinic treatment person it for 994,000 persons (namely go to a doctor averagely 1.3 times per month each person) ,Take place total hospitalization cost total 140 million, time hospitalization cost 141.5, time at one's own expense expense 23.4 yuan, at one's own expense rate 16.5%, time conduct, it pays expenses to be 54.1, pool money 38.3% to basic overall payment rate of hospitalization cost.
Why is the submitting an expense account rate of ordinary clinic insufficient? Why does the situation at one's own expense take place frequently? As to this, Zhang XueWen explains, it is a reason that the hospital makes medicine at one's own expense suddenly, in addition, section hospitals such as dept. of orthopedics, tumour,etc. include in counting too, there are many project and medicines at one's own expense of these hospitals, drawing to submitting an expense account rate is low and very obvious. Such as the intersection of oral cavity and section hospital, check administration submit an expense account how much does it want, even several can settle, and the project purely at one's own expense of having a denture made etc. may cost thousands of yuan, rate at one's own expense is very high.
XueWen Zhang say ordinary clinic conduct method increase by 300 yuan per month people's guarantee treatment, in addition special, doors waited to meet slowly that there are doors in Guangzhou before this, made the personal overall burden of joining the clinic hospitalization cost of sponsors lighten by about 40%. " but the consumption of conducting the fund at present is relatively anticipated low " . He analyzes, this has mainly more joined sponsors to conduct the policy and does not understand to the medical treatment of ordinary clinic up till now, have not used the new policy to enjoy the due medical guarantee; In addition because the fixed medical organization has certain deviations to pursue a policy, the new policy has not got sufficient use yet.
[Expose ]
Hospitals prescribe more medicines at one's own expense
Presume that examines prescription limit once
"See now the clinic can submit an expense account, some hospitals will prescribe more medicines at one's own expense, make and check the project more, write a prescription few. I watch the intersection of endocrine and disease of respect this time, spend 300 more than, including being check,etc., wipe out a dozen yuan only finally " . Miss Wu seeing the doctor in one the first, second and third hospital, complain to the reporter these two days, line up, arrange, for a long time, wipe out a dozen yuan finally at the place where the special window of the medical insurance valuated.
It is reported, say as Miss Wu, after the clinic treatment of the medical insurance is implemented, have some hospital for prevent from, clear, break through the intersection of per person and limit, close standard the end of the year really, store in making more medicines at one's own expense, making few medicines in catalogue range or presuming that examines phenomenon of the prescription limit once each time. Zhang XueWen says, these ones that violate medical insurance policy and agreement regulation. "Take tertiary hospital as examples, the ordinary clinic conducts second-class only about 12% of rate at one's own expense before the method is implemented, the method rises to 17.8% after implementing, increasing degree reaches 48.3%, the rate at one's own expense of the first and second class hospital increases in various degrees too. "
In addition, some hospital presume, examine times of limit, especially a few hospital put up announcement, stipulate, join sponsor the intersection of prescription and the intersection of account keeping and the intersection of pool and money pay 50 or yuan of limits every month also, lead to the fact the hospitals at all levels are second-class the clinic expenses drop. According to the data that health authorities announce, clinic expenses will be 225.6 yuan and 143.7 yuan respectively time of third, the 2nd quarter of 2009 of Second Grade hospital, and after the method is implemented, join sponsors in three, Second Grade hospital second-classly the clinic expenses are reduced to 175.6 yuan and 113.8 yuan respectively, decreasing amplitude is 22% and 21%.
Someone, in order to use up 300 yuan limit
Even run hospital 12 times
It is reported, a few join sponsors after the clinic treatment of the medical insurance is implemented too, no matter is sick, insist on using and is enough for 300 yuan limit every month. Zhang XueWen introduces: "We find, in two months when someone implemented in the policy in the course of surveying and studying, go to a doctor and reach more than 12 times, does not obviously accord with the ill law most person on average. According to the information of hospital's, join sponsors partly and hold " uses in vain " Wrong for idea,it is seek medical advice, call the roll it write a prescription, ask for great treatment only minor illness, quarrel to make trouble wilfully as doctor not to last disease, cause the doctor to be difficult and construct and cure, use medicine rationally due to illness, and therefore bring out a great deal of Answer
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