Keep a grip on medicine at one's own expense of medical insurance patient

Keep a grip on medicine at one's own expense of medical insurance patient
Keep a grip on medicine at one's own expense of medical insurance patient
Cover the enlargement of Taxi with the medical insurance, the increase of the number of people of effecting an insurance, a lot of hospitals are exploring how to safeguard the interests which join the sponsor, manage that pen that a doctor prescribed in the hand well. Today, we pick up some experiences of subsidiary Xuanwu Hospital of Capital University of Medical Sciences, also hope the regional hospital can provide the experience of lightening patient's burden of medical fee for this edition. --Xiao Wei of JieSong reporter the intersection of Chu and dawn bright one introspection of case Yang, cub reporter of this newspaper, editor of edition, this Subsidiary Xuanwu Hospital of Capital University of Medical Sciences has such an example: A woman patient, because acute gall stone pancreatitis amalgamates other complications to this courtyard of treatments, in hospital for 36 days, costs more than 110,000 yuan, the fee of Western medicine is 88,000 yuan among them. And 39% of the Western medicine expenses are that the medicine at one's own expense bend over and set up thiazole of health. The patient uses this medicine for 19 days, costs 34,000 yuan altogether. If continue taking, will bring heavier financial burden to patient. The pharmacists of this institute are analyzed and proposed, generally speaking, be only just use the dog days to set up thiazole of health when is health of Fluorine thiazole able to bear medicine or song mould being infected with seriously. This piece have precise evidence indicate, can't use the intersection of Fluorine and the intersection of health and thiazole at the clinical patient, whether use the medicine at one's own expense and be canvassed. Meanwhile, bend over and set up the thiazole oral administration of the health and absorb the utilization ratio and reach 96%, intravenous injection and oral result nearly equate. Oral administration can stint on expenses on the premise of guaranteeing curative effect while giving medicine, so the doctor changed dosage forms in time after the patient is eaten independently. Such analysis has ensured the patient's interests, has offered the experience for medical activity in the future too. This example is that this institute explores that keeps and pays attention to one that the Trinity controls in real time in medicine, clinic, medicine " Divide the lens " . Xuanwu Hospital is the A hospital that the department of medical insurance of Beijing confirmed, the medical insurance patient can be " free " The ground reaches this institute seeks medical advice. How to guarantee a medical insurance patient uses medicine safe and effectively and economically, manages the content as a focal point of this institute. The department of nerve internal medicine inactive styptic valve runs director Jiao WeiPing's introduction according to the medical insurance of this institute, it is the medical insurance mainly there are three kinds of medicines at one's own expense beyond submitting an expense account: First, there are replacable medicines in the catalogue; Second, the curative effect of this medicine does not clearly or still have objection; Third, curative effect is really very good, but because cost an arm and a leg, not every patient can bear. Clinical new medicine increase constantly, have a lot of expense medicine since outside the the intersection of medical insurance and catalogue among them. In order to safeguard the medical insurance patient's rights and interests, let the doctor cooperate with all strength, control medicine at one's own expense, pharmacy dept., department of nerve internal medicine and medical insurance ran and ensured infarction of brain under the system to be in hospital to different medical treatment last year patient's administration situation has been analysed and researched. They find, the patient of infarction of brain uses the quantity biggest, expenses most high to draw present with respect, the intersection of Rhizoma Chuanxiong and the intersection of piperazine and sodium chloride, sting five plus, the intersection of thrombus and coherent, refreshment, wait quietly 10 kinds of injectable preparation use medicine the average amount of money has reached ten thousands of yuan in accordance with Damien, accounts for more than 50% of the total expenses for medicine, among them the amount of money accounts for 12.8% of the total expenses for medicine if injectable preparation at one's own expense uses medicine in accordance with what Damien drew and presented with respect alone. In the face of this kind of situation, this institute has adopted different management tactics. Hospital leader and medical insurance go through personnel to play to each department to discuss with clinical doctor, expert, pharmacy dept. pharmacist together, analyze the operating position of medicine at one's own expense together. In addition, there are medicines or apparatus substituted in the medical insurance catalogue, the hospital will control the consumption of medicine and apparatus at one's own expense firmly. If, but can substitute in the medical insurance catalogue by other methods, will try hard to reduce and use the medicine or apparatus at one's own expense. It is told reporters that it is trained that the Vice Presidents of this institute are lucky tomorrow: The artery sheath of the department of nerve internal medicine gets involved and treats surgery, while pulling out the sheath tube, the daily artery sheath styptic valve arrests blood, the patient needs oneself to bear the expenses of more than 4000 yuan. But through the clinical practice, after the doctor presses for 2 minutes, let the patient lie in bed for one day, also can achieve the styptic goal. Such styptic valves have been already all inactive in this courtyard of departments of nerve internal medicine now. Train and speak frankly luckily, indeterminate to curative effect, whether or the medicines that the ultra applicable scope used in the medical insurance catalogue, if is the use of clinical scientific research, support that the hospital will offer; Ordinary patient's use, need examining and approving strictly. Like some antimicrobial, at the time of the result that medicines can't arise in the medical insurance that only when range, will use the antibacterial medicine at one's own expense. And the medicine of more expensive price, the hospital will choose according to patient's situation after communicating with the patient. Before using medicine at one's own expense, should sign the agreement with patient relative. "As to these medicines, no matter whether the patient has medical insurance, the hospital should treat cautiously, try hard to reduce a patient to bear. " Train and speak frankly luckily. In order to make it convenient for the doctor to make good use of the medicine in the medical insurance catalogue, the medicine head of the department Wang YuQins of this institute tell reporters, the pharmacy dept. combines the medical insurance catalogue of situation of the hospital and Beijing, the intersection of editor and " the the intersection of Xuanwu Hospital and the intersection of medicine and manual ", " Xuanwu Hospital uses the medicines register " two pointed manuals, it is at public expense to divide the medicine into, eight classifications of needing personal part to bear, restrain indication, restriction indication from and need individual's bearing, non- medical articles, limit clinic to use and limit indication etc. at one's own expense, help the doctor inquire about and compare. On the basis of medical insurance catalogue which Beijing made in 2006, own medicines catalogues of the editors of this institute, have supplemented some medicines changing and newer situations in the medical insurance catalogue, and done appropriate adjustment according to factors such as clinical experience, analysis on medicine side effect of the hospital,etc.. "The security, validity, economy of the medicine are our most important factor of assessing medicine. " Wang YuQin says. In addition, this institute is also carrying on the management education of medicine at one's own expense of the medical insurance patient of the range of the whole institute constantly, control at the meeting announcing by pharmacy dept. every family use at one's own expense situation of medicines in the whole the intersection of institute and the intersection of medical insurance and at one's own expense medicine regularly, the department to use medicine or is prone to excess administration excesslying warns. The clinician must be reported to pharmacy dept. while meeting the patient of big volume consumption of medical insurance, the pharmacist searches the literature, the rationality that the course to patient's drug therapy especially medicine at one's own expense use is controlled and assessed, and do with the medical insurance together and consult, put forward the instruction of using medicine rationally. Have set up to a pharmacist tentatively and controlled the medicine using proportion at one's own expense by cooperating with clinical department, medical insurance department, promote the clinical mode that uses medicine rationally, guarantee the medicine proportion at one's own expense of the medical insurance is limited to 8%. Examine the system that the medicine using proportion at one's own expense controlled medicine at one's own expense, is it difficult to carry out? While interviewing, as asking about why can person in charge and doctor of department of this institute be at the time of this question of controlling expense medicine of since a patient of medical insurance, a word that they often say is " We have been doing it in this way all the time " . The reporter finds, the reason why they answer like this, because control the idea of medicine at one's own expense to already " take root " ,Become the intersection of habit and thinking of them, so this nothing can be spoken while being novel in their view. Neural physician Ma QingFeng tells reporters, the doctors of this institute's income has nothing to do with medicines income, so doctors will not enable because of creating income in consideration Use the expensive medicine. Contrary to it, the medical insurance is done every week to do the operating position of medicines? 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Nerve head of the department of surgery Cai Li of the function introduces newly, situations are different that every department uses medicine, as to departments such as blood, oncology department,etc., there is fewer administration of this department, the proportion of medicine at one's own expense is corresponding and relatively low too. The hospital carries on human-based management according to every department situation, demand to be different to the medicine proportion at one's own expense of each department too, pertinence is very strong. Though this institute has not tied medicines income to doctor's income, the proportion of medicine at one's own expense is an department and one of the standards when the doctor examines at the end of the year. If the medicine using proportion at one's own expense is too high, will influence the doctor, year-end score of the examination of the department. This way has got rid of economy to restrict, has given the definite and encouragement to the doctor from spirit. It is trained that lucky tomorrow to think, though will control the medicine at one's own expense to reduce the incomes of the hospital to a certain extent, but consider from a long-term and help the development of hospital greatly. "After going through practice of one period, the doctors find too most medicines at one's own expense can find substitutes in the medicines catalogue of the medical insurance, the medical insurance is the most basic insurance, the demand that can guarantee to basically use medicine. " He says.


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