Attend to the service price on the low side clinically Attend to the fee insufficient actual cost 10

Attend to the service price on the low side clinically Attend to the fee insufficient actual cost 10
Attend to the service price on the low side clinically, 10% fewer than the actual cost should transfer staff reporter Wang Jun flat hospital to pursue and has not accompanied and attended to serving to attend to the fee, patient's satisfaction is raised. Attend to, charge unable to remedy and increase the cost served newly, the hospital can only pay the bill by oneself, lead to the fact " the patient is satisfied, the hospital sustains losses in business " In the surgical inpatient area of pancreas of gallbladder of the People's Hospital of Jiangsu Province, after operation of hernia of Zhang LanYing of old man 81 years old, lie in bed and praise the nurse of inpatient area for looking after well directly. The old man nd urination etc., the nurse helps her to wash the face, brush teeth, rub one's body with a towel, feed meals, hot water bubble foot, the lower part of the body is sterilized, assist defecation and urination etc.,s, anything does not get bored using family members. Trying too comfortable to accompany 4 inpatient areas that melt and attend to, each inpatient area of the People's Hospital of Jiangsu Province increases the assistant nurse about 10 persons newly, they make up " 1+1 " together with original nurse in the inpatient area Attend to strength. Institute this have, accompany and attend to pilot rectangular light duckweed, nurse of inpatient area, introduce, have, accompany, take, attend to, " dominate " by the nurse The intersection of patient and necessary all service, the intersection of patient and until " life is attended to " relative in hospital, Role in come out liberation,need again for " too busy to do it "ing Have worried. The heads of the nursing department of this institute take care of beautifully to explain, the patient recovers seven fen depends on attending to. Postoperative lying in bed on patient's wound, lung and urine way and is infected with is a common complication, every nursing speciality, put in place, right away can lower complication effectively, shorten a patient's hospital stays, spend less money enduring hardships little too. Pilot the intersection of inpatient area and investigation reveal, attend to while being good " all cover " ,The infection rate obviously drops in the courtyard, patient's satisfactory rate is more than 98%. Director of Jiangsu Province people Wang Hong say, Shu Xin has not accompanied melting to attend to proceeding from humanized idea, nurse getting therapeutic to nursing, basic nursing, live, attend to and psychology attend to in the form of the best collecting to an organic whole, reflect whole, humanization, specialized and not accompanying and attending to melting in the course of attending to. Up to the end of 2010, the whole country 1251 tertiary hospital start 9646 attend to the ward while being good. Attend to the reform to pursue, the pilot hospital is while obviously promoting, patient approves degree is being strengthened constantly for the medical service quality, attend to and charge but can't remedy and increase the cost served newly, lead to the fact " the patient is satisfied, the hospital sustains losses in business " . The electricity physiological head of the department Li Li of nerve of the People's Hospital of Zhejiang Province has carried on the investigation. Took the inpatient areas of 60 berths as examples, generally only disposed 15 nurses originally, tried " not accompanying and attending to " After serving, need to increase 15 more nurses on the original foundation, the ones that and allocate separately and are specially trained are partial to 5 workers. Through calculating, every increase of the hospital is a nurse, it is about 80,000 yuans that the annual expenditure increases, increase 15 people, the annual expenditure increases by 1,200,000 yuan; Partial to the monthly salary of 2500 yuan of workers, increase 5 people, annual expenditure is 125,000 yuan. In addition, staff training expenses and acquiring the basic nursing tool, an inpatient area of 60 berths, increase and invest about 1,500,000 yuan altogether every year. In order to arouse the nurse's working enthusiasm, a lot of hospitals can only pay the bill by oneself, send to the nurses " The bonus " . BJ Union Hospital invests 5 million yuan to replenish for pilot ward nurse, 2 million yuan is used in the special hillock nurse to replenish, more than 2,400,000 yuan is used in the night nurse to replenish, bonus and performance are rewarded and assigned and is inclined to the clinical first line nurse in a more cost-effective manner. Chinese the intersection of hospital and XiaoHong Chen, Deputy Chairman of association, say, " attend to the demonstration ward while being good " Attend to wholly the responsibility system, nurse's responsibility is strengthened, the working intensity is strengthened, the hospital puts into and strengthens, attending to the grade is charged and should be adjusted. It is not enough to pay the material cost consumed in the course of attending to that the current grade attends to the expenses standard. And should attend to the intersection of cost and the intersection of rate and large the intersection of manpower and cost, ignore into the association of Beijing, have a nurse with hospital often, when she attends to the old patient on postoperative first day the morning, find its left and right foot is different in temperature, then further inquire the patient's limbs feel. This nurse judges according to the patient's main suit and one's own training knowledge the postoperative deep intravenous thrombus may take place to a patient, report the question to a doctor immediately, has prevented postoperative complication one in time. Such a slight thing, that reflected is " absolute principle " Basic nursing is not simple definitely " The foot of bubble of washing hair " . Deputy Bureau Director of Beijing Municipal Health Bureau Deng XiaoHong points out, the care is that one has professional lines, technology, needs the service activity of the high sense of responsibility, and paying prices of the clinical care are generally on the low side at present, can't reflect that attend to the value working, have influenced the nursing staff's working enthusiasm seriously. At present, the nursing fee of every pilot hospital still continues to use the old standard. The current grade attends to the expenses standard, it is not enough to pay the material cost consumed in the course of attending to. And should attend to the intersection of cost and the intersection of rate and relatively loud manpower cost, often ignore. Beijing Municipal Health Bureau has checked and calculated all medical project cost of 8 city owned large-scale general hospitals, attend to fee and all lose one of the projects as 4. Beijing Municipal Health Bureau statistics show, the cost that the first grade of Beijing attends to costs 96 yuan each day, and the present charge is only 9 yuan, first grade attends to 10% that the expenses are fewer than the actual cost. Weigh with the price standard of Beijing, the nurse carries on a speciality to wash hair for the patient, the income is still less than a hairdresser's and wash hair the worker. In November of 2009, the organization of department of public health of Jiangsu Province will attend to and charge the investigation of the current situation to 50 above- second -class medical organizations in the whole province. This investigation result reveals, the grade attends to the actual cost and is far higher than the expenses standard, one, two, actual cost that the third grade attends to are 46 yuan, 29 yuan, 14.8 yuan every bed day separately, according to the present pricing level, the tertiary hospital attends to average 17% that can only compensate the actual cost of price in hospital. Attend to and charge the low health care of our country and serve cost accounting relevantly, medical treatment charges and overweights the cost of the materialization, it is less likely to consider other factors such as manpower, management. The expense composition that in hospital the patient, medicines, high quality consumptive material, fee of large-scale inspection and examination take the main part, and reflect high technology, expenses of the value of risky medical worker's labor service are obviously on the low side. The expenses of nurse's technological labor service value, it is low to the intensity that can be ignored in the medical all-inclusive cost. According to the investigation, an operation patient of the ordinary surgery of drum-tower hospital of Nanjing is in hospital for 30 days, costs 52132.45 yuan altogether. Attend to the intersection of fee and 251 only, account for 0.48% only. It is not relevant to attend to and charge low and return and attend to the charging item completely. It is reported, attending to the price project of charging mainly includes basic nursing price project and daily general therapeutic price project in hospital. The price projects of these two parts both only represent a small part attend to the activity clinically, a large number of gaps and omissions exist. The investigation of the department of public health of Jiangsu Province indicates, nearly 40 operation projects that the nursing staff finishes have not included in the scope of project of government issused price. Does the nurse " only compensate Earn " ,The hospital should make money and support oneself, should be certainly regarded as the account of input and output. Not because the hospital does not want to enter more nurses, but can not really afford to raise too many nurses care and lose money seriously, attend to paying price and? �� Xing lead food last benzene �Ť��� of neck 1 earth gather around Jia messy howl writing brush brightness pair all �� s rich is striking to last �� fervents hoarse to dredge �� shake to last brightness pole satin � thumb large bamboo or straw hat with a conical crown and broad brims clears bad-tempered all Rs thin Stilbene �� all crane �Ǯ����� utter Jie father �� of ascarid of Laos flurried assuare whether there aren't ��Curtain �� is beautiful that Zhai consult � yellow Mei �� and sigh? The nurse allocates seriously and insufficiently, expedite the emergence of a middle industry chain and accompany and attend to the company directly. Partial to the worker's use in a large amount, not only not merely unable to guarantee to attend to security and quality, but also result in attending to " shrinking " greatly ,Have also increased the patient's financial burden. In " the nursery work does not earn money, hire the nurse to sustain economic losses more more " Idea drive under,a lot of hospital for reducing manpower cost,at nurse implement by " the dual track system" at personnel system management ,Namely employ the nurse with the treatment by way of casual labour. A large number of system of appointment nurses enter clinically, the unofficial nurse in-staff gets the unequal pay for the equal work, income and paying disparity with a wide gaply. And countries such as U.S.A., Canada, Australia,etc. adopt one after another " The high salary adds the green card " Wait for the policy, has caused our country to attend to the brain drain in a large amount. Head of the nursing department of the People's Hospital of Peking University Xu GuoYing says, present nurse's high pressure, responsibility are great, and the status is low, the treatment is low, would like to be fewer and fewer as the nurse's persons. When doctors and patients conflict, patient and relative do not dare to get angry to the doctor, often sprinkle being angry to nurse's head. Present nurses are mostly an only-child, can not often stand the grievance, do for some time and can not go ahead, the nurse leaving office rate remains high, the brain drain is serious, the team is unstable. Hong Wang say Xin Shu have, accompany ward have one hundred profit on patient and have, hurt, have basic manpower, material resources, support of funds, can not go on for a long time. Ministry of Public Health cure the intersection of policy and department attend to the intersection of office and relevant person in charge, say, solve the intersection of nurse and the intersection of manpower and in short problem fundamentally, the nurse's labour value is twisted for a long time, our country will probably present " the nurse will neglect " in the following several years . Not having nursing expenses standard which accompanies and attends to the ward to make as soon as possible, raise and attend to the price, reflect nurse's value, attending to the fee can be paid to Ma XiaoWei, Vice Minister of Ministry of Public Health, fully by the medical insurance and pointed out, the hospital launches " The demonstration project of the high-quality care " The activity, it is easy to do a ward, it is all right to make 5 wards, but accomplish 15 wards, on the issue that will reach system and mechanism. In November of 2009, the national development and reform committee announces " reforms the opinions of medicines and medical service price forming mechanism ". " suggestion " is proposed, on the basis of medical service price project of the norm, improve clinic diagnosis, attends to, the operation and other medical care limit prices which reflect medical worker's technological labor service value appropriately. Department of public health check sanction by the intersection of Jiangsu Province and Price Bureau, province, the intersection of Jiangsu Province and comfortable to have, accompany the intersection of nursing and fee of inpatient area standard the People's Hospital: First grade attends to original every day 10 yuan is adjusted to 90 yuan, second attends to every day 6 yuan is adjusted to 60 yuan, tertiary to attend to every day 3 yuan is adjusted to 30 yuan. The nursing expenses heightened, are used mainly for paying the assistant nurse's salary remuneration and relevant insurance premium. Compared with nursing fee in the past, have not sounded a little expensive to accompany and attend to the expenses standard of the ward. But patient and relative do accounts, it is still very worthwhile to discover. For example one patient, in hospital, family have two 3 people look after by turns, please partial to Engineer, relatives ask for leave and delay work, travelling expenses are a sum of big expenses back and forth, but is partial to at least dozens of yuan in one day of worker, more than one hundred yuan at most. Wang Hong says, has not accompanied and attended to success charging rationally to pursue, have reflected the technological value attended to, odd-shaped at present to torsion " Raise medicine with medicine " The situation is very important. Chen XiaoHong does not think our country have nursing expenses standard which accompanies and attends to the ward to should make as soon as possible, raise and attend to the price, reflect nurse's value, attending to the fee can be paid fully by the medical insurance, this will help to attend to the sustainable development of the undertaking. (The source of this text: Www.people.com.cn - People's Daily's author: Wang JunPing)

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