Have managed the pilot project already for 3 months in the clinical route The hospital holds the wait-and-see attitude

Have managed the pilot project already for 3 months in the clinical route The hospital holds the wait-and-see attitude
Popularize the clinical route to manage, contribute to improving medical quality, controlling the medical cost, " it is expensive to see the doctor " to relieve . On June 1, our province makes and issues " manages the pilot work scheme in the clinical route ", confirm 62 pilot hospitals, this means public hospital reform of our province takes an important step again. But the popularization of large area of the clinical route still faces the bottleneck. Originated from U.S.A. since the eighties of last century, clinical route, this management mode,s had nowadays already adopted one after another by countries all over the world, the large hospitals of Sichuan, Beijing, Tianjin,etc. began to launch research and pilot work of clinical route of some number since 1998 in our country. In our province, the provincial hospital will start 3 departments of the first batch of pilot projects in August of 2008, until gallbladder excise skill, the intersection of uterus and the intersection of smooth muscle and tumour, the whole hip joint, replace skill, include in the clinical route and manage under the peritoneoscope, become the first " The person who eats crab " . Have already received" heat is held " ,What meanings have the clinical route? Is there He ShiHui as to common people? The department of public health of the province cures the relevant persons in charge of policy and gives an explaination: "Under the traditional medical mode, direct against the same kind of disease, different hospitals, different doctors usually have different making a diagnosis in ' the route ', usually assessed by the medical matters department or board of trustee of quality, because has not sought unity of standard, random and relatively big, difficult to guarantee, appraise objective and just and effective, medical quality difficult to improve. " And after implementing the management of clinical route, to the same kind of disease, the doctor must make a diagnosis according to fixed mode and procedure, for example, what be must checked by project, what medicine should be used, how longly, etc it will be hospital stays. Because the standard is unified, all is checked to have according to following, all more right quantization of the result. This undoubtedly helps to impel the medical organization to fulfil the public service function conscientiously, offer safe, effective, convenience, cheap health care service to masses. "The public hospital reform pilot project is difficult point and focal point of the new medical reform; Strengthen inside the hospital management is that the public hospital reforms one of three major fields; But manage the clinical route, strengthen an important content of management inside the hospital, unreasonable and improving the relationship between doctors and patients and having positive meanings to improving medical quality, controlling the medical expenses. " The department of public health of the province cures the relevant persons in charge of policy and summarizes out and implements the importance of the clinical route under the medical reform background at present with three sentences. "Clinical route, standardized to make a diagnosis, attend to procedure is to for, have the intersection of complication and getting simple disease frankly speaking, clinical and experienced experts summarize the whole medical plans and service routines summed up, will have a guidance function to most doctors, are very beneficial to most patients too. " The yellow strong doctor, general head of the department of surgery of provincial hospital, has on managing in the clinical route and agrees to the attitude. The department which he belongs to, begin to standardize the procedure of making a diagnosis to implementation of number such as acute appendicitis, gallbladder calculus as far back as 2005, "this is our exploration in early days of management of clinical route. " At present, the provincial hospital has already had 14 disciplines, clinical route of 28 number entry that are managed, by the end of 2009, there are nearly 800 example patients in all through the clinical route, get positive, effective, standard, economic making a diagnosis. While interviewing in the hospital, reporters have seen because Xiao County peasant Wang AiMin 54 years old of gallbladder calculus hospital treatment. "Admitted to hospital three days ago, did the operation yesterday, could have a meal today, leave hospital tomorrow! " The expenses of its whole treatment are about 7000 yuan, " because of being included in the clinical route, the sun has been shortened in hospital, the expenses have saved about 700 yuan too, more important, from checking, treating to the application of postoperative antibiotic, the course of making a diagnosis entirely is more rigorous, science, rational. " General other Coco is in hospital in the total forest to hold and introduce first. " improve medical quality, control the medical cost, raise the management level of the hospital, improve patient's satisfaction, promote the sustainable development of the medical industry " ,On the seminar, the positive meanings in management of clinical route of persons in charge of 62 pilot hospitals form the common understanding. But the pilot project starts nearly 3 months, the reporter finds while interviewing many hospitals are still looking around among them. Hesitate to look around, prove what the clinical route is implemented is difficult. Where is the difficulty but on earth? The department of general surgery of provincial hospital has an intimate knowledge of this as the first batch of pilot departments. "Clear framework, clear management responsibilities, appropriate management procedure of organization, one can't be few; Design, implement, control, analyze, improve, one step can't leak! From confirming number, making and entering the standard of the foot-path, establishing instructing to appraise the group and superintending and checking the group, making the new examination measure, all of us prepare abundant earlier stage, but still meet many questions, for example some number enters the standard of the foot-path it is not complete enough, lead to the fact that it is on the low side to enter foot-path rate; Because patient medical knowledge lack and doctors and patients communicate uncompletely, patient produce follow the doctor's advice behavior; Take their own roads by hospital, each other's scarce organization and exchange; Medical personnel's work load increases greatly, enthusiasm remains to further improve etc.. " In addition, in some insiders' view, it is the clinical route experience " dilatory " that paid and reformed and has not still connected in time yet according to number Piece reason. Clinical the intersection of route and reform should move forward in a more cost-effective manner, have incident to conform to beat happen. In July, according to the reports of newspaper, Guangzhou was born in the baby of less than one week, when hospitalized for treatment due to illness, demanded to do 189 inspections within 79 hours, including projects such as AIDS, syphilis, glycosuria,etc., costs nearly 6000 yuan. In the face of querying, the explanation of the school is, " belong to the set menu inspection of the clinical route, the doctor has no right to reject him. " It is not unique, the similar incident appears in the newspapers in the end frequently: The girl two years old of Jingmen in Hubei lives in the hospital because of cold and fever, is " checked " The project is up to 43 items, including projects such as syphilis,etc., costs more than 1000 yuan; Kunming Liu whether citizen accept, infuse 4 days continuously behind the amygdaline operation, accept again AIDS, gonorrhoea,etc. were checked in 5 days hereafter, the expenses are up to more than 3000 yuan Even if is a layman, can judge that exist and " check and overcharge arbitrarily " among them according to general knowledge The phenomenon, as to this, can all attribute to " clinical route " "set menu check " ? Some the first, second and third and a doctor of hospital in Hefei says frankly, " this obviously utilizes the loophole of the clinical route to implement checking arbitrarily, arbitrary charge, also exposing some problems that the clinical route is existing at the beginning of pilot project. For example, the hospital makes the route and supervises by oneself oneself, ' work as athlete and a referee both ', how to guarantee not to makes a mistake and can let people trust? Enter a foot-path patient to accept after the standardized treatment, can return the outlet foot-path when what situations are met? To the constant answers of these questions, it is exactly the course that the clinical route system is being improved constantly too. " While interviewing, the expert thinks, " clinical route " Although there is good original intention, any implementation of health care reform should regard medical ethics as soul, so, are moving forward and arriving In the route management of the bed, should be through making the measure of propagating the scheme, improving the examination measure, improving the system loophole etc., arouse the enthusiasm of medical personnel arisesing. Making a diagnosis and giving treatment in the course, the doctor is except carrying out the relevant norm of the clinical route, is it necessary to use some of clinical experience judgement to check the project too, and clear tells patient or its relative. Already been engaged in practising the forest for several years and holding seeming first in clinical route reform, "the control over variation situation is a focal point of pursuing the clinical route too, in the reform, organic to combine regulation with flexibility only, could make clinical route avoid excuse that become ' check and overcharge arbitrarily ' and avoid the responsibility gold medal, fully realize the positive realistic meaning of the clinical route. " [Chain ] clinical route, namely direct a certain disease against, make one standardization that specialist must follow treat mode and treat procedure generally speaking, and the special thinking group carries on supervision according to the standard route, the patient is from admitted to hospitalling to leave hospital, checking, surgery, treating, attending to,etc., follow the relatively standardized procedure, thus realize " With curing with the disease " . In 2009, Ministry of Public Health will print and distribute the clinical routes of 22 specialities and 112 pieces of number, 73 hospitals start the clinical route to manage in the whole country. This year, will also make the clinical routes of 100 pieces of number. The medical reform goal task in our province of 2010: Pursue the means of payment of paying, prepaying according to number paying, total value according to the number of people etc.; Choose the clinical routes about 50 kinds to pay the pilot project according to number. (reporter Wang HuiHui)

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