Medical network - on February 16, according to the zhenyuan in tianjin, tianjin will be cancelled in 2016, the city's public hospital drug addition, on the basis of medical consumables which were scrapped in 2017 bonus, to alleviate the burden of patients hospitalized.
Thus, after the anhui province, tianjin became the second cancel consumables addition province this year.
Last year, the general office of the people's government in anhui province has been issued by the medical care system in anhui province in 2016 to deepen "comprehensive reform pilot notice the key tasks in the request, from October 20, 2016, the provincial public medical institution can cancel the individual medical consumables fee rate and balance bonus policy, medical consumables according to the actual purchase price sales.
After that, the cities in anhui province are "consumable zero bonus", earlier in the 2016 years away, delayed also shall become effective as of January 1, 2017.
In addition to the two provinces, and the dongguan city of guangdong province, zhuhai, zhongshan, and xiamen city in fujian province, "consumable zero bonus" team is gradually expanding.
However, with the "drug zero bonus" brought series of challenges to hospitals and drug companies, consumables bonus cancelled, hospitals and medical equipment companies and really ready?
Public hospital income narrow channels
It is understood that in 2016 has been cancelled due to tianjin city public hospital drug addition, all at the same time reduces the large medical equipment inspection fees, cancel the consumables bonus again this year, tianjin public hospital compensation mechanism, will be used by service charge, medicine supplies bonus income, government subsidies three channels, instead of service charge and government subsidies two channels.
Therefore, tianjin will take to improve the value of medical personnel technical services analyzes, nurse cost, operation expenses, Chinese medicine treatment, according to the proportion of 85% to compensate, the rest by the Treasury to transitional allowance and hospital digestion solution on its own. At the same time, the hospital will further strengthen management, reform the mechanism of logistics, reduce the cost.
In tianjin scheme, "consumable zero bonus" implemented, the hospital income channels from 3 to 2, the resulting income gap fill by three parts, namely, to improve the medical service price, government subsidies and hospital to digest, this file with the state department to "zero drug addition," the spirit of consistent.
Just, documents designated by the state council allocation proportion is "811", namely the fiscal subsidy 10%, hospital digestion by 10%, 80% by improving medical service price compensation. And tianjin is 85% by improving medical service price compensation, 15% by fiscal subsidies and hospital to digest. Note that finance gives the transitional allowance, as the name implies, the final 15% May be required by the hospital to digest.
Whatever share proportion, many places from the past to cancel drug consumables addition, once the relevant compensation mechanism is not sound, relevant policy cohesion is not enough, the pilot hospitals face common practies.
According to the 21st century business herald, known as the "central union" xiangya hospital, central south university recently have been revealed, cancel after drug addition, hospital revenue of 200 million yuan a year, shall not be kept back 50 million equipment procurement budget this year. "Drugs zero bonus", instead of big medical equipment suppliers by its harm, this is one of the fire affected "gate".
On January 21, according to the southern metropolis daily reported that guangdong province people's hospital of zhongshan city people's congress, said "cancel after drug consumables addition, hospital losses of more than 20 every day". Because common people 1000 yuan medicine before, now only 850 yuan can get back, "the medicine did not move, health care and did not move, is equal to the hospital to supplement their patients". And the government in 2015 to the hospital basic no input, feel hospital loss is too big, spent 930000 yuan in 2016.
In 2015, qionghai people's hospital of hainan province through the adjustment of medical service prices increase income accounts for only 39.5% of cancel the drug addition, 8-9 months only two months loss of 1.757 million yuan.
YiXie enterprise or become "flange"
Also from the "zero drug addition" experience, "consumable zero bonus", some hospitals in order to break through the losses or would use "tricks", and medical equipment enterprises become the ultimate "flange" instead.
"Once in the medical profession, a think-tank, drugs zero bonus" dramatic events have done inventory after the reform, the hospital how to slash drug firms 5 knife, a knife knife killing me!
"Ingenious ways is owed money not to. Such as part of the large hospital somewhere with "hospital medicine" in the operation cost and management cost of pharmaceutical affairs nowhere, stop paying drug payment for three months in a row. In 2016 alone, more than 40 vendors payment unpaid for more than 10 billion yuan. According to industry insiders, "the reason out of the interview, mainly want to reversed transmission drug firms concessions even rebates, to bear the cancellation of drug addition to reduce the loss of the income from the hospital."
"Ingenious ways required rebate. A municipal hospital, according to the public in medicine bargaining agreement requirements, quarterly sales amount in the top 50 medicines, according to the principle of link quantity and price on the basis of the agreed price, according to the sales ranking, purchase price need to adjust again. In particular, the domestic drug sales, top five discount again increased by 10%, 6-10 discount increased by 8%, and so on. Import or joint venture of medicine in the top 10 discount rose 5%, ranking 11-50 discount by 3% (the original discount can be exempted from 5 or higher), even "kickbacks" is "net price" clearly.
"Ingenious ways of three is required drug firms" donation ". Late last year, somewhere who planning commission was exposed in the process of drug centralized bid procurement, without approval, without authorization, in the name of the donor to drug companies "capital takes up preferential benefits compensation and scale". Got a lot of money, according to the purchasing amount of 1% 5%.
Four is on drug firms "ingenious ways. Last September, a hospital to get out the announcement, specify its wholly owned subsidiary of the bidding medicine to the hospital the only distributors, after business company, the hospital has a direct business with all hospital drugs to finish, through its wholly owned subsidiary and give rise to the profit margins of 5% ~ 10%.
Five is the pharmacy trusteeship "ingenious ways. While the hosting companies want to gain custody qualification, is the need to get out drug income part of the profits (30% 40%) to the hospital, also pay the hospital pharmacy staff wages. This is considered by many in the industry is also in disguise "avoid drugs zero bonus policy". |
