日期 : 2021-04-28
The performance appraisal results of national tertiary hospitals are released, and the proportion of internal consumption is still the focus
A few days ago (March 31), the People's Government of China recently released a "Circular of the General Office of the National Health Commission on the National Monitoring and Analysis of the Performance Appraisal of National Tertiary Public Hospitals in 2019" (hereinafter referred to as the "Circular").
In the "Bulletin", the National Health Commission not only analyzed the performance appraisal of tertiary public hospitals across the country in 2019, but also clarified the focus of subsequent work.
The National Health Commission stated that from January to April 2020, it will focus on optimizing performance appraisal methods and form a performance appraisal manual for secondary and tertiary public hospitals (2020 version), which will “focus on monitoring the revenue of high-value medical consumables. "Comparative" is included in the evaluation index system.
In other words, in the future inspections of tertiary hospitals by the state, the proportion of income from high-value consumables will still be the focus of the investigation.
The development of the national medical level is uneven, and the proportion of high-value consumables revenue has increased
According to the inspection data of the National Health Commission, the integrity rate of the first page data items of the inpatient medical records of tertiary public hospitals in 2019 was 99.99%, an increase of 8.41 percentage points from 2018; the data accuracy rate was 98.28%, an increase of 16.52 percentage points from 2018.
In 2019, tertiary public hospitals transferred 14.9604 million patients to secondary hospitals or primary medical and health institutions in the Medical Federation, an increase of 14.93% year-on-year. Among them, the number of outpatient and emergency and inpatient transfers increased by 11.13% and 39.23% respectively. The proportion of discharged patients with surgery, minimally invasive surgery, and four-level surgery have steadily increased year-on-year, and tertiary public hospitals are more motivated to implement functional positioning and tiered diagnosis and treatment system requirements.
Status of transferred patients from tertiary public hospitals from 2016 to 2019
Surgical development of discharged patients from tertiary public hospitals from 2016 to 2019
In addition, the energy consumption expenditure for 10,000 yuan of income in 2019 fell to 95.71 yuan, a year-on-year decrease of 12.80 yuan.
2016-2019 10,000 yuan income and energy consumption expenditure (yuan)
But it is worth noting that there are still many problems in the performance appraisal of tertiary hospitals in 2019.
From the perspective of regional development, the overall indicators of tertiary public hospitals in Sichuan and Chongqing in North, East, Central and South China, and Southwest China are relatively good, while the overall indicators in the Northeast, Northwest, and Southwest regions (except Sichuan and Chongqing) are relatively weak. Medical service capabilities, funding for scientific research projects, shortage of doctors, and information construction are also showing a relatively obvious trend of polarization.
For example, the proportion of patients discharged from hospital with fourth-level surgery in Tibet is less than 10%. The mortality rate of low-risk groups in Heilongjiang, Liaoning, Tibet, Jilin and other places is significantly higher than the national average, and the top 20 third-level public general hospitals with CMI value are concentrated. In Beijing, Shanghai, Jiangsu, Zhejiang and other places; the proportion of pediatricians in Xinjiang Production and Construction Corps, Heilongjiang, Inner Mongolia, and Hebei is relatively low, and the proportion of psychiatrists in Xinjiang Production and Construction Corps, Ningxia, Gansu, and Hunan is relatively low. Tibet The medical-care ratio in the autonomous region and the Xinjiang Uygur Autonomous Region has not reached the target value.
In addition, in terms of the use of high-value medical consumables, tertiary public hospitals focused on monitoring the revenue of high-value medical consumables as a proportion of the total revenue of consumables in 2019, which is an increase from the previous year.
In this regard, the National Health Commission clearly pointed out that the future needs to further strengthen the control of drugs, sanitary materials, and inspection and inspection costs.
The budget of the National Health Commission drops sharply, and the medical field will continue to live a "tight life"
In fact, just before the National Health Commission just issued the "National Health Commission 2021 Departmental Budget", it was clear that the National Health Commission's general public budget allocated 1377699261 million yuan in 2021, which is a decrease of 12,490,932,200 yuan compared to 2020.
Among them, health expenditure (category) public hospitals (funds) general hospitals (items), the budget for 2021 is 310,063,500 yuan, a direct decrease of 70.12% compared to 2020.
According to the National Health Commission, the main reason for the decline in funding is that one-time expenditures such as epidemic prevention and control are no longer arranged and the implementation of tight day requirements has reduced related funding.
In other words, in addition to the financial funds for the new medical infrastructure after the epidemic, the main tone of the medical field in 2021 will be "too tight."
Based on the performance evaluation results of the above-mentioned tertiary hospitals, the future large-scale remediation of high-value consumables in secondary and tertiary hospitals across the country seems to be "doomed."
Up to now, after multiple rectifications such as the two-invoice system, quantity purchasing, and the "blacklist" of high-value consumables, the moisture content of high-value consumables has been "controlled" a lot.
In the future, under the requirements of the National Health Commission, controlling the cost of consumables and converting consumables from hospital income items to cost items will continue to be the primary task of remediation of high-value consumables in various regions.
There is no doubt that, following the second round of procurement of high-value consumables at the national level, a new round of shuffling will begin again...