Every time by reporter Li Biao Every time by intern reporter Li Xuanzhang Every time by editor Chen Xing
July 28,National Health CommissionThe 12th press conference of the series “Everything is for the Health of the People – Our Ten Years” was held to introduce the progress and achievements of the deepening of medical reform in various places since the 18th National Congress of the Communist Party of China.
Xu Shuqiang, Director of the System Reform Department of the National Health CommissionAt the press conference, it was stated that since the 18th National Congress of the Communist Party of China, all localities have vigorously promoted the system integration and implementation of the task of deepening the medical reform, and achieved positive progress and obvious results.
The reform of the salary system is an important part of the comprehensive reform of public hospitals, and all localities attach great importance to this work. Specific to the local, what are the practices for the reform of the salary system of public hospitals? What is the salary level and satisfaction of medical staff?
To this,Ningbo Mayor of Wuhu City, Anhui ProvinceIn response to a question from the “Daily Economic News” reporter, he said that Wuhu City started a new round of public hospital salary system reform in 2016, exploring the establishment of a public hospital salary system that adapts to the characteristics of the medical industry.
Photo source of the press conference site: Photo by intern reporter Li Xuanzhang
Reforming the method for assessing the gross salary of hospitals
When it comes to the specific practices of the reform of the salary system of public hospitals in Wuhu City,NingboThe first is to reform the method for assessing the total amount of hospital wages. Implement the “two permits”, innovatively design the total salary calculation formula, reasonably determine the total salary and adjust it dynamically. The overall stability of the salary level is ensured by the adjustment coefficient, and binding conditions are set to control the unreasonable behavior of the hospital. In 2021, the total approved salary of municipal public hospitals will increase by 50% compared with 2016.
The second is to guide the internal salary distribution system. Implementing the autonomy of the internal distribution of public hospitals, adopting the five-type job performance distribution method, solving the original problem of unbalanced performance distribution, and reflecting the value orientation of technical labor services. In 2020, the Second People’s Hospital of the City launched the reform of “RBRVs workload performance management based on CMI index”, and the hospital’s business and income structure have been significantly optimized. In 2021, the number of difficult cases will increase by 29% year-on-year, and third- and fourth-level surgeries will increase year-on-year. 17%.
“The third is to scientifically determine the target annual salary of the dean. Implement the annual salary system for hospital leaders, and make it clear that the annual salary of the dean and the chief accountant is arranged by the government’s financial budget. The income of hospital leaders is linked to the income level of employees, the hospital’s comprehensive target assessment and personal assessment results. “NingboSay.
The fourth is to innovate hospital performance management and result application. For ten consecutive years, the comprehensive target assessment of public hospitals has been carried out, and the assessment results have been scientific, accurate and efficient through information technology, and the assessment results have been linked to the total salary of employees and the annual salary of the dean. In 2021, the medical service income of municipal public hospitals will increase by 4.6 percentage points compared with 2016, and the per capita wage income will increase by 43% compared with 2016. “The sense of belonging and teamwork spirit of medical staff has been enhanced, and their enthusiasm has been significantly improved.”Ningboexpress.
Continuously improve the reform path of “three medical linkages”
“Three medical linkage” is the essence of Fujian Province and Sanming City’s experience in deepening medical reform. What new explorations and new practices have Fujian Province made in recent years?
Huang Yu, Deputy Director of the Secretariat of the Fujian Provincial Medical Reform Leading Group and Deputy Director of the Provincial Health CommissionHe said that on the basis of summarizing the experience of Sanming, the provincial party committee and the provincial government have introduced relevant reform measures to continuously improve the reform path of “three medical linkages”, and the policy superposition effect has further emerged.
according toHuang YuAccording to the introduction, the relevant reform measures of “three medical linkages” are mainly carried out from three aspects. The first is to deepen the medical reform and ease the burden of medical treatment for the masses.
“At present, 280 drugs and 13 types of consumables have been implemented in centralized procurement. This year, 40 more drugs and 5 types of consumables will be selected to carry out the third batch of provincial-level centralized procurement, and explore the formation and participation of inter-provincial alliance procurement; carry out large-scale medical Provincial centralized procurement of equipment. About 460 million yuan has been saved in the past two years; the per capita inpatient cost of public hospitals in the province is 5.31% lower than the national average, and the average outpatient cost is 6.1% lower.”Huang YuAt the same time, “vacating the cage and changing the bird” will be implemented to promote the dynamic adjustment of medical service prices. The pharmacy service charging policy is piloted in provincial hospitals; in 2021, the proportion of medical service revenue will reach 32.03%, an increase of 9.96 percentage points over 2012. Implement the settlement of medical insurance agency for medicines and consumables, and the settlement cycle is shortened to 23 working days.
The second is to deepen the reform of the medical insurance system and improve the efficiency of fund use. The provincial-level overall adjustment mechanism for employee medical insurance has been improved. The disparity in the amount of funds per capita in 9 cities and one district in the province has been reduced by 23%. This year, the provincial-level overall adjustment ratio has been increased to 50%. The policy of coordinating general outpatient services for employee medical insurance and family mutual assistance has been fully implemented, and the proportion of payment for medical treatment in primary medical institutions has been increased to 90%. Promote the integrated reform of clinical pathway management and collection and payment, and increase the proportion of collection and payment by disease, DRG, and DIP to 41.5%.
The third is to deepen the reform in the medical field and help the high-quality development of public hospitals. Focus on deepening the reform of the salary system, improve the total amount of hospital salaries, and expand the target annual salary system for the dean to the party secretary and chief accountant of the hospital. In 2021, personnel expenditure will account for 38.97%, an increase of 9.95 percentage points compared with 2012; the target of all staff in public hospitals The annual salary system reform has been extended to 34% of the province’s counties. Promote mutual recognition of inspection and inspection results, and implement pilot reforms such as “unaccompanied” wards, family beds, and long-term care insurance to effectively improve patients’ medical experience.
Source of cover image: Photo by intern reporter Li Xuanzhang
