Official post: a group of hospital consumables used, being monitored
A number of hospital consumables used, monitored today (
, hebei province health bureau issued the file on the medical establishment that decide a dot medical expense index abnormal growth system of early warning alert notice (
Hereinafter referred to as the 'notice')
'Notice' clear, to strengthen the medical establishment that decide a dot regulation of medical treatment charge, according to the relevant provisions of the state and province, set up the medical establishment that decide a dot medical expense index abnormal growth early warning alert system.
In simple terms, the province health bureau in hebei province by the medical regulation big data analysis system, real-time monitoring of the indicators of medical expenses, mainly for the following to remind: 1, the designated retail drug store out new, stop network factors, such as medicine or annulus compared to the total cost of more than 150%;
2, medical institutions, medical or annulus compared to the total cost of more than 50%;
3, the same of generic drugs only purchase price is high, do not purchase price low;
4, all expenses than similar medical institutions at the same level for comparison. analyze the mean larger;
5, similar medical institutions, at the same level with disease patients burden rate of the highest;
6, focus on drugs, dosage of medical consumables, diagnosis and treatment project in individual cases,
Total amount, total amount, the dosage of day)
7, similar medical institutions, at the same level for comparison. analyze directory drugs and diagnosis and treatment projects outside the utilization rate of usage is bigger in the more than agreement;
8, medical institutions, with the same level and kind diseases drugs, medical supplies, diagnosis and treatment projects of special exception (
Such as: check costs accounted for more than 85%)
9, medicine (
With the common name with specifications)
, medical consumables purchase or settlement price is higher;
10 and the same medical institutions have multiple hospital interval time is too short;
11 and other abnormal monitoring indicators.
It is known that medical institutions in after receiving the abnormal growth index push notifications, shall, without delay, for the purpose of this institution index analyzes reasons for abnormal growth, and within 10 working days through medical insurance bureau in hebei province interactive platform to submit analysis report, analysis report to indicate the problem relating to the department and the relevant responsible person.
Is not submitted to exceed the time limit, the provincial medical insurance bureau on the basis of the assessment method in the annual appraisal shall be penalised.
On the whole, in addition to all medical institutions in hebei province into, a group of designated retail drug store is monitored in the province health bureau.
Deduct the deposit, the most severe cancel coverage in addition to identify unusual growth index of the project, the file also made clear penalties: 1, start questioning;
Provincial health bureau in hebei province by the medical regulation big data analysis system, the medical establishment that decide a dot that are attached to the push notifications related expenses index real-time monitoring, and monitor the effect of push notifications.
For 2 consecutive months after reminding index is still abnormal growth of medical expenses, start questioning remind mechanism.
2, questioning remind;
Interview mainly medical institutions relevant expenses index analyzes reasons for abnormal growth and to urge medical institutions formulate corrective actions.
Without any reason not to accept appointment, provincial medical insurance bureau assessment method based on listed in the annual appraisal shall be penalised and supervisor, at the same time in hebei province medical treatment to the public security bureau's website.
3, timely rectification;
Medical institutions should be according to the content of the interview, finish the rectification, effectively curb unreasonable cost growth.
For questioning after the relevant expenses index is still abnormal growth of medical institutions, start up supervisory procedures.
4 and listing division;
Medical institution within 5 working days in the province health bureau submit improvement scheme, according to the rectification scheme completed rectification within a time limit, the provincial health bureau in hebei province by medical supervision big data analysis system, real-time tracking corrective to carry out the situation, to ensure the corrective effect.
Fails to complete the rectification of the medical institutions, the department or individual (
When, at the end of the liquidation deduct margin and give appropriate pause 3 - health care service
6 months of treatment;
To refuse or obstruct, not cooperate refuses to rectification, will remove health care service agreements, and health in hebei province to the public security bureau's website.
These drugs, difficult on March 5, the central committee of the communist party of China, promulgated by the State Council's opinions on 'on deepening the reform of medical security system, clearly put forward a sound strict powerful fund regulatory system.
According to documents, to perfect innovation fund supervision way.
Set up the mechanism of supervision and inspection of the norm, the implementation of big data to implement dynamic intelligent monitoring.
Improve the monitoring mechanism for medical services, the establishment of mandatory disclosure of information, in accordance with the law in accordance with the rules to the public information such as medical costs, cost structure.
In April last year, the national WeiJianWei drug policy and system for basic drugs department issued the national health committee about drug use monitoring and clinical comprehensive evaluation work notice, across the country to monitor all equipped with use of the drug.
The hebei province directly to all medical institutions (
All levels of hospital + designated retail pharmacies)
Include monitoring of drug use and disease prevention and control of concrete data monitoring, cancel the worst health care services, is aggressive.
It also virtually to a group of clinical curative effect is not good, but takes up too much the focus of the medical insurance fund drug bring new shocks.
Hebei initiatives also has certain model significance.