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国务院办公厅印发了《深化医药卫生体制改革2016年重点工作任务》(国办发〔2016〕26号),明确了2016年在深化公立医院改革、推进分级诊疗制度建设、巩固完善全民医保体系等方面的医改重点工作。而总额预付制作为国际上先进的支付方式,对费用控制管理起到一定的效果。将总额预付落实到具体医疗机构的层次,直接影响着整个国民医疗保险制度的成败。按照总额控制政策,提出了三个方面的应对策略,在发展战略方面,加强内涵建设,转变增长方式、发挥医联体作用,建立双向转诊、开拓市外市场,促进医疗资源合理配置;在医疗业务管理方面,严格监督管控,确保医疗质量和安全、落实临床路径,控制医疗费用、优化服务流程,提供优质服务;在医院行政管理方面,强化成本控制,降低运行成本、加强信息化建设,提高决策水平、转变管理职能,形成管理合力。
The General Office of the State Council promulgated the “Key Tasks for Deepening Medical and Health System Reform in 2016” (Guo Ban Fa [2016] No. 26), which clarified that in 2016, in deepening the reform of public hospitals, promoting the construction of grading medical treatment system and consolidating and perfecting the national health insurance system Medical reform in key areas. The total prepaid production as the international advanced payment methods, the cost control management has played a certain effect. The implementation of the total advance payment to the level of a specific medical institution directly affects the success or failure of the entire national medical insurance system. In accordance with the total control policy, three countermeasures were put forward. In terms of development strategy, the Company strengthened the connotation construction, changed the mode of growth, played the role of medical association, established two-way referral, opened up markets outside the city and promoted the rational allocation of medical resources; In respect of medical business management, the Company strictly supervised and controlled the quality of medical services, ensured the quality and safety of medical services, implemented clinical approaches, controlled medical expenses, optimized service procedures and provided quality services. In terms of hospital administration, the Bank strengthened cost control, reduced operating costs, strengthened information construction, Improve the level of decision-making, change management functions, the formation of management force.