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一、医保制度的实施,医院面临以下方面的挑战1、现行医保实行的是基本医疗保障,要求医生用最小的医疗费用治好病。病人将根据各医院的技术水平、医疗质量、收费水平和服务态度等状况无约束地挑选医院求医;2、医疗保险增强了参保者的费用意识,合理使用个人帐户资金,使整个医疗市场消费的总支出减少;3、处方药和非处方药管理制度的建立,使消费者小病不去医院而直接在定点药店购药,成为普遍现象,因而就诊人数及收入明显减少;4、付费方式改变不仅使医院单病种收入锐减,医院所面临的政策拨款不足,经营权有限而资金紧张的局面加剧,影响医院资金的正常运转;5、国家整顿医药市场措施出台将各医疗机构折扣率控制在15%以内产生业务收入减少;6、医疗市场供求关系发生质的变化,医院间竞争日趋激烈;7、医疗管理难度加大医患间矛盾增大,根据医保要求,医院实行“总量控制,定额结算”的定额标准,严格控制病人检查和药费,可能造成病人没有完全痊愈就出院,另外,医疗费用查询、质疑等将更多而引发新的医患矛盾;8、医院有些医疗收费价格远远低于医疗成本,且不随国家物价上涨指数变化,由于医疗收费价格太低和政府政策性补偿不
First, the implementation of the medical insurance system, the hospital is facing challenges in the following aspects: 1. The current health insurance system implements basic medical insurance and requires the doctor to cure the disease with the minimum medical expenses. Patients will be selected according to the hospital’s technical level, medical quality, level of fees and service attitudes without restriction to seek medical treatment; 2, medical insurance enhances the cost consciousness of the participants, rational use of personal account funds, so that the entire medical market The total expenditure on consumption has decreased; 3. The establishment of prescription drug and non-prescription drug management system has made it common for consumers to purchase drugs without going to hospital but directly at designated drug stores. As a result, the number of patients attending the clinic and their income have decreased significantly; The single-disease income of hospitals has been drastically reduced, the hospital has faced a lack of policy funding, the operation rights are limited, and the situation of tight funding has intensified, affecting the normal operation of hospital funds; 5, the national rectification of the pharmaceutical market measures introduced to control the discount rate of medical institutions in Less than 15% generated business income reduction; 6, the medical market supply and demand relations have qualitative changes, hospitals increasingly fierce competition; 7, medical management is more difficult to increase the contradiction between doctors and patients, according to medical insurance requirements, the hospital to implement “ total control , Fixed quotas ”of the quota standards, strict control of patient examinations and drug charges, may cause the patient to be discharged without full recovery, in addition, medical Cost of inquiries, questioning, etc. will lead to new and more patient conflicts; 8, hospitals and some medical care price far below the cost of health care, and do not change with the national inflation index, because the price is too low medical fees and compensation is not government policy