一般诊疗费政策质疑及启示

Question and Inspiration of General Medical Fee

为肯定医生医疗技术价值和对基层医疗卫生机构进行补偿,国家制定了一般诊疗费的政策,即基层(县级以下)医疗卫生机构原来收取的挂号费、诊查费、注射费和药事服务成本合并为一般诊疗费,并将其纳入医保基金支付范围。国务院办公厅文件规定,收取一般诊疗费,不增加群众负担。笔者对合并到一般诊疗费下四项费用过去的收费情况,以及相关政策之间的关系进行分析后认为,一般诊疗费政策脱离实际,政策之间相互矛盾,执行后难以达到预期效果。这启示我们,制定和执行医药卫生政策,要把握好顶层设计,把握好政策间的统筹协调,建立中立和科学的政策评估机制。

To affirm the value of the doctor＇s medical technology and compensate the primary health care corporations, countries develop medical fee policy which the diagnosis fee, inspecting fee, injecting fee and physician service fee, and merges the health insurance fund payment scope. It was stipulated by the General Office of Sate Council, medical fee charged, not increasing the people burden. In the paper, the author believed that the medical fee policy was divorced form the reality seriously and difficult to achieve the expected effects, after analysising the past situation of the four cost, as well as the relations among the policies. It will be evident that the policy is a failure. The inspiration is that laying down implementation medicine and health policy, we should grasp the key design, in a well-coordinated manner through overall planning, and establish a neutral and scientific evaluation mechanism.