Where does the brake applying the brake step on one

Where does the brake applying the brake step on one from
Staff reporter Han Lu

Support out of control

Induce the patient who should put up a bridge to put the support, reflect that the support is abused. "Some doctors will say to the patient, making and putting up a bridge will turn on the chest, it is low to put the support wound, please decide. " Famous cardiologist, knowing vascular disease branch's General Board Hu Da of Chinese medical science say, induce the patient so, cardiovascular dept.(internal medicine) is not the specific phenomenon in the hospital. Generally speaking, few patients need to put more than 3 heart supports, but much patients have more than 10 has put in our country.

Hu Da says, it is still a support to choose to put up a bridge, should hold a consultation together through cardiovascular dept.(internal medicine) and heart surgical department expert, decide according to concrete condition. In the world, support and it puts up a bridge proportions of surgery to be 71~81, in China, this proportion is up to 121.

Attentive stem patient " Criminal's blood vessel " The support is put in the blood vessel at the same time with having nothing to do, reflect that the support is abused too. Hu Da points out, according to the evidence of a large number of clinical research in recent years, the domestic and foreign guide thinks unanimously, the acute treatments of the myocardium infarction patient should be limited to opening the sick blood vessel which cause myocardium infarction, namely " criminal's blood vessel " ,And should assess other sick blood vessels that the patient exist at the same time after being steady, deal with according to the circumstances. But many clinicians of now " Accomplish at one stroke what should be carried through by stages " ,Have nothing to do with infarction in the vascular narrow position and put the support too.

This used naked support, but use the medicine support, it is another form of expression that the support is abused. The price of the naked support is about half of the medicine supports. Hu Da says, while rescuing acute myocardium infarction patient, uses medicine support and naked support while opening the relevant blood vessel of infarction, there is no prominent difference on the result. "At present, whole world is generally using the naked support of low price, U.S.A.'s naked support consumption accounts for 20%~30% that the support used the total amount, European countries account for about 50%. In 240,000 supports that our country will use in 2009, the naked support proportion is only 3.3%. On one hand because the price of the naked support is low, the profit is thin, the enterprise lacks the enthusiasm produced and sold, on the other hand because the hospital is unwilling to order. " Hu Da says.

It is expressed that Chinese surgery of medical equipment employer's organization plants into professional committee's president Yao Zhi of the thing and repairs, the abuse of the medical consumptive material behaves at dept. of orthopedics very obviously too, if a 26 -year-old woman's patient only needs to punch and lighten in the marrow on the femur the pressure can cure pain, but is demanded to make artificial joint and replace the operation by the hospital. "Not only some general hospitals, general doctors do so, some famous doctors of hospital also do so. "

From which broken one should the interests chain

It is not innate that the heart gets involved in the consumptive material being treated and uses unstandardly. According to the intersection of moustache and large one introduction, our country begin to lead coronary heart disease into and get involved and treat the eighties from last century, but the at first just simple sacculus expands the skill, the hospital that can launch is very limited, the consumptive material used does not charge to the patient alone, sacculus and conduit can also be reused. In recent years, as the support is planted into the gradual introduction of skill and medicine support, get involved therapeutic success rate is higher and higher. But because the consumptive material expenses are expensive, the support operation becomes lucrative, medical manufacturing enterprise, managing enterprises and the medical organization in the same interests roller chain.

At the intact the intersection of interests and roller chain, need control whether products price not merely, still use the behavior of the products. Hu Da shows, the task of top priority is to give play to the role of independent managenment of the trades, convene the relevant discipline expert, jointly get involved in the heart and treat and make norm and guide, what patients defined should do, how to do, make sure what intensity it is. Meanwhile, the supervision department of the government should monitor the unstandard medical behavior conscientiously too.

The external environmental factor can't be ignored either. Stay in the Qi jade platform of the leader of discipline inspection group of department of public health of Guangdong Province and talk at a meeting, he has ever seen enterprise holds medicines " The public relation training class " Teaching material,it is that inside head of the department divide 6 major types on medicine in detail, sum up how not to let doctor not agreed by the 9 kinds of methodses of evolution, and all these are the summary of experience of the medical representative having dealings with doctor on the first line for a long time. "Handle like this, I'm afraid few doctors can withstand. "

An officer of health authorities says, the Ministry of Health has been already coordinating the judicial department, devote more efforts to bribing the domain commerce of the health care and bribing square punishing in the case. Carry out and bribe enterprises strictly at the same time " The blacklist system " ,As to listing in the regional commerce and bribe the bad enterprises recorded, cancel and participate in medical procurement in the locality in its 2 years the qualification of submitting a tender firmly.

Make good use of the strength of the medical insurance

Medical consumptive material price timid and high abusing persistent ailment to be difficult to cure, let many knowledgeable people turn sight to the medical insurance to seek the prescription. Yao Zhi repairs and says, the medical insurance department speaks for patient's interests, should strive for the rights and interests in the price negotiation for the patient. Though some places are tried to some extent in this respect, riper experience and method probably also look for to the other countries or areas.

Department stipulates the Singaporean medical insurance, the doctor, for not needing the patient that put the support to put the support, or put more than 3 supports for the patient, must state the reason to the specialized committee. If doctors have not provided the rational reason, not merely the medical insurance department will refuse to pay the expenses, the doctor's qualification of practising medicine will be queried too. Moustache large to think of our country the intersection of medical insurance and department should the norm submits an expense account according to make a diagnosis by all discipline too, and refuse to pay the expenses produced in excessive medical treatment.

A hygiene administrator says, only under the prerequisite of separating medicine, single number is paid and total value is prepaid and made for the means of payment of reforming the medical insurance, ones that managed on the foundation the clinical route, could encourage the active control cost of medical organization, inhibit excessive medical treatment.

Yao Zhi repairs and takes Taiwan of our country as examples. He says, the department of medical insurance of Taiwan stipulates very low artificial hip joint price, though most foreign corporations can't accept, a company named Zimmer, in order to keep the position of its market accepting. The company is large by consumption to realize the financial affairs balanced, a benefited one is the patient finally. Such a method is worth our drawing lessons from too.



Where does the brake applying the brake step on one from