Infusion has been popularized rapidly since it was introduced into China. However, in foreign countries, infusion is equivalent to a small operation. Previously, I saw a story that a foreigner was told to have an infusion in a Chinese hospital because of a cold. He almost thought he was going to die. In recent years, the state has become more and more strict in the control of intravenous infusion, As recognized as the most dangerous way of administration, intravenous infusion gradually lost the outpatient market. Now, a new wave of grass-roots transfusion restriction orders have been issued.
Primary medical institutions in many cities shall not provide intravenous drug delivery services after receiving the notice
This time, it is not just hospitals above level II, but grass-roots medical institutions. Recently, primary medical institutions in many cities and regions of Henan Province received a notice (as shown in the figure) requiring all outpatient infusion to be stopped and the transfusion restriction order to be upgraded again.
Now medical institutions at all levels implement the 'infusion sweeping', whether it is community hospitals, township health centers, village clinics or clinics, it will be difficult to want infusion in the future! It seems that the era of infusion really needs to wave goodbye to us.
Therefore, for most village clinics, this provision does not restrict infusion, but prohibits infusion, which has a great impact on everyone.
As a member of grass-roots medical institutions, the author has a lot of feelings and has something to say:
I have something to say to the health authorities:
First of all, I have something to say to the health authorities:
Recommendation 1: improve protection, and grass-roots doctors should cooperate with the implementation of the transfusion restriction order
In fact, our doctors are well aware of the harm of excessive infusion, but once the infusion is not available, the income of many doctors, especially grass-roots doctors, will be greatly affected. Therefore, in order to fundamentally reverse the situation of excessive infusion, we should not only standardize and manage the system, but also pay attention to reasonably improving the income of grass-roots doctors and adjusting and limiting the performance distribution proportion after infusion, Only in this way can doctors better cooperate with the implementation of the transfusion restriction order.
The clinic is a unit with high incidence of medical accidents. It is good to restrict the infusion in the clinic to avoid many medical accidents, but it should also consider the remuneration of village doctors and appropriately improve the treatment of village doctors. How to improve the treatment and pension of village doctors should also be considered.
Suggestion 2: if you want to ban it, you should ban it all
To prohibit infusion, all are prohibited, including hospital outpatient clinics, individual clinics, village clinics, etc. in this way, it is fair for everyone to be on the same starting line, will not let patients misunderstand, and can coordinate to change patients' infusion habits.
Suggestion 3: purchase channels are limited together
If the restriction of infusion is only aimed at grass-roots medical institutions, it is still imperfect. If it is necessary to limit it, it should be limited both upstream and downstream. Restrict the purchase of infusion sets and various injection liquids, punish dealers and make them afraid to sell. Whoever sells them will directly lose their business qualification, and there will be no liquid to lose overnight. The sales of injection drugs in pharmaceutical companies will be solved at once.
Recommendation 4: improve the purchase and bidding system of essential drugs
We will improve the purchase and bidding system for essential drugs and include cheap drugs commonly used in rural areas into basic drugs. The document stipulates that health centers and clinics are only allowed to sell basic drugs. I hope this sentence can be adjusted. There is no medicine, there is no medicine, this medicine is not allowed to be sold, and that medicine is not allowed to be sold. Farmers participate in the new rural cooperative medical system, acupuncture, massage, cupping and other appropriate technologies of traditional Chinese medicine in the clinic. The new rural cooperative medical system is not allowed to be used and reimbursed. These problems are not conducive to improving people's sense of acquisition.
Recommendation 5: add general diagnosis and treatment of traditional Chinese and Western medicine to the village clinic license
It is suggested that the qualified licenses of all village clinics should be added with general diagnosis and treatment of traditional Chinese and Western medicine, rather than most of them are written about general medical services. Although there are documents requiring village clinics to have at least four kinds of appropriate technologies of traditional Chinese medicine, village doctors in some areas will be punished for developing appropriate technologies such as acupuncture, massage or cupping because they are not included in the license.
Recommendation 6: improve the mutual referral mechanism, and large hospitals can't take all sizes
The state should improve the system of mutual referral between grass-roots medical institutions and hospitals. Grass-roots institutions can completely ban transfusion. Those who really need infusion should be transferred to hospitals. Hospitals should also transfer some who do not need to be treated in hospitals to grass-roots units and take all major and minor diseases.
Recommendation 7: public expenditure and clinic construction should be included in special funds
The infusion is cancelled, the income of the village clinic will decrease sharply, and the village doctors will lose a lot. However, the village clinic has the mission of adhering to the front line to protect the health of residents. Therefore, it is suggested that public expenditure and clinic construction expenditure should be included in the government budget, and special funds should be allocated to pay year by year to ensure the public and public welfare of the village clinic.
Suggestion 8: open up the market and let traditional Chinese medicine pass on better
Traditional Chinese medicine has been developed under the premise of self-management since ancient times. Now traditional Chinese medicine has become western medicine; The clinic is combined, and the secret recipe is no longer used; The traditional Chinese medicine in the clinic is not included in the reimbursement of cooperative medical treatment, and the common people take western medicine instead; The unique skills such as pill, powder, ointment and pill were blocked by the regulatory system; The income of acupuncture moxibustion is low and will be lost; The traditional Chinese medicine planted and collected by ourselves has not become a fake medicine; Even many modern medical students think that traditional Chinese medicine is unsanitary. Can he taste the four Qi and five flavors of traditional Chinese medicine? Under similar circumstances, who of the next generation of children is willing to learn the abstract knowledge of traditional Chinese medicine? Traditional Chinese medicine is at risk of survival in name only.
Therefore, it is suggested to allow qualified traditional Chinese medicine doctors to set up individual clinics or operate independently in collective health rooms; The varieties of traditional Chinese medicine used shall not be excessively limited and shall be encouraged to be included in the reimbursement of NCMS; Special prescriptions and preparations verified to be effective for long-term use are allowed to be operated after category filing.
Recommendation 9: restrict infusion and don't be eager for success
This is also a little worry. Limiting the abuse of antibiotics and limiting infusion is conducive to improving the health level of the people and preventing the practice risk of grass-roots medical institutions.
However, how many of the nearly 1.4 million rural doctors in China can flexibly use the appropriate technology of traditional Chinese medicine? How many people can really dialectical prescription? The direction is correct, but it is not advisable to be eager for success.