12 major Beijing hospital referral for rehabilitation of patients with clear criteria for 8 kinds of diseases
The Beijing News (reporters Wen Ru intern Dai Xuan) yesterday, the Beijing Municipal Hospital rehabilitation hospital combined HA started. In the morning sun, Ahn and colleagues of 12 major hospitals for the diagnosis and treatment of acute patients with stable disease over the period of eligible to go to hospital in xiaotangshan and old age receive rehabilitation therapy. At present, already covered by the rehabilitation of stroke, brain trauma, fracture, 8 kinds of diseases.
Yesterday, the old Beijing xiaotangshan hospital, Beijing hospitals and general hospitals was signed by representatives of two-way referral in patients with the Beijing municipal hospitals and rehabilitation agreement. From now on, HA, municipal General Hospital, in the hospital, Cancer Hospital, the infectious diseases hospital (in patients with non-infectious diseases), 12 level-III hospital and municipal rehabilitation medical rehabilitation specialty hospital to form joint.
"Patient referral to get continuity, integration of medical and rehabilitation services. "HA, the relevant person in charge, in rehabilitation hospitals may become secondary cerebral infarction disease changes, the patient may have transferred out of the hospital's technical support, also through the green channel back to level-III hospital to continue treatment. Meanwhile, tertiary-level hospital could also free up more beds for critically ill patients, and improve efficiency.
Chaoyang Hospital President Chen added, Chaoyang hospital to participate in exploring grading diagnosis and treatment since the outward transfer of patients from the hospital generally less than a turn from the outside. He explained that this part more than 1400 beds in hospitals and discharged about 80,000 patients a year, exploring grading diagnosis and treatment since there are only about 3000 patients to go out. To really establish a proper diagnosis and treatment mechanism, remains to be further mobilization of hospital and patient attitudes change.
Links
12 hospital referral for rehabilitation of patients with specific conditions
Background
HA, the relevant person in charge, has 83 million disabled people in China, 270 million chronic patients and 100 million patients with chronic pain, rehabilitation there is huge demand.
At present, the level-III hospital cardiovascular, tumor and limb fractures among hospitalized patients, more than half of patients in need of rehabilitation treatment, but because of poor exports are often stranded at the three hospitals, affecting the efficiency of hospital, patients and is not conducive to professional rehabilitation.
Hospital list
2 rehabilitation medicine featured hospital: Beijing elderly hospital, Beijing xiaotangshan hospital and
12 joint hospitals: Beijing friendship hospital, Beijing Tongren hospital, Beijing Chaoyang hospital, Beijing jishuitan hospital, tiantan hospital, Beijing anzhen hospital, Beijing shijitan hospital, Xuanwu hospital, Chang Gung Memorial Hospital of Tsinghua University in Beijing, the Beijing Hospital of traditional Chinese medicine, Beijing Cancer Hospital and Ditan Hospital in Beijing
(According to the pilot, and gradually add other eligible municipal hospitals to rehabilitation medicine combined)
Disease categories and standards
Referrals involving cerebral vascular diseases, bone and joint diseases, skin, heart and lung disease, cancer, and so on.
At present, stroke, traumatic brain injury, spinal cord injury, peripheral nerve loss, following artificial hip/knee replacement, knee anterior cruciate ligament reconstruction, and fracture and hand injuries, according to State Health Planning Commission on issuing stroke 8 common species (ESS) rehabilitation of two-way referral standards (for trial implementation): notice of request for referral;
Referral of patients with cardiovascular diseases, cancer and other ranges and is organizing experts to draft standard.
Specific model
In 12 major hospitals for treatment during acute and in stable condition after the patients, eligible to go to 2 rehabilitation medicine special hospital for medical rehabilitation.
In rehabilitation hospitals may become secondary cerebral infarction disease changes, the patient can be transferred out of the hospital or continue treatment through the green channel back to level-III hospitals.
This year the target
400 patients with rehabilitation referral tasks will be completed this year.
Current situation
Between May last year and April this year, Beijing rehabilitation medicine conjoined enter into the pilot preparatory phase 2 features rooms on the hospital received patients rehabilitation medicine 468 people, municipal hospitals transferred patients received 226 people.
It is reported that 2 features 345 beds hospital rehabilitation rehabilitation medicine, currently receive 2,400 patients a year. , HA said, is expected in 2020, two hospital beds will be 550, 4,658 receiving rehabilitation patients a year.
After visiting
To ensure continuous treatment of patients?
The HA staff, rehabilitation can reduce the recurrence of the disease, making their recovery better, continuity of development of rehabilitation medical services can realize the continuous treatment of patients.
Reporter from Beijing Ann Fiona hospital understand to, Ann Fiona hospital annual do heart open chest and bracket implanted surgery 25000 cases, which most need do operation Hou rehabilitation, currently accept heart surgery of patients in the, about 50% of patients in operation Hou easy have anxiety depression, about 30% because activities by limited and lost work capacity, also has part patients due to operation Hou smoking drinking, and had food fat, and lack activities, and mood depression, improper of lifestyle led to disease recurrence, staff introduced, if patients in operation Hou accept rehabilitation treatment, Can solve these problems.
' Expenses would increase?
, HA said, rehabilitation therapy to relieve medical structural problems, but also to patients with deep cuts in spending, to a certain extent, ease the doctor difficult, expensive and health insurance payment pressures.
Early pilot and old Beijing hospital, Beijing xiaotangshan hospital statistics, rehabilitation medical and functional recovery of patients with overall length of stay shortened, medical spending reduced. Data and case studies showed that patients who did not undergo early rehabilitation medical, twice to its medical spending is for 3 times.
After referral health-care policy to keep up? HA said that although two rehabilitation hospitals belong to class a General Hospital, but as long as the patient referral, reimbursement can be seamless.
Cooperation can improve hospital efficiency?
According to City medical tube Council introduced, 2015 Beijing Municipal Hospital average hospital day is 8.3 days, and United States and China Hong Kong area not to 7 days, if through rehabilitation patients ordered referral, put average hospital day down to 7 days, according to 2015 9 Home Municipal integrated hospital admitted 473,200 hospital patients measuring, can more received 71,700 hospital patients, hospital patients increased 15.14%, equivalent to new a 1500 Zhang bed of three level integrated hospital, conducive to ease "doctor difficult" problem.
It is understood that the anzhen hospital coronary heart disease postoperative rehabilitation needs each year, the hospital supports 11,000 people a year, patients of 4000 people, Beijing has more than 6,000 people in need of postoperative rehabilitation of patients with; tiantan Hospital of Neurology annual discharge 17000-18000, 40%-50% in need of rehabilitation. Hospital managers, municipal level-III hospital in urgent need of providing postoperative rehabilitation of patients with "export", improve the efficiency of municipal hospital beds.
(Editors: Hao Long UN654)
2016-05-07 02:45:40
The Beijing News
北京12家大医院患者可转诊康复 明确8病种标准
新京报讯 （记者温薷实习生戴轩）昨日，北京市医管局启动市属医院康复医联体。在朝阳、安贞、同仁等12家大医院接受诊治且急性期间病情稳定后的患者，符合条件可转至小汤山及老年医院接受康复治疗。目前，该康复模式已覆盖脑卒中、脑外伤、骨折术后等8病种。
昨日，北京小汤山医院、北京老年医院与综合医院代表签署了《北京市属医院康复患者双向转诊协议书》。今后，市医管局将在市属综合医院、中医院、肿瘤医院、传染病医院（非传染病患者）等12家三级医院与市属康复医学特色医院形成康复医联体。
“患者在转诊后能获得连续性、一体化的医疗康复服务。”市医管局相关负责人介绍，在康复医院可能发生二次脑梗塞等病情变化时，患者可享受转出医院的技术支持，也可通过绿色通道转回三级医院继续救治。同时，三级医院也可腾出更多床位为危重症患者服务，有效提高使用效率。
朝阳医院院长陈勇同时提到，朝阳医院参与探索分级诊疗以来，从医院向外转出的病人普遍比从外转入的要少。他介绍，医院本部床位1400多张，一年出院约80000名患者，探索分级诊疗以来，一共只有约3000例患者向外转出。要真正建立分级诊疗机制，还有待医院的进一步动员与患者就医观念的改变。
链接
12家医院患者转诊康复具体情况
背景
市医管局相关负责人介绍，我国现有8300万残疾人、2.7亿慢性病人和1亿慢性疼痛患者，对康复医疗存在巨大需求。
目前，三级医院心脑血管、肿瘤、肢体骨折等住院患者中，一半以上患者需要康复治疗，但因出口不畅常滞留在三级医院，影响大医院使用效率，且不利于患者得到专业康复训练。
医院名单
2家康复医学特色医院：北京小汤山医院和北京老年医院
12家合作医院：北京友谊医院、北京同仁医院、北京朝阳医院、北京积水潭医院、北京天坛医院、北京安贞医院、北京世纪坛医院、宣武医院、北京清华长庚医院、北京中医医院、北京肿瘤医院和北京地坛医院
（根据试点情况，逐步将其他符合条件的市属医院加入康复医联体）
病种与标准
转诊病种以脑血管病、骨与关节疾病、心肺疾病、皮肤、肿瘤等为主。
目前，脑卒中、脑外伤、脊髓损伤、周围神经病损、人工髋/膝关节置换术后、膝关节前交叉韧带重建术后、骨折术后和手外伤等患者根据国家卫计委《关于印发脑卒中等8个常见病种（手术）康复医疗双向转诊标准（试行）的通知》要求进行转诊；
心血管疾病、肿瘤等患者的转诊范围和标准正在组织专家起草。
具体模式
在12家大医院接受诊治且急性期间病情稳定后的患者，符合条件可转至2家康复医学特色医院接受康复治疗。
在康复医院可能发生二次脑梗塞等病情变化时，患者可转出医院，也可通过绿色通道转回三级医院继续救治。
今年目标
今年将完成400例康复患者转诊任务。
目前情况
去年5月至今年4月，北京市康复医联体试点工作进入探索筹备阶段，2家康复医学特色医院共接收外院转入患者468人，其中接收市属医院转入患者226人。
据悉，2家康复医学特色医院共有康复床位345张，目前每年能接收2400名康复病人。市医管局表示，预计2020年，两家医院康复床位将达550张，每年接收康复病人4658名。
追访
能否确保患者连续治疗？
医管局工作人员介绍，康复能减少疾病复发，使患者术后恢复效果更好，发展康复延续性医疗服务，能真正实现患者的连续治疗。
记者从北京安贞医院了解到，安贞医院每年做心脏开胸与支架植入手术25000例，其中绝大部分需要做术后康复，目前接受心脏手术的患者中，约50%的患者在术后易得焦虑抑郁，约30%因为活动受限而失去工作能力，还有部分患者由于术后吸烟喝酒、过食肥肉、缺乏活动、心情抑郁等不当的生活方式导致疾病复发，工作人员介绍，如果患者在术后接受康复治疗，完全可以解决此类问题。
患者费用会不会增加？
市医管局负责人表示，康复医疗的展开能够有效缓解医疗结构性问题，而且能够大幅缩减患者开支，在一定程度上缓解看病难、看病贵和医保支付的压力。
据北京小汤山医院和北京老年医院早期试点统计，介入康复医疗的患者功能恢复明显，总体上住院天数缩短，医疗花费开支相应减少。有数据和案例显示，没有接受早期康复医疗的患者，其医疗花费是接受者的2倍到3倍。
转诊后医保政策是否跟上？医管局负责人说，两家康复医院虽属于综合性非A类医院，但只要患者转诊，医保报销可以无缝衔接。
能否提高合作医院效率？
据市医管局介绍，2015年北京市属医院平均住院日是8.3天，而美国和我国香港地区不到7天，如果通过康复患者有序转诊，把平均住院日降到7天，按照2015年9家市属综合医院收治47.32万住院病人测算，能够多收7.17万住院病人，住院病人增加15.14%，相当于新建一个1500张床的三级综合医院，有利于缓解“看病难”问题。
据了解，每年安贞医院冠心病术后康复需求大，医院每年支架1.1万人，搭桥4000人，其中北京患者中有6000多人需要术后康复；而天坛医院神经科每年出院17000-18000人，40%-50%需要康复。医院管理人员介绍，市属三级医院急需为手术后需要康复的患者提供“出口”，提高市属医院的病床使用效率。
(责任编辑：郝龙 UN654)
2016-05-07 02:45:40
新京报