China canceled outpatient transfusion medicine to curb excessive medical overtreatment | outpatient infusion | _ news

Original title: China canceled outpatient transfusion in medical act to curb excessive medical treatment

Changzhi people's hospital outpatient transfusion room. From China's inland Shanxi Changzhi City Health Department "cancel outpatient infusion" notice for nearly a month. Recently, this reporter visited the city's main Government-run hospital in Changzhi people's Hospital, Changzhi medical college affiliated hospital and other hospitals found that hall dedicated to receiving outpatient transfusion patients, display cases vacant, doors locked. Fan Lifang photography

CNS, Taiyuan, August 30 (reporter Fan Lifang)-TCM as main therapy in China, 8 bottles of fluid volume per capita per year billed as "fluid power". In 2016, with the official stop transfusion medicine in some hospitals in Jiangsu Province, Shanxi Changzhi and other places also follow, "cold infusion" abnormal health condition was improving.

For a long time, the abuse of antibiotics, intravenous fluids overflowing excessive medical treatment in China criticized here, Chinese officials have been working to curb unreasonable medical acts, medicalization changing habits back medical benefits the public good.

From China's inland Shanxi Changzhi City Health Department "cancel outpatient infusion" notice for nearly a month. Recently, this reporter visited the city's main Government-run hospital in Changzhi people's Hospital, Changzhi medical college affiliated hospital and other hospitals found that hall dedicated to receiving outpatient transfusion patients, display cases vacant, doors locked. Lu flew Changzhi people's Hospital nurse told reporters that every winter, high incidence of respiratory disease, where 20 seats "is filled."

Lv Jinmei has a habit of living in Shanxi rural areas each year in spring or autumn, whether or not there is sick and goes to the local village health clinic for intravenous infusion, "the first day is sterilized liquid, fat emulsion in the second and third day (energy medicine)", she heard many people say, this will ensure throughout the year without getting sick.

Intravenous infusion that is considered the most dangerous by international drug were popular in China's vast countryside. As with the Lv Jinmei, transfusion can allow pain to quickly eliminate many superstitions, and effectiveness of disease prevention. A public data show 2011 infusion market capacity in China 10 billion bottles (bags) or above, 8 bottles of intravenous fluid per person the equivalent of 1.3 billion population, much higher than the international average level of 2.5 to 3.3. First on behalf of the provincial health department to stop outpatient transfusion in China's Jiangsu, Nanjing three years of general hospital outpatient infusion volume at more than 200,000 people, 10% of total visits.

Category of venous transfusion in medicine belonged to invasive procedures, the equivalent of a small operation, so the clinics do not provide infusion is considered international medical practice. "Injections of insoluble particles into the bloodstream, prone to inflammation of the veins and other adverse reactions, especially with infusions of antibiotics abuse, will ultimately lead to no cure. "Changzhi city, Shanxi province, Wang Yuhua, Director of Medical Affairs admitted that, generally speaking, the infusion is only for first aid, used by patients with severe patients cannot eat" final delivery ".

Shanxi University, school of political science and public administration, public management, Dr Yan Ying believes that acts of transfusion medicine in the civil "prevailing" is "guided" results of "lack of government investment in public hospitals, hospital ' medicine ' rely on ' more drugs, more inspections, large prescription ' pursued by revenue. "Yan Ying to reporters an account, in the case of therapeutic effect, a box of oral ofloxacin tablets left (an anti-inflammatory drug), the price is RMB 12, can take 3 days and the same drug, intravenously cost more than 100 Yuan a day," spent 3 days is about 400 Yuan, equivalent to 30 times of oral medications. ”

In recent years, the Chinese Government has initiated one of the major health care reform is to reduce the hospital's reliance on drug income, and raise the level of medical service charges, reflecting the social value of health workers. Cancellation of outpatient transfusion medicine was also the industry believes is the extension of the health care reform act.

Public information, effective July 1, 2016, apart from the children's Hospital, in Jiangsu Province, more than 460 full stop over more than two public hospitals outpatient intravenous antibiotic, became China's first comprehensive stop outpatient infusion of provinces. In late July, Changzhi city, Shanxi health family planning Commission held a press conference, from August 1, 2016 second-level medical institutions in the city to stop outpatient intravenous antibiotic, October 1 full stop outpatient infusion therapy (except for children's hospitals and pediatric).

Since 2016, though not uniform provisions at the national level, many officials have introduced policies that specifically limits the outpatient transfusion policy step by step. According to media reported, April 7 up, Fujian, sanming city, full stop patients outpatient vein infusion (Pediatric except); May 1 up Yunnan gejiu city people Hospital except emergency section, and pediatric outside, stopped vein lost note antibacterial drug; June 1 up Urumqi friendship Hospital stop outpatient infusion: June 2, Sichuan province people hospital full stop adult outpatient infusion (pediatric and tumor outpatient chemotherapy, special infusion except); Inner Mongolia autonomous region, people hospital all outpatient infusion room has canceled, Fu you canceled outpatient transfusion room of the autonomous region, set aside part of their emergency transfusion room for emergencies or at night need to play "a bit" of patients.

However, many canceled outpatient transfusion of hospital suffering the public concept of years of medical challenges. Changzhi city, Shanxi province people's Hospital doctor of respiratory medicine Su Hui told reporters that according to relevant provisions, by doctors to determine required transfusion patients, according to its priorities go to the grass-roots medical institutions, clinics, or register, "infusion is not required, we will do our best to explain, most are acceptable. ”

"Want to eliminate unnecessary transfusion, needs to consider the vision of the reform of the medical system. "Yan Ying suggested that before health insurance from the Government's" cost recovery "returns to the role independent negotiation functionality of payers," If doctors prescribe medication, insurance companies have the right to refuse reimbursement, or even cancellation of licenses and given the appropriate care, management and other monetary value; also, to play a simple, convenient, cheap, check the advantages of traditional Chinese medicine. "(End)

Responsible editor: Kun Qu SN117

Article keywords:
Outpatient infusion of excessive medical treatment

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中国多地区取消门诊输液医学行为 遏制过度医疗|门诊输液|过度医疗_新闻资讯

　　原标题：中国多地取消门诊输液医学行为 遏制过度医疗

图为长治市人民医院门诊输液大厅。距离中国内陆城市山西长治卫生部门“取消门诊输液”通知近一个月。近日，记者走访该市主要的官办医院长治市人民医院、长治市医学院附属和平医院等多家医院发现，专用于接收门诊输液患者的大厅内，陈列柜空置，房门紧锁。 范丽芳 摄

　　中新网太原8月30日电 (范丽芳)曾以中医诊疗为主要治疗手段的中国，因每年人均8瓶的输液体量被外界称为“输液大国”。2016年，随着江苏官方在部分医院叫停门诊输液医学行为，山西长治等多地也纷纷跟进，“小感冒大输液”的畸形医疗状况正在得到改善。

　　长期以来，抗生素的滥用、静脉输液泛滥等过度医疗行为在中国饱受诟病，此间，中国官方一直致力于遏制上述不合理的医疗行为，改变民众就医习惯，回归医疗普惠公益性质。

　　距离中国内陆城市山西长治卫生部门“取消门诊输液”通知近一个月。近日，记者走访该市主要的官办医院长治市人民医院、长治市医学院附属和平医院等多家医院发现，专用于接收门诊输液患者的大厅内，陈列柜空置，房门紧锁。长治市人民医院护士长芦飞告诉记者，每到冬季呼吸道疾病高发期，这里20个座位“被挤得满满的”。

　　生活在山西农村的吕金梅有一个习惯，每年开春或秋冬之交，不论有没有生病，都要去当地村卫生所进行静脉输液，“第一天是消炎液体，第二天和第三天输脂肪乳(能量补充药)”，她听许多人说，这样能保证一年四季不生病。

　　静脉输液这一被国际认为最危险的用药方式却在中国广大农村流行。与吕金梅一样，许多人迷信输液能让病痛快速消除，还有防病功效。一项公开数据显示，2011年中国输液市场容量在100亿瓶(袋)以上，相当于13亿人口每人输了8瓶液，远高于国际上人均2.5到3.3瓶的水平。中国首家以省级卫生部门名义叫停门诊输液的江苏，其南京三甲综合性医院年门诊输液量基本都在20万人次以上，占就诊量的百分之十。

　　静脉输液在医学上属于侵入性操作范畴，相当于一次小手术，所以门诊不提供输液被认为是国际医务惯例。“注射液中的不溶性微粒进入血液循环，极易出现静脉炎症等不良反应，尤其是伴随输液产生的抗菌药物滥用，将最终导致无药可用。”山西省长治市医政科科长王玉华坦言，一般来说，输液是仅对急救、重症患不能进食患者使用的“最后给药方式”。

　　山西大学政治与公共管理学院公共管理博士晏英认为，输液医学行为在民间“盛行”是被“引导”的结果，“政府对公立医院投入不足，医院长期‘以药养医’，依靠‘多开药、多检查、大处方’来追求经收入。”晏英为记者算了一笔账，在治疗效果相当的情况下，一盒口服左氧氟沙星药片(消炎药的一种)，价格是12元人民币，可服3天；而同样的药品，静脉注射一天的花费超过100元，“3天花费就是近400元，相当于口服药物的30倍。”

　　近年来，中国政府启动的医疗体制改革重点之一，就是减少医院对药品收入的依赖，并通过提高医疗服务收费水平，体现医务工作者的社会价值。取消门诊输液医学行为，亦被业界认为是上述医改行为的延伸。

　　公开资料显示，2016年7月1日起，江苏省除儿童医院外，460多家二级以上公立医院全面停止门诊患者静脉输注抗菌药物，成为中国第一个全面叫停门诊输液的省份。7月下旬，山西省长治市卫生计生委召开新闻发布会，要求从2016年8月1日起在该市二级以上医疗机构停止门诊患者静脉输注抗菌药物，10月1日起全面停止门诊患者静脉输液(儿童医院和儿科除外)。

　　2016年以来，国家层面虽未作统一规定，多地官方纷纷出台相关政策，逐步明确限制门诊输液的政策。根据媒体报道，4月7日起，福建三明市全面停止患者门诊静脉输液(儿科除外)；5月1日起云南个旧市人民医院除急诊科、儿科外，叫停静脉输注抗菌药物；6月1日起乌鲁木齐市友谊医院停止门诊输液：6月2日，四川省人民医院全面停止成人门诊输液(儿科和肿瘤门诊化疗等特殊输液除外)；内蒙古自治区人民医院所有门诊输液室已取消，自治区妇幼保健院已取消门诊输液室，留存了一部分急诊输液室用于突发或夜间需要打“点滴”的患者。

　　然而，许多取消门诊输液的医院遭遇民众多年形成的就医观念的挑战。山西省长治市人民医院呼吸科医生苏卉告诉记者，根据相关规定，经医生判断的确需输液的患者，依据其病情缓急转至基层医疗机构、门诊，或办理住院，“不需要输液的，我们会尽力解释，大多数还是接受的。”

　　“想要彻底杜绝不必要的门诊输液行为，需要从医疗制度改革的大视野来考虑。”晏英建议，政府的医疗保险要从之前的“成本补偿”角色回归到具有独立谈判功能的支付方，“如果医生乱开药，保险公司有权拒绝报销，甚至被吊销行医执照；同时给予其相应的护理、管理等货币价值体现；另外，还要发挥中医药简、便、廉、验的优势。”(完)

责任编辑：瞿崑 SN117

文章关键词：
门诊输液 过度医疗

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