Chapter 535 Worst outcome: hospital goes bankrupt and collapses

High-quality diagnosis and treatment capabilities are the key to controlling medical costs.

For example, Xu Qiu can avoid unnecessary examinations when treating diseases or performing operations, and basically does it in one step, rarely requiring repeated medical treatment. Therefore, the data of patients under Xu Qiu must be extremely good.

If the national average medical cost is 5,000 yuan, Xu Qiu's patients may average less than 1,000 yuan.

Another requirement: detailed financial expenditure data.

This is the key to the DRGs grouping of medical expenses. How to group various diseases and how to price them must be done under big data.

But Daxia still does not do well in this regard.

Until last year, the penetration rate of electronic medical records was less than 50%. In the domestic medical database, even half of the statistical data could not be obtained. In addition, the medical records that have been included in the management also have problems such as inaccurate diagnosis and treatment data and irregular medical record coding. It is almost impossible to accurately calculate clinical costs...

With poor diagnosis and treatment capabilities and inaccurate cost estimates, the forced promotion of DRGs will only result in a bad account.

The previous project-based charging was suffered by patients and medical insurance bureaus.

Now the unlucky ones have become patients and hospitals.

"I also understand that the mandatory implementation of DRGs will intensify the conflict of interests between hospitals and the relevant parties of the Medical Insurance Bureau, but this is the general trend and I can't do anything about it." Fu Qing sighed.

After a pause, he said: "Moreover, it may not be the same as you think. Top hospitals may not necessarily make money!

"Jinghai People's Hospital is the DRGs pilot hospital in Baiyun Province. In the first half of the year, their neurosurgery department lost more than 20 million yuan, more than 20 million yuan for one department..."

Xu Qiu's face was serious.

Jinghai People's Hospital was the first stop of his neurosurgery academic lecture. The neurosurgery department of this hospital ranks first in the province and is also well-known in the south.

As an ace department, it actually lost money?!

Fu Qing explained: "The chief neurosurgeon of Jinghai People's Hospital is too stubborn. He insists on using the most reasonable treatment methods and refuses to choose low-priced, primitive equipment and drugs to reduce costs.

"And their department has the best neurosurgery medical resources in the province, so they spent the medical insurance funds like water, and lost tens of millions in half a year. He was transferred last month, and the director was replaced."

Let doctors only do what they should do. This sentence seems to be nonsense, but it is difficult to achieve.

In addition to authoritative guidelines, effective diagnosis and treatment methods, and the comprehensive conditions of the patients themselves, there is another important factor to consider in clinical practice - the guidance and norms of laymen to clinical doctors.

Now the system has undergone tremendous changes, but Jinghai People's Hospital still goes its own way, and it will definitely be criticized.

Xu Qiu pondered: "The current situation is that medical institutions, from top to bottom, have to rely on cost-saving to meet the provisions of DRGs?"

Fu Qing shook his head: "It's not that exaggerated, but in the past, the treatment methods were considered first, and then the cost. Now it may be necessary to put the cost first, and then choose the diagnosis and treatment method within a reasonable price range."

Xu Qiu himself is not worried.

From the moment the patient was admitted to the hospital, he accurately selected the examination method, avoiding many seemingly reasonable but actually meaningless examinations, and he had already started to save money. There were not many people in the industry who could control the cost of diagnosis and treatment lower than Xu Qiu.

However, other doctors in Linyi could not do it.

The original intention of DRGs must be good, and the ultimate goal is to control medical insurance costs, save costs for hospitals, and save money for patients. However, when it is truly implemented at the grassroots level, the best outcome is that major hospitals lose money, doctors' salaries decline, and medical insurance has to take a step back and find various reasons to subsidize doctors and hospitals to ensure that doctors have a bite to eat.

In order to subsidize their families, more doctors can only rely on part-time jobs to maintain their previous income, such as conducting Internet consultations on certain platforms, or even running Didi and delivering food after get off work.

As for the worse outcome than this, it is the collapse of the hospital. Doctors find that they have to deduct dozens or even hundreds of bonuses for each patient they receive. Everyone starts to shirk responsibility. At this time, the National Health Commission issued a document prohibiting refusal of diagnosis. In the end, the doctors found that they could not fight, so they took their practicing physician certificates and directly changed their careers and ran away, and the entire medical system was shaky.

"Is there a solution?" Xu Qiu asked.

Fu Qing thought for a long time and said, "Yes, the general policy of DRGs cannot be changed, but each province has a certain degree of autonomy and can make appropriate modifications within the framework of DRGs according to local conditions."

There are hundreds of versions of DRGs in more than 30 provinces in China, and some provinces and cities are different from each other.

Fu Qing said, "But, at present, there is no DRGs version suitable for the local area in the country. The medical level of our Baiyun Province is not outstanding, and there is no precedent for reference. Therefore, we can only learn from the experience of Tiandu."

The DRGs promoted in Baiyun Province today are derived from the Tiandu version, and the same system is used by top hospitals such as Union Hospital and Fuwai Hospital.

Xu Qiu thought for a moment and said, "Tiandu is very different from Baiyun Province in terms of medical level and the degree of perfection of electronic data. Theirs may not be suitable for us..."

Fu Qing was waiting for this sentence. He looked at Xu Qiu with burning eyes: "Are you interested in formulating a version for Baiyun Province?"

Xu Qiu did not refuse.

If the existing DRGs are implemented, Linhai First Hospital will definitely be able to survive with him, but other hospitals in the province, and even many ordinary tertiary hospitals across the country, may face greater losses.

The top three hospitals are also not immune, and are likely to operate with huge losses of hundreds of millions every year.

Today's Daxia needs a medical system that is more suitable for the level of medical development and regional characteristics to solve the problems between medical insurance, hospitals and patients.

"Okay, I'll try my best." Xu Qiu agreed.

He now has to fight against liver tranquilizer, develop new drugs, prepare for next year's world competition, and may also need to study head transplantation... There are already so many important tasks, it doesn't matter if there is one more.

Numb.

...

After leaving Fu Qing's residence, Xu Qiu contacted Shen Hua.

Tiandu.

Shen Hua's actions were exactly the same as Xu Qiu's. When she heard the ringtone, she first slowly took out her mobile phone, then stretched her arms, tilted her head back, and looked at the caller ID on the screen from a distance.

"It's Dr. Xu Qiu." The assistant reminded.

Shen Hua felt as if an electric current had passed through her body. She quickly clicked the button and answered it with an excited voice: "Hello, Xu Qiu!"

Since the world's first complete cranio-cerebral separation surgery at the beginning of the year, Xu Qiu has neglected neurosurgery.

Ceutical-Jakob disease, which belongs to the Department of Neurology, does not count.

This year, she saw a genius in neurosurgery go astray, doing a modified SUN surgery one moment and a palm-finger regeneration surgery the next. In her opinion, Xu Qiu should be locked up in neurosurgery, and he should be locked up in a small dark room until he opens up a few restricted areas for brain surgery!