After the implementation of DRG payment reform in many places, some hospitals are reluctant to accept "complex patients", in this regard, industry insiders said: once the cost is exceeded, the hospital needs to bear its own costs, "hard work for a month, the result of the department deduction money", "the patient's complaint is just an ordinary disease, a check found that there are a variety of comorbidities".
Recently, after the reform of the payment according to disease diagnosis-related groups (DRGs) in many provinces and cities, the growth of medical expenses has been significantly controlled, but a new situation has emerged: some medical institutions are reluctant to accept complex patients. According to industry insiders, "there are many operation steps that need to be dealt with for complex patients, and the cost is significantly exceeded after benchmarking against DRG." According to the existing medical insurance regulations, doctors often have to do hard work when it comes to reality. ”
Professor Gao Jiechun, director of the Hospital Management Institute of Fudan University, gave an analogy to reporters: The variety of medical insurance payment is like "a restaurant", and DRG payment is more like "a variety of packages at a variety of prices". However, when the cost is reduced, the disadvantages of DRG payment are gradually emerging. A doctor in a hospital explained that ordinary pneumonia is used as a trap for "severe pneumonia", which may bring more benefits to the hospital; under this guidance, medical institutions may be reluctant to admit truly complex cases, and intensive care and other departments with difficult and miscellaneous diseases will also be greatly affected.
To tell the truth, I'll just ask what kind of system this is, I'm a medical worker, and the doctor is tired enough, so I can't be pitted by the doctor, right? In the long run, it is the unlucky patients who can't be used for imported medicine, all of them are domestic drugs to see a doctor, the hospitalization expenses are down, the number of days of hospitalization is long, and it is possible that many patients will be delayed! The system is updated and optimized, but it must be reliable, otherwise it can only be counterproductive!