Nowadays, the community hospital at the "doorstep" of residents has gradually entered the hearts of residents by virtue of its advantages of being close to home, short queues and fast medical treatment. So, does the problem of "difficulty in dispensing" that has plagued community hospitals for many years still exist?
"Thank you so much to the community health service center for making my mother's rare disease medication so convenient and saving half of the cost through the wonderful hands of the community family doctor team!" The gold and silver cups are not as good as the reputation of the common people, and a compliment from the mouths of the residents may represent the true feelings of most residents.
What is the progress of the problem of "difficulty in dispensing medicines" in community hospitals? Can residents get rare medicines? With such questions, the residents came to the Laoximen Street Community Health Service Center (hereinafter referred to as Laoximen Social Health).
Let rare drugs no longer be rare
"Dr. Kong Chunhui from Lao Ximen Social Health is my mother's family doctor, can he prescribe medicine?" Recently, Ms. Chen, a citizen, called the 12345 citizen hotline to consult whether her mother's rare disease medication "Wei Wanxin" could be prescribed from a community doctor. It turned out that Miss Chen's mother, Grandma Jin, suffered from transthyretin amyloidosis cardiomyopathy (commonly known as "starch heart") and needed to take Pfizer's innovative drug for rare diseases in China, chlorabendazole acid soft capsules (trade name: Wei Wanxin), but the high price of 4~50,000 yuan/box put a lot of pressure on the whole family, although the drug entered the medical insurance catalog through national negotiations in 2021, it still needed 16,000 yuan/box.
Soon, the matter was transferred to the old Simon Social Guard. According to Zhong Jie, deputy director of Laoximen Social Health, Miss Chen's mother, Grandma Jin, has been at Dr. Kong Chunhui for daily diagnosis and treatment for a long time, and for a period of time, Grandma Jin's unexplained heart failure made Dr. Kong very puzzled, and at his suggestion, Grandma Jin obtained the final diagnosis of transthyretin amyloidosis cardiomyopathy in Zhongshan Hospital. This result made Ms. Chen's family's financial burden immediately increased, even if the cost of medicine has been reduced, but Zhongshan Hospital is not equipped with this drug, with a prescription from a tertiary hospital, you still need to pay 38% of the proportion of self-payment at the pharmacy, and the amount of payment for this drug alone is as high as 6,080 yuan per month! In late November 2023, Ms. Chen heard that through hierarchical diagnosis and treatment, electronic prescriptions can be issued at community family doctors, and they can also be settled according to medical insurance at pharmacies, and the cost is lower. In order to figure out how to go to the community to issue an electronic prescription, Ms. Chen called the 12345 citizen hotline, and the scene at the beginning appeared.
Zhong Jie told reporters that after receiving this matter, the center attached great importance to it and immediately sent the medical department and the pharmacy department to inquire about the inclusion of the drug in the medical insurance. In order to help patients facilitate the dispensing of medicines and save medical expenses as much as possible, Sun Lei, the chief of the pharmacy department, took the initiative to call Ms. Chen, reminding Ms. Chen of the medical history and documents that she needs to bring to the clinic next time, and to accompany Ms. Chen to register, prescribe and charge through the electronic prescription circulation mode during the whole process on the day of treatment.
On the day of the visit, Director Chen Min, who received the patient, prepared a handwritten prescription for the patient just in case. After more than an hour of on-site communication, Ms. Chen finally received a box of "Wei Wanxin" in the first medical store according to the community's 20% payment ratio, saving more than 3,000 yuan a month. Ms. Chen sincerely sighed: The combination of the family doctor system and the hierarchical diagnosis and treatment system truly allows citizens to reap the convenience and benefits of seeing a doctor in the community! Mom's rare disease medication has become so convenient through the wonderful hands of the community family doctor team, and it has also saved half of the cost, so thank you so much to the community health service center!
Zhong Jie said that it has always been the wish of the medical staff of the entire center to make "rare drugs" no longer rare and allow residents to solve the problem of dispensing drugs in community hospitals "at their doorstep". In April and August 2023, the Municipal Health Commission issued documents one after another, encouraging all districts to establish their own formulary catalogs for chronic diseases and common diseases in each medical association. Combined with the drug needs of residents in the jurisdiction, expand the local drug allocation, adjust and optimize the drug supply catalog.
Today, there are 687 kinds of drugs without extended prescriptions and 1,061 kinds of medicines containing extended prescriptions, an increase of 33 varieties compared with the same period last year.
Hotlines and extended prescriptions to solve people's worries
"For example, azelastine hydrochloride nasal spray for asthma and respiratory diseases, we did not have it last year, and after residents reported the need for this kind of medicine through the hotline, we have increased it this year." In Zhong Jie's view, this hotline has solved the drug needs of many residents for the center, "Residents express what they want through the hotline, and our staff will record it, and then pass it on to the group where our cadres belong, and try to introduce the medicines needed by residents to the center." ”
In addition, the extended prescription service was also upgraded in January this year. When a contracted resident who is referred by a family doctor from a community hospital to a higher-level hospital returns to the community for treatment, the family doctor can continue to use the same drugs prescribed by the specialist doctors of the higher-level hospital, including non-essential drugs that are not available in the local drug depot in the community, and deliver them to the community health service center free of charge through third-party logistics, so that people can get the relevant drugs nearby.
In addition, Laoximen Social Health also provides medical services for residents through the additional "Internet +" outpatient clinic, "Doctors can diagnose and treat patients at any place through mobile phones, and at the same time rely on Chinese medicine or medicine to deliver medicines to patients' homes." Zhong Jie said.
In Zhong Jie's view, the center collects patients' drug needs through online + offline, before and after diagnosis and treatment, and during diagnosis and treatment, and continuously expands the local drug library. At the same time, the introduction of "Internet +" outpatient clinics, and make full use of electronic prescriptions, extended prescriptions and other policies and measures to benefit the people and facilitate the people, so as to meet the drug needs of community residents for common and frequent diseases.
In a previous interview, Wen Daxiang, Secretary of the Party Leadership Group and Director of the Shanghai Municipal Health Commission, and Director of the Municipal Administration of Traditional Chinese Medicine, said that reviewing the "community changes" this year, the types of diagnosis and treatment diseases that can be carried out by the community health service center have increased, and the diagnosis and treatment ability of patients with common, frequent and chronic diseases has been improved, and there are more drugs that can be dispensed. In view of the fact that there are still residents who feel that "some drugs cannot be dispensed in the community", which is related to multiple factors such as the different quantities of drugs in hospitals at all levels, and the shortage of some drugs due to the shortage of raw materials, the Municipal Health Commission will continue to promote the expansion of the community health drug catalog.
Reporter / Zhang Yi
Editor / Huang Qianwen
Photo / Laoximen Street Community Health Service Center
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