Not long ago, Ms. Feng, who was preliminarily diagnosed with thyroid cancer in Yan'an, Shaanxi Province, rushed to Beijing with a series of checklists. Unexpectedly, the attending doctor asked Ms. Feng to check the full set again. Such a large number of repeated examinations aroused Ms. Feng's dissatisfaction, and after the publication of the report, it also aroused the public's expectations for "mutual recognition of medical examinations".
The problem of "mutual recognition of medical examinations" has been around for a long time, and repeated examinations not only bring greater economic burden to patients, but also consume more time and energy for patients, which greatly undermines patients' experience of medical treatment.
To this end, as early as February 2006, the former Ministry of Health issued a notice requiring medical institutions to establish a system of mutual recognition of inspections, including not only mutual recognition of test results, but also mutual recognition of inspection data. In July 2, the former Ministry of Health issued the Notice on Strengthening the Construction of Medical Quality Control Centers and Promoting the Mutual Recognition of Inspection Results of Medical Institutions at the Same Level, which made detailed provisions on the relevant work. In March 2010, the National Health Commission, the National Health Insurance Administration and other departments jointly formulated the "Administrative Measures for Mutual Recognition of Inspection and Inspection Results of Medical Institutions", which pushed the relevant work to a new height. Against this backdrop, it is understandable that patients are still suffering from repeated examinations, which has sparked heated discussions.
Why is a job still facing such and such blockages from 2006 to the present?
The first is that the endogenous motivation of medical institutions for this work is insufficient. After so many years of medical reform, there is a problem that has always plagued the development of hospitals. That is, the return on human labor is too low. Although the technical value of doctors has been greatly improved after several medical price adjustments, compared with the overall development level of society, few hospitals can still allow doctors to obtain a decent income through registration fees. Now that there is no markup on drug costs and consumables, the labor income of doctors, or the outpatient income of hospitals, mainly depends on various laboratory tests. In particular, patients who see a large hospital may have all kinds of tests done more than once in other hospitals, and if these tests are all mutually recognized, the financial situation of these large hospitals will be affected.
Secondly, the changes in the human body are continuous, and the changes in many conditions are unpredictable. Therefore, the time limit of an examination is difficult to determine. For a patient with intracerebral hemorrhage, as long as there are changes in vital signs, a CT scan of the head is required to determine the changes in bleeding and adjust the treatment plan. Routine blood tests or blood biochemistry may change from day to day. This does bring variables to the doctor's judgment. Therefore, doctors are more likely to get the latest test results from the bottom of their hearts, which is an important reason why they are more willing to repeat the test results. In the report, some experts also suggested that in response to the issue of legal liability, the relevant departments should improve legislation and implement the corresponding responsibility allocation mechanism.
In addition, there are always some inspection items in large hospitals that are different from other hospitals, sometimes checking an inspection is also a check, checking a bunch of inspections is also checking, since you want to check the results of the items, you just come to it again. This is also the psychology of some doctors when they choose those tests that can be prescribed or not.
In short, although "mutual recognition of medical examinations" is an important means to optimize the medical process, there are still many blockages, and it is necessary to improve the mutual recognition standards, establish incentive mechanisms, and strive to enhance the enthusiasm of medical institutions for active implementation. Just as drug markups can cause hospitals and some doctors to prescribe large quantities, when testing income becomes an important source of income for hospitals, prescribing more tests becomes an option in medical behavior.
Shanshui Source: China Youth Daily