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Total paid medical system Pathfinder
This year, the Ministry of Human Resources and Social Security has been brewing in the health care payment mechanisms in more action, and in the outpatient service and capitation payment system is activated, the total payment mechanisms in place to implement once meet resistance. Recently, the Ministry of People s Insurance Health Insurance Secretary, Yao said: "At present, the document issued, many places do not know how to do. Capitation payment total should explore ways to explore the direction is more to the hospital medication autonomy. "
This reporter has learned that China s current health insurance fund is facing the pressure of rising medical costs. According to statistics, China s per capita health expenditure growth of 14%. This time, the Ministry of People s Insurance medical institutions and health care departments want to be able to do risk quintals.
In order to enhance the enthusiasm of medical institutions, the People s Insurance Department will carry out exploration by DRGs, plans to give hospitals more autonomy, the specific course of treatment, the hospital can have more right to the drug of choice.
To achieve this goal, the People s Insurance Department will also reform the management of health insurance directory, Yao said: "The future of drug A and Medicare B directory to gradually eliminate the difference, directory management audit will also change, to quality control to gradually direction of development. "
Annual cost settlement
Total amount of prepaid health care system is Medicare departments of medical institutions in the assessment, to calculate the per capita health care costs, costs of the standard here fixed to the hospital pre-paid medical expenses, if the actual cost overruns, cost overruns in part by the hospitals themselves.
At present, most areas have adopted pay-for-service payment. Than the current Medicare payment, the total pre-paid system to enhance control of medical practices, can effectively improve the health care institution to open a large prescription, chaos checks, arbitrary charges, any expansion of services and other defects.
According to Reporters learned that Shanghai has been the pilot of the total amount paid by the mechanism, health insurance departments are organized every year on the 1-year hospital Medicare to negotiate with the hospital total costs, this amount paid on an annual basis negotiations have been in containing health care expenses rapid growth has played a role.
Yao said: "In the past health care sector is concerned about the budget and settlement of revenue management, is to focus on strengthening expenditure budget management, group management, the various groups need to calculate the settlement amount of expenditure and how much different hospitals and expenditure budget What is the amount. "
For this reason, people carry out in co-ordinating the Department made a "how much money to do many things" concept. According to Yao introduction: "I basically made the calculations, according to these hospitals to calculate the tax-free high-tech enterprises, commercial drugs counted as income tax, business is good."
The health care sector is now facing pressure than in large medical institutions, due to rising medical costs, the threshold current deductibles and payment lines have no control over pay increases.
Total prepaid system, however there are some problems, the total pre-paid method is usually to pay for health care institutions a year total, in this case, the hospital is the biggest risk.
Medical institutions and doctors in order to improve the enthusiasm of the People s Insurance Department plans to phase out the use of medical management and the right medicine to the hospital.
The right medication to be delegated
About how to assess the value of medical services, Yao said: "Medicare should pay for health economics from the perspective of input and output, health insurance departments should also strengthen the research in this area."
In recent years, with investment in improved health care and medical institutions in support of the policy, after years of expansion of development, China s medical institutions, health care quality has also improved, but, once the hospital s total control of a charge in the cost fixed case, how to ensure quality of care? This is a problem faced by medical institutions, but also the challenges facing drug development companies.
According to Yao introduction: "The future medical treatment for full liberalization of the right, according to the DRGs of the pilot hospitals, the patient medication will no longer points A and B drugs, drug use entirely by the hospital to decide how to evaluate hospital , on how to use drugs. "
In addition, the choice of drugs in the directory, the People s Insurance Department has new ideas. Yao said: "The meaning and management of drug prices to adjust the starting point, what is the price of the drug purchase, should cure the patient as a starting point, to consider the economic value of pharmaceutical drugs."
Social Security Medicare national human researcher Dong Zhaohui said: "A new drug program is not cost-effective, we should pay for the new treatment program cost? If this treatment be integrated into the health insurance reimbursement directory, how to be drug list? Last , from the perspective of equity and efficiency, what treatment should be encouraged to limit what treatment options? these issues will be fairness in the assessment and evaluation of the budget in the affirmative. "
Ensure perfect maintenance Introduction to German Clinical Engineering Management
Currently, the hospital medical equipment, fixed assets accounting for the proportion is increasing. Of Zhejiang Province, the major hospital medical equipment, hospital fixed assets accounted for 1 / 3 to 1 / 2, the amount to several hundred million dollars from tens of millions of yuan range. How to use medical equipment in the application of scientific and efficient management has become the normal operation of the hospital in one of the basic work is very important. It also asked the medical management of medical equipment medical equipment in use must have a scientific, rigorous, efficient, development of management thinking and management tools, and transactional management model can not meet the development needs, the need for management of all system theory to guide the process of establishing standards for the systematic management model, changing only in transactional work Gangjumuzhang to advanced management philosophy of continuous self-improvement in order to adapt to the environmental development.
Reporters in June 2005 with the Health Department of Zhejiang Province, organized delegation of medical device management technology to Germany for a number of medical institutions were investigated to understand the management of its medical equipment and management systems, medical equipment procurement management, quality assurance of medical devices and risk management. German hospitals in the medical equipment management, strategy and daily management measures, there are many advanced concepts and methods we can learn, learn.
Clinical Engineering Department is the primary sector in the German hospital medical equipment to ensure the success of the role of an important sector, the project managers, biomedical engineers, clinical engineers and other accessories. According to focus on work, the department can be divided into: one of the main department responsible for maintenance, parts replacement referrals, routine maintenance and repair, project management; department two main responsible for procurement, inspection equipment (including safety and function tests), project registration, records management, contract management, the reported loss and replacement of equipment. Just from the division of labor, it seems that with the country\\ s hospitals is no different, but the number of personnel and technical standards are obviously better than the national hospital.
■ advanced facilities
In Germany, medical institutions, clinical engineering work from the actual workplace considerations, clinical technology and clinical engineering departments generally adjacent to an emergency to facilitate a timely response, which is the country\\ s hospitals located in the basement of the Equipment Division , the edge of the corner there are obvious differences.
Münster University Hospital and the San Lucas at the hospital clinical engineering department, maintenance area are equipped with cranes and all kinds of line maintenance tools, equipment and a large number of monitoring equipment (such as electrical safety analyzers, ecg simulators, defibrillator analyzers, infusion pump analyzer, electro-surgical device analyzer, digital multimeter, oscilloscope, and x-ray inspection equipment, etc.), and a full range of machine tool facilities, maintenance engineers table facade design is also very reasonable, and a variety of interfaces, and a sound grounding protection.
■ work initiative
German hospital clinical engineering department has a clear mode characteristic – medical equipment for clinical passive, less maintenance, proactive, planned, preventive maintenance (pm) very well. This is because the law forced the hospital for safety and quality control. In Germany, health care institutions in the management of medical devices are legally binding, the iec, iso and eu norms of a large number of standards, recommendations and pointers, must be strictly managed in accordance with prescribed procedures. pm is one of the important content. pm is the regular monitoring of medical equipment, maintenance and quality assurance, its main purpose is to reduce the use of equipment failure caused by medical malpractice; to ensure safe and effective; extend equipment life, reduce equipment cycle costs; to comply with relevant laws and regulations requirements.
Establishment of such a management system requires the following procedures pm: First of equipment risk analysis, a clear risk level to determine the test items, cycle, step; employ relevant staff, the purchase of the necessary testing equipment; determine the device\\ s detection cycle, according to the need to observe test results and test the device\\ s state of the project cycle to adjust.
pm steps are: regular maintenance (including lubrication, adjustment, etc.), performance testing, electrical safety testing, test data recording equipment, labeling. Only for the general visual equipment, conventional and environmental testing. However, the sensitivity for high-maintenance equipment would need to follow these steps to carry out step by step. For example, Münster University Hospital, Department of Biomedical Engineering, with a separate ventilation pm departments, each ventilator use, ventilator requirements of both internal and external piping for perfect cleaning, disinfection, machine maintenance, preventive maintenance , functional testing, the final label, clinical sign engineer to ensure that the next patient use the safe operation of respiratory function, a hundred percent good. Because properly maintained, many in the country has basically been out of the old model is still normal breathing machine, both to ensure the safe and saving medical equipment investment. Of course, also be equipped with a certain amount of spare equipment used for working capital.
In Cummings large hospitals, medical engineering department established a computer program management of the pm program; Department of Biomedical Engineering at the San Lucas Hospital, in the labeling with the device management – file management device with bar code labels can be used hand-held barcode readers and handheld computers simple and accurate fixed asset management, as well as to confirm the date of the management and maintenance of equipment pm confirmation mark.
■ participate in the management
German hospital clinical engineering department, including not only the conventional sense of the functions of procurement, inspection, training, maintenance, repair and asset management, is also involved in the development of hospital policy goals, such as hospitals and infrastructure projects, the financial cost accounting, clinical research projects working for the realization of the hospital efficient running low, make a significant contribution to technological development; appropriate, the department has also been the hospital management\\ s attention, in terms of staffing, training and other aspects of the hospital\\ s support.
Recommendations in the medical engineering department and management, procurement of equipment into the hospital very rational, but the quality control management is a big investment, including advanced testing equipment, cleaning and disinfection of equipment; In addition, equipment management and technical personnel are highly professional skills from routine equipment operation, basic theory, computer applications as well as board-level repair, metal processing, measuring and testing should be a certain degree of proficiency, confirms the quality of medical engineers to improve their own professional development is a fundamental discipline.
Contrast our case, the domestic medical institutions Clinical Engineering Division has experienced decades of development from scratch, to the 1990s has a certain scale. However, in recent years, with the medical device technology development and introduction of a large number, medical engineering department of the hospital but appeared functional weakening of the phenomenon of loss of personnel. The reason is because China has not addressed the medical institutions in the quality management of medical device laws and regulations. Medical institutions has yet to create a complete set of scientific management, hospital leaders re-purchase of equipment, light management; engineering and technical personnel not actively involved in clinical medicine and effective implementation of the quality control of medical devices.
Various medical institutions in Germany, under the constraints of the relevant laws and regulations, medical institutions and medical staff with clinical engineering and other disciplines on the development status of the investment in medical equipment, use, maintenance and quality control from the dominant position. This will help ensure the continued development of medical technology and medical safety and quality.
Four years, new medical reform plan to be ready to come to achieve health insurance, medical and pharmaceutical linkage
Medical reform has now entered deep water, deep-seated contradictions touched more and more increasingly difficult. Reform, such as riding a boat behind, and only continued forward. Must conscientiously sum up more than two years experience in the practice of health reform, pay close attention to the development of "second five" deepening medical and health system planning. — Li
With 2012 approaching, the new three-year mandate health reform countdown. Where the next step toward health reform, it is society as a whole are very concerned about the topic. Recently, Hu Jintao, Vice Premier Li Keqiang in the "Seeking Truth" published an article, require careful summary of more than two years experience in the practice of health reform, pay close attention to the development of "second five" deepen the medical and health system planning. This means that a new four-year medical reform program (the "second five" has been a year) will soon emerge.
Advisory Committee members of the health reform: new plan introduced late this year or early next year
Li Keqiang, this is called "the deepening medical reform in line with national conditions to promote the establishment of the health system to benefit all the people," an article published in the November 16 issue of the twenty-two this year, "Seeking Truth" magazine. Article published in a few days before the State Council Medical Reform Office of the seventh plenary session was held, to discuss the main content is the "second five" medical reform plan to develop the situation. National Development and Reform Commission deputy director, Office of the State Council, Director of Sun Zhigang, health reform at the meeting pointed out that "five" medical reform plan is the next four years the guiding document for health reform. Requires careful drafting group meeting of the member units to absorb the views and suggestions, revise and improve the health reform as soon as the report of the State Council Leading Group meeting.
As early as June 23, Li Keqiang, the State Department to participate in medical reform Expert Advisory Committee at its first plenary meeting, he proposed to "focus on key and difficult problems in research, planning a good second five health reform plan."
The day of the birth of the Medical Advisory Committee to change the positioning of medical reform program is the commitment to consultation and demonstration, the local health reform practices research, analysis assessing the effect of health reform, suggestions and ideas as well as public information.
As health care reform one of 36 members of the Advisory Committee, Professor of Peking University s Guanghua School of Management, China Economic Research Center Director Liu Guoen Health attended the two meetings, and participate in the "second five" medical reform draft plan consultation. He told reporters the South, after the June meeting, 36 experts and scholars according to their research interests or expertise to collect and collate data, analyze data, make recommendations, report writing, for the formation of the final health reform plans do provide a reference. He estimated that the end of this year or early next year will put health care reform plan.
Sun Zhigang was held August 18 in the "2011 China Health Forum," revealed that the next five years to promote health care reform need to focus on five tasks: establish universal health insurance system with Chinese characteristics; expand deepen the reform of public hospitals; prominence to training training; further promote drug production and distribution sector reform; continue to enhance the level of the equalization of public health services.
These signals show that the path the next few years, health reform is gradually clear.
Li Keqiang: medical reform "bow is no turning back."
In early 2009, the State Council issued the recent focus on medical and health system implementation plan (2009-2011). The industry as a portfolio of new health care reform, including five key reforms: accelerating basic medical security system, the initial establishment of a national essential drug system, improve primary health care service system, promote the equalization of basic public health services and promote public hospitals reform.
Li Keqiang, "Seeking Truth" published an article on the new three-year evaluation of health care reform, "said the five key reform measures recently put in place gradually, marking the initial task of health care reform has made important progress." As a universal basic health care to benefit about 95% of the country population, the grass-roots organizations drug prices down 30% on average, three new medical reform central government funds 331.8 billion yuan and so on.
However, Li also pointed out that health reform also faces many difficulties and challenges, mainly in: long-standing shortage of basic medical insurance, the total lack of medical resources and configuration unreasonable, urban and regional imbalance in health development, talent is weak and "drugs make doctors" and other conflicts still exist, medical treatment is difficult and expensive problem is rather prominent. Meanwhile, progress remains uneven around the reform, medical reform policies and some local funds may not be implemented, mechanisms and system construction is lagging behind.
Li Keqiang said, "bow is no turning back." Medical reform has now entered deep water, deep-seated contradictions touched more and more increasingly difficult. Reform, such as riding a boat behind, and only continued forward, in order to consolidate and develop the results of the previous stage of reform, achieve greater progress. To explore health care reform must be out of this worldwide problem of Chinese-style solution to the road.
Scholars: should realize health insurance, medical and pharmaceutical linkage
New health care reform is just a three-year mandate to complete summary, go to "deep water" and the road will be what health reform as a major force point? In Liu Guoen seems, is still the most important reform of public hospitals. Through the reform of public hospitals "in increasing vitality, plus push" to achieve. Within the system that is perfect the mechanisms of activation by the medical staff motivation and energy to improve the effectiveness of the service capacity. "The most important is to implement an independent public corporate governance structure of the hospital, president of the cadres from the business into a professional manager, the responsibility, authority and clearly defined through the contract form, activate the power." In the outside, you need the government to optimize social Office of Medical conditions, health care professional the whole society platform, so that medical staff have more choices, can facilitate the free movement of competition among hospitals, in turn, will also play a catalytic role in the reform of public hospitals.
Peking University s China Center for Economic Research Li Ling, deputy director also believes that the next few years, health reform should be the main point is to accelerate the force of public hospital reform, from the pilot into a fully open, and resolve to hold down prices, excessive medical treatment and other issues. Ling said the new medical reform more than two years, the biggest effect is basically to achieve full coverage health insurance, but the only solution was to pay for health insurance problems, the hospital is providing services side, is the core strength. However, in recent years, the reform of public hospitals is still lagging behind, the mechanisms and medical benefits or reduce health care has not been checked over. Medical institutions operating system is still built on the expanding volume of medical services, such as more drugs, more checks, in which case, the actual mechanism of health care over health care in the hospital for further stimulus, because the more services, from social security in can get the money more. Now to really provide appropriate medical care, the right medicine, your doctor can really solve the problem. The next step must be to achieve health insurance, medical and pharmaceutical linkage, to form the three together, otherwise people are still not affordable.
TI for medical imaging applications to provide the best noise performance and low power ADC
Texas Instruments Incorporated (TI) announced the industry s best noise performance with minimum power consumption of 80MSPS, 8-channel 14-bit ADC (ADC). The ADS5294 can be 5MHz to support 75.5dBFS best signal to noise ratio (SNR), the sampling rates up to 80MSPS, fully meet the designer of the high power efficiency and low cost designs. ADS5294 at 80MSPS and can provide high performance under 77mW per channel, the lowest power consumption, integrated digital processing block, low-frequency noise suppression mode, and programmable input to output mapping function. All of these features can help the designer in a smaller package to integrate more features to the development of smaller medical imaging systems.
Key features and benefits
Industry-leading low-power low-noise performance: ADS5294 provides best-of SNR, can help designers of high-density applications without increasing power consumption in case of increased number of channels;
5MHz/80MSPS when the SNR is 75.5dBFS
5MHz and the decimation filter is enabled when the SNR is 78.2dBFS
SFDR of 84dBc at 5MHz/80MSPS
Under the power per channel 80MSPS 77mW (two per channel LVDS line)
Low-frequency noise suppression mode
Digital processing blocks integrated system of several commonly used functions, such as 2, 4 or 8 filter with dual-channel or 4 channel average or extraction function;
Digital processing block can be used to greatly enhance the SNR and harmonic filters, narrow-band applications, while reducing the output data rate;
Dual LVDS interface: The ADS5294, the digital data available for each single or dual channel LVDS output pins to reduce the number of interface lines. This will create a two-wire interface, serial data rates to maintain low to enable designers to use low-cost FPGA;
In addition to medical imaging systems outside, ADS5294 also for radar, communications, test and measurement, and other multi-channel data acquisition applications bring the same advantages.
Availability and Packaging
12 mm x12 mm, 80-pin QFP package ADS5294 is available now.
Tools and Support
To test the ADS5294 under a variety of situations to provide flexible environments, evaluation boards now (EVM) has started to provide. ADS5294EVM can be ordered through the following site.
Verify circuit board signal integrity requirements of IBIS models are available now.
Highly optimized simulation products and a full range of products medical applications
ADS5294 is optimized for TI s analog products, the newest member, designed to meet the medical imaging systems and other medical applications. Include:
Ultrasound: Ultrasound applications AFE58xx family for analog front end for handheld systems AFE5801 and AFE5851, for portable to mid-range systems AFE5805 and AFE5804, and high-end ultrasound systems AFE5807 and AFE5808.
TITX810T / R switch on the transmitter all the complementary products;
ECG / EEG: ADS1298 series of front-end for the electrocardiogram (ECG), electroencephalogram (EEG) and other patient care applications to bring the highest integration and lowest power consumption.
TI s full range of medical applications, including semiconductor products and other embedded DSP and MCU processor, rich analog signal chain, power management and wireless connectivity solutions to help manufacturers accelerate the medical electronics market.
China is expected to become the world s largest medical device market
Fuji Photo Film (China) Investment Co., the former vice president of 27 Goto Tanigaki said, as China\\ s accelerated urbanization in rural areas and expanding middle class, China is expected in the future to become the world\\ s largest medical device market.
Goto radiation in the 2011 academic year in North America during an interview with reporters, said it is optimistic about China\\ s medical device market, General Electric (GE), Siemens and Philips, the world giant in the medical field on the layout of the 1990s, China market, Hitachi, Toshiba and other Japanese manufacturers are the late 1990s into the Chinese market. Recently, due to appreciation of the yen, export medical devices to reduce profits, many Japanese companies to invest in China began to accelerate speed to market.
Goto said, at the same time, China\\ s local enterprises is also increasing. Five years ago, not a Chinese company will participate in academic radiology in North America. This year, attend the annual meeting of Chinese enterprises reached more than 10, hundreds of participants.
2011 school year will be the North American radiation from 25 to 30 in Chicago McCormick Convention Center, attracting 60,000 from around the world industry participants.
Talking about health care reform in rural China and rural urbanization impact on the medical device market, Goto said, the acceleration of urbanization in rural areas led to the proliferation of small towns, people increase the demand for medical care. However, due to the small town of resources and medical qualifications of doctors as large cities, the popularity of the Internet gave birth to a business opportunity: small town doctor can be taken through the network spread to large hospitals, medical images, physicians, hospitals, large physician from the diagnosis of views. He disclosed that the company is currently in progress in this regard Fuji attempt, cooperation with local enterprises in China, for small towns to provide medical diagnostic products and services.
Goto Tanigaki stepped down in January this year to return after he was responsible for business in China for seven years.
U S researchers a breakthrough in fight against Ebola virus
Interfere with the use of genetic material in particulate Ebola virus propagation research breakthroughs. Laboratory studies have shown that Ebola virus infection in monkeys receiving the Ganges a pilot drug treatment mortality.
According to Agence France-Presse reported, Boston University School of Medicine, "the country of potential infectious disease lab" experts 托马斯盖斯 Burt led the team to select two groups of Ganges monkeys application of this test drug. According to reports, the drug containing small interfering RNA of the Ebola virus can damage the reproductive mechanism of action of the enzymes needed to achieve the purpose of interfering virus propagation.
The researchers first for the first group of three monkeys injected dose can be lethal Ebola virus subtype "Ebola – Zaire," the next few days, these monkeys injected continuously for four experimental drugs, the result of which a monkeys died.
The second group of four monkeys injected the same dose of the virus subtype, after receiving seven consecutive experimental drug treatment, the results of all survived.
Two sets of experiments in both monkeys infected after a monkey did not receive the experimental drug treatment, and ultimately death.
Gaisibote said that this is the first time, researchers have developed a make non-human primates infected with Ebola virus survived the drug breakthrough. Based on this study, is expected to develop such a test batch preparation of drugs for the treatment of Ebola cases.
Ebola virus can be transmitted through blood and secretions can lead to Ebola virus hemorrhagic fever, the patient may include fever, nausea, vomiting, diarrhea, body aches, and in vivo bleeding and other symptoms, mortality rate of about 50% to 90 %.
According to data released by the World Health Organization, the first time since 1976, has been found infected with Ebola virus, the global total of about 1850 cases of such cases reported, of which about 1,200 deaths.
The study published in the latest issue of the medical journal "Lancet" on.
Fudan University develops high precision navigation system neurosurgery
Shanghai Science and Technology \", the plan was\" subject \"precision neurosurgery navigation system,\" Digital Medical Research Center of Fudan University has successfully developed, Huashan Hospital and other units recently completed clinical trials.
The surgical navigation system with a computer, so craniotomy \"hit rate\" higher. To brain tumor surgery, for example, the traditional craniotomy approach is first based on MRI, CT and other imaging data, to determine the exact location of tumor, in order to formulate surgery. To ensure accuracy, often relatively large incision surgery, the doctor can see only the surface of exposed organs. If you accidentally damage a major blood vessels, tissue, lead to disastrous consequences; If for \"prudent\" and less removal of some tumors, and could have serious consequences. What cut much more deeply cut, mostly dependent on the doctor\\ s personal experience.
\"High-precision neurosurgery navigation system\" to MRI, CT and other medical imaging data based on the computer shows a three-dimensional visualization of the \"virtual human brain.\" Doctors in the hands of the probe point where, if the tumor has reached the edge of the front is not important to the organization, and so on. After accurate positioning, the computer displayed on the screen will be 11. Thus, under the guidance of the probe scalpel, you can safely step by step approach cancer, sure. Clinical trials showed that high-precision navigation technology, surgery can be centimeter-level positioning accuracy becomes millimeter, the average navigation accuracy less than 2 mm.