"After waiting in line for more than 3 hours, we only stayed in the consultation room for 1 minute, and the doctor asked us to go for an examination, and we waited for more than half an hour to pay for the examination. Finally, after the examination and the results were out, I went to the doctor to read the report, and I had to queue up to pay the medicine fee in less than two minutes. ”
One night a few days ago, because the child had a high fever of 39 degrees, Wang Xi, a resident of Qingdao City, Shandong Province, came to the hospital with the child, but he didn't expect that there were more than 180 people in front of him, and it was already 8 o'clock in the evening. She waited patiently for the doctor, spending nearly 5 hours before and after, and the time to actually see the doctor was 5 minutes at most, "the rest of the time was spent on queuing up to pay the fee in all aspects of getting the number, checking and prescribing medicine." This can't help but make her sigh: can we optimize the medical treatment process and make it more convenient to see a doctor and pay the fee?
There are not a few people who have the same experience as Wang Xi. Recently, respiratory infectious diseases such as influenza and mycoplasma pneumonia have increased, and the queues in tertiary hospitals, especially children's hospitals, in many cities across the country are serious. The reporter of "Rule of Law**" noticed that the queue was mostly at various payment windows. Many patients or family members complain that they have to queue up to pay fees in each link of the hospital, taking numbers, checks, testing, and medicines, and the cumbersome process makes medical treatment long and difficult. Once there is a problem with the multi-function self-service machine in the hospital, even if it is repaired quickly, it will lead to a large number of patients who are not able to see the doctor.
The charter from Hedong District, Tianjin is stuck in the payment link of the multi-functional self-service machine. Recently, at 8 o'clock in the morning, he took his child to a tertiary hospital, at this time the outpatient hall was already full of people, and the queue in front of several multi-functional self-service machines was getting longer and longer, and there was no sign of moving forward. It turned out that there was a problem with the machine and I couldn't swipe my medical insurance card. "There is no choice but to wait, once the machine fails, even if it is only a few minutes, the queue for payment will be stretched in an instant. The charter says.
According to Zhang Mei, a resident of Beijing, there are often long queues in hospitals, and although there are factors that medical resources cannot meet the needs of patients, the unreasonable design of the treatment process is also one of the important reasons. In order not to waste time, she first searched for various strategies on the Internet, and finally summed up a set of optimal plans: the emergency department should take the child for pre-diagnosis, and the outpatient clinic can directly take the number and line up to the triage table to open the test sheet without taking the child, and then hurry up and queue up to pay the fee on the machine, and trot to draw blood and queue up, which may be dozens of numbers in 1 minute. After the estimated time, go home and bring the child over, wait for the results to come out and let the doctor see it, and then quickly go to the queue to pay the fee, and finally go to get the medicine.
Even if not a minute or second was wasted, in the end, it took 4 hours for the child to see a doctor. It would be nice if you could scan the code to pay the fee, or can you try to pay later?This will definitely save you a lot of time. Zhang Mei said.
The reporter noticed that the "diagnosis and treatment before payment" model proposed by Zhang Mei has been carried out by many hospitals across the country.
In 2022, the Health Commission of Lianyungang City, Jiangsu Province issued the "Work Plan for the Implementation of "Diagnosis and Treatment Before Payment" in the Outpatient and Emergency Department of Medical Institutions in Lianyungang City (Trial), and citizens can sign a contract for "diagnosis and treatment before payment" when making an appointment. Once**, you can complete the whole process of consultation, examination, laboratory test, medicine collection and other operations, without on-site payment.
In Suzhou, Jiangsu Province, the "diagnosis and treatment first, pay later" medical service currently covers more than 70 hospitals. It is expected that by the end of this year, it will basically cover the city's secondary medical institutions and realize the access and operation of 90 hospitals.
Zhuhai, Shenzhen, Guangzhou and other places in Guangdong Province have also launched a trial trial of "credit medical treatment" this year, allowing patients to pay the fee "at most once".
Dozens of medical institutions in Shijingshan District, Dongcheng District, Fengtai District, Miyun District and other places in Beijing provide "credit + medical" services to the society. Statistics show that the length of stay in the hospital has been reduced by an average of 60%.
On November 28, the reporter came to Beijing Zhongguancun Hospital and saw a notice of "credit medical treatment" erected next to the self-service machine. It is understood that customers aged between 18 and 62 years old who pay social security normally in Beijing can apply, and after opening, they can apply for a credit line, pay after diagnosis and treatment, and save time waiting in line for payment and payment.
While waiting in the hospital, the reporter saw that many patients were using "credit medical treatment" for self-help**. Before coming to the hospital to see a doctor, you have to pay the fee first and then check, the doctor prescribes the medicine and has to pay the fee first and then get the medicine, back and forth queue waste a lot of time, now the doctor has issued a bill to directly check, take the medicine, and finally pay the fee, which is much more convenient!One patient said that although "credit medical treatment" saves time, but can only apply for a credit line from a designated bank, and it is more troublesome if there is no bank card, "It would be better if you could authorize the bank card of any bank bound to Alipay and WeChat for credit medical treatment."
On November 26 this year, the National Health Commission said at a press conference that outpatient services should be optimized, and the implementation of first medical treatment and then payment, no need to pay for the whole process of medical treatment, credit payment after consultation, and minimize the waiting time of patients during the treatment process.
In the view of Liu Xiaofeng, director of the Medical and Health Legal Professional Committee of the Shaanxi Lawyers Association and director of the administrative and medical law department of Shaanxi Xu Xiaoping Law Firm, how to simplify the medical treatment process and improve the people's medical experience has always been an important work for health departments at all levels to actively explore and improve and the payment system, so much so that the civil affairs department also specifically requires medical institutions to reserve 30% of the offline number source to facilitate the elderly to seek medical treatment.
Wang Yue, a professor at Peking University's School of Medical Humanities, believes that there is no problem in implementing the "first visit and pay later" model, especially for the vast majority of medical insurance patients and patients with good credit.
Electronic payment has been widely popularized, and there is a complete credit evaluation system behind it. Nowadays, in many scenarios such as car rentals and hotels, consumers can pay without a deposit, and medical institutions can also follow the development trend of this society and change the process in time, which can save the time of most patients. Wang Yue said.
However, Deng Liqiang, executive director of the China Health Law Society, believes that the premise of "first treatment and then payment" is the improvement of the citizen integrity system. "In reality, many public medical institutions have arrears and evasion, and there are very few that can be recovered, and most of them can only be processed by financial write-offs. In order to avoid this kind of evasion and arrears, some hospitals put the responsibility of preventing patients in arrears from 'escaping' on the ward and on the doctors, which increases the burden on doctors and is very unreasonable. ”
In response to the problem of the capital flow of "credit medical treatment", the reporter combed through the public information and found that some areas are taking measures to plug the loopholes and realize that the whole process of capital flow can be monitored.
Taking Zhuhai City, Guangdong Province as an example, the insured can only open the "credit medical treatment" service after passing multiple identity verifications such as the national medical insurance electronic certificate, Guangdong Provincial Unified Identity Authentication, and Guangdong Credit Signature. In case of malicious arrears, the hospital can upload blacklist data and suspend the insured's "credit medical treatment" qualifications, and the insured during the blacklist period cannot enjoy medical insurance treatment in any medical institution in the city, and the blacklist can only be lifted and the medical insurance treatment can be resumed after the arrears are paid off.
In Liu Xiaofeng's view, models such as "diagnosis and treatment before payment", "scan code payment" and "online payment" can be further realized in the future, but in the process, it should be noted that the patient's medical expenses are pre-deposited through the third-party payment platform and transferred to the medical insurance payment platform or medical institutions, and even have the function of balance and storage, so it should be implemented by the platform with the qualification to operate financial business, and it is necessary to ensure the safety of the people's funds. On the basis of ensuring the safety of funds, the operation method should be simplified as much as possible and convenient for the elderly to use.
In addition, a large number of examination and diagnosis results are fed back to patients through online platforms, although the number of queues can be reduced, but the protection of patients' privacy, the declassification of medical information of specific groups of people (such as military personnel and military scientific researchers), and the statistics of diseases in specific regions and groups cannot be ignored, so the data compliance construction of medical institutions should attract sufficient attention. Liu Xiaofeng said.
Wang Xi, charter, and Zhang Mei are pseudonyms in the article).
Rule of Law ** Reporter Zhang Shoukun).