The National Healthcare Security Administration has released multiple batches of project approval guidelines, which new "aging friendly" price items will be added

2024-11-15

Recently, the National Healthcare Security Administration has accelerated the preparation of pricing project approval guidelines, and has released multiple batches of approval guidelines including nursing, comprehensive examination, ultrasound examination, and rehabilitation. These guidelines aim to establish a series of "aging friendly" pricing items from different service scenarios and perspectives, in order to encourage and support medical institutions to provide diversified and high-quality medical services to the public, especially the elderly, ensuring that they can have a safe, effective, convenient, and reasonably priced medical experience. Promote artificial intelligence technology assisted rehabilitation examination With the acceleration of population aging in China, the incidence rate of chronic diseases of the elderly is increasing year by year, and the demand for rehabilitation medical services of the elderly is increasing. In response to the problems of inconsistent names and unclear policy boundaries of rehabilitation projects in various regions, the National Healthcare Security Administration has standardized and integrated commonly used rehabilitation projects into 17 price items based on functional impairment types. Combined with the characteristics of rehabilitation treatment, rehabilitation training projects are priced uniformly according to the duration, in order to facilitate better implementation and evaluation. At the same time, the National Healthcare Security Administration is promoting the application of artificial intelligence technology in assisting rehabilitation examinations or training. The rehabilitation examination or training conducted using artificial intelligence technology will be used as an extension of the rehabilitation project. These extension items have the same output as the main service, but differ in service methods or application scenarios, and are priced according to the main service. The setting of expansion items provides a fast track for the improvement and progress of medical technology, enabling medical institutions and enterprises to receive policy support for improvements made on the basis of existing price items, thereby quickly solving the charging needs of medical institutions. It is expected that by the first half of 2025, after the implementation of rehabilitation project guidelines in various provinces, rehabilitation services assisted by artificial intelligence technology can be charged at the same price level as the main item, avoiding duplicate charges with the main item. This will enable medical institutions to train medical personnel to provide rehabilitation services, as well as use artificial intelligence technology to assist in rehabilitation examinations or training, which is beneficial for the application and promotion of AI assisted technology in clinical practice. Meeting the diversified medical service needs, some elderly patients have a strong demand for single room wards due to poor sleep or disease rehabilitation needs. At present, the resources of single room wards in medical institutions are not sufficient to meet these needs, and relevant departments are promoting the aging friendly and convenient transformation of hospital wards. In order to encourage medical institutions to optimize the allocation of medical resources and further improve the hospitalization experience of patients, the project guidelines stipulate that the bed fees for single rooms that meet the personalized needs of patients shall be adjusted by the market, and the medical institutions shall independently and reasonably formulate the charging standards, which shall be chosen by patients themselves; For those who cannot meet the conditions of a single room with an independent bathroom and air conditioning, the medical insurance department will urge medical institutions to strictly control the bed fee charging standards, or temporarily implement the original government guidance price, to prevent the medical experience from not improving and the burden of medical treatment from increasing. At the same time, the project guidelines emphasize that the hospital bed fees for two, three, and multiple rooms that meet the basic needs of the public will continue to be guided by the government to maintain their public welfare positioning, thereby ensuring overall stability in the burden on the public, affordability of medical insurance funds, and sustainable development of public medical institutions. In addition, in response to the medical problems of the elderly, weak, bedridden or mobility impaired, the National Healthcare Security Administration has absorbed local exploration experience and established "home bed construction fees" and "door-to-door service fees" based on the actual needs of the masses, promoting the extension of medical services to patients' families. Among them, for patients who meet the conditions for setting up family beds, medical institutions will dispatch medical personnel to provide on-site bed and file services. When medical institutions provide medical services to outpatient or home bed inpatients, they adopt a charging method of "door-to-door service fee+medical service price". That is, the door-to-door service itself charges a "door-to-door service fee", and the medical services, drugs, medical consumables, etc. provided are subject to the medical price policy implemented by this medical service. Establishing unaccompanied care services to reduce the burden on family members In order to solve the common problem of "one person hospitalized and the whole family rushing around" in families, the National Healthcare Security Administration has added a "unaccompanied care service" pricing item, in which professional nursing staff from medical institutions undertake all life care for patients. This not only helps improve the quality of nursing, but also greatly reduces the burden on patients' families. It is reported that the "unaccompanied care service" is subject to government guided pricing management and is only applicable to special grade and first grade nursing patients, and is temporarily not included in medical insurance. This group of patients usually accounts for about 10% of hospitalized patients. Patients or their families can choose to receive "unaccompanied care services" provided by medical institutions, or choose socialized and market priced caregiver services. Since the launch of the "unaccompanied care service" pricing project, it has received widespread support. Industry insiders pointed out that the establishment of this project has expanded new development space for the nursing industry, created new expectations for attracting more talents to join the nursing industry, and is expected to optimize the overall supply of nursing resources, improve the professional level and service quality of nursing. With the increasing attention of the elderly to palliative care, the National Healthcare Security Administration actively responds to the national call to improve the quality of life of end-stage patients and promote the rational allocation of medical resources, and has established a separate "palliative care" project in the comprehensive examination project guidelines to guide the continuous improvement of medical service levels. The 'palliative care' service not only includes routine diagnosis and care, but also includes physical, psychological, mental, and humanistic care services for terminally ill or elderly patients, aiming to help patients spend their final stage of life in a relatively comfortable, peaceful, and dignified manner. According to the project guidelines, once a medical institution charges for the "palliative care" project, it will no longer charge the "inpatient examination fee" and "graded nursing fee" again. In addition, the National Health Insurance Bureau has also set up bedside ultrasound, Internet diagnosis (re consultation), remote monitoring and other service projects in project initiation guidelines such as ultrasound examination and comprehensive diagnosis, to provide more convenient medical services for the elderly and other patients with mobility difficulties. These measures will guide medical institutions to continuously improve medical services, making it more comfortable and convenient for elderly people to seek medical treatment. The introduction of a series of "aging friendly" pricing policies not only promotes medical institutions to provide more diversified, personalized, and high-quality medical services, allowing elderly patients to enjoy a more comfortable medical experience and more intimate services, but also further stimulates the rapid growth of demand for elderly medical services and promotes the development of the elderly health industry. (New Society)

Edit:He Chuanning    Responsible editor:Su Suiyue

Source:Guang Ming Daily

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