全科医学 第4讲 Family Practice Management.ppt

PracticeManagement

P411-419

《全科医生执业方式和服务模式改革》的主要内容

引导全科医生以多种方式执业政府为全科医生提供服务平台推行全科医生与居民建立契约服务关系按签约服务人数收取服务费规范全科医生其他诊疗收费合理确定全科医生的劳动报酬加强全科医生服务质量监管探索建立分级医疗和双向转诊机制《浙江省基本医疗保险付费方式改革》的复合式付费体系实行总额控制，推动医疗保险后付制向预付制转变统筹考虑定点医疗机构级别、类别、特点、承担的服务量以及承担的首诊、转诊任务、门诊就诊率、住院率、均次费用、费用构成、目录外自费比例、成本调整等因素，合理确定各定点医疗机构年度医保基金支付预算总额门诊在总额控制基础上，积极探索按人头付费落实签约医疗机构和医保医师的医疗服务责任，将门诊按人头付费与家庭医生制、社区签约首诊、大医院专家社区预约诊疗等相衔接住院及门诊大病、常见病在总额控制基础上，逐步推行按病种付费、按床日付费Costofopening/runningamedicalclinic?Cananyonetellme(someonewhoactuallyknowsplease)howmuchitwouldcostto1)openanewclinic2)maintaintheclinic.Iknowitvariesdependingonlocation,Iamlookingforasuburbancomparison.Itwouldbeextrahelpfulifanyonehasexperiencewiththecostofrunninganaturopathicclinic.BestAnswerMyfriendshe5othersopened2clinics.At3yearsouttheyworkfornothing(nosalary)asanyprofitgoesintorunningtheclinics.Thefrontofficestaffisalltheirkidsspousessotheyarefreeaswell.ToopencostEACHofthemupfrontalmost1million--forthebuilding,theequipment,refurbishingthebuildingtohealthOSHAhandicappedcodes,trainingthestaff,purchasingthelabxrayequipment,softwareforbillingEMR,gettingannualinspections,purchasingasmallpharmacysupply,regularsupplies,computersforcharting,younameit.Daytoday,Idonotknowthecosts,exceptnoonehasseenasalaryyetthatisaprinciple;thestafftheyhired(includingme)getspaidofcourse.Thereisalsothebackofficestufflikemalpracticeforeveryone,payrollaccountingservices,insuranceaccounts,workerscompcharges,inspectionfees,etcetc.

项目预算（万）备注计划申报1卫生局、民政局、规划局、环保局等房租10城乡结合部1200平米，诊间20间，20张病床房屋改造及装修5环评7非放环评2万，放射环评5万污水处理1家具5诊察床、病床、输液椅等网络建设5服务器1台，电脑5台X光机5F50—100II50毫安床旁X射线机。国产DR约50万康复设备5颈椎、腰椎牵引设备、拉力器、划船器、肌肉训练器、滑轮吊环、拐杖、平行木、轮椅和助行器、中频治疗仪、脉冲电疗机、音频电疗机、超短波治疗机、红外线治疗机、磁疗机、生活训练用具、针灸用具等三大常规仪器10日常医用仪器3听诊器、血压计、医用推车、氧气瓶、高压灭菌设备、洗衣机、电冰箱