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省府将大幅削减不必要医疗开支达八千万





根据环球邮报的报道,8月23日上周四,安省政府宣布取消安省医疗保健计划(Ontario Health Insurance Plan,OHIP)中多项非必要医疗服务,包括在医生诊所做怀孕尿检,清除耳垢,以及不严重的髋/膝关节疼痛接受核磁共振(MRI)或断层扫描(CT)检查等。削减服务将于今年10月1日生效,此项改革可以为省府每年节省大约8300万元。

上周四,安省政府与安省医学协会(Ontario Medical Association,OMA)公布安省医疗保健计划(OHIP)的十几项变革,目的是节省资金,保护患者避免接受不必要检查和治疗带来的风险,也将服务更加集中在真正有需要的患者身上。

今年2月,安省仲裁官员卡普蓝(William Kaplan)领导的工作组对省府与医学协会的观点进行了协调,目标是在本财年为省府节省1亿元,下一财年再节省3.6亿元,总额达4.6亿元的资金。



OHIP改革是省府与医学协会达成了共识的结果,节省资金为8300万,距离省府的目标1亿元还有部分缺口。

安省医学协会代表、多伦多西区医院神经麻醉师特南本(Paul Tenenbein)指出,这些建议是基于证据、最佳实践以及与专家咨询,协会与政府的共同目标是提高医疗系统的服务质量。

省府代表泰博(Joshua Tepper)是北约克综合医院的行政总裁,他与特南本医生共同主持这个工作组。泰博表示,改革反映出医疗体系现代化面临的持续挑战。

安省卫生厅长叶励雅(Christine Elliott)的发言人表示,政府的宗旨是接受任何保护和提高患者护理质量的建议。

自由党临时党魁傅雷瑟(John Fraser)表示,更大的挑战还在后面。



安省医疗保健计划中被取消的服务如下:

* 不再对鼻窦问题拍X光或非必要的精确检查,可节省199万元;

* 停止给门诊病人使用老旧的动态心电图检测仪,可节省852万元;

* 家庭医生不再给患者近期发生的同样不适症状重复转介专科医生,可节省660万元;

* 清除耳垢服务仅限于耳垢导致的听力丧失或无法用处方药治愈的情况,可节省260万元;

* 取消手术前不必要的“病史和身体状况”评估,可节省616万元;

* 医生上门服务仅限于身体虚弱的老年人和无法出门的病人,可节省1850万元。



* 对慢性髋关节和膝关节疼痛患者减少不必要的CT和MRI成像扫描检查以及手术咨询,膝关节关节镜检查微创手术不再适用于退行性膝关节疾病患者,可节省1000万元;

* 医生不会开出没有必要的CT和MRI的检查处方,患者也不必接受不必要的X光射线,同时节省1200万;

* 更新门诊心脏监测标准并使用更现代化的设备,可节省2327万元;

* 减少在诊所的尿液妊娠试验,该测试的信息也会少于血液妊娠试验,可节省77万元;

* 减少不必要的喉部(声带)检查,可节省67万元;

* 严格设定可接受不孕症诊断的宫颈粘膜测试范围,可节省3万元;

据报道,安省2019-20年度支付医生的工资约136亿,全安省医疗预算总额635亿元,占比不到22%。



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