Some patients are required to undergo repeated examinations when seeing a doctor, which is expensive and time-consuming.
Why did the CT scan I just took no longer recognize it when I changed hospitals?
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After just finishing the examination in the hospital, if you change to another hospital or even another campus or department, you need to check again, which is expensive and time-consuming. This situation makes many patients very angry when seeing a doctor. In this regard, professionals suggest that mutual recognition of inspection and test results in medical institutions should be promoted to save patients money and time and reduce expenditures on medical insurance funds.
"Six days ago, I just had a CT scan at a hospital in the city. After I took the film to the county hospital in my hometown, I didn't expect to have it done again." On January 2, Ms. Guo from Henan accidentally fell and died. Hit to the head. She had a CT scan at a nearby hospital and was later diagnosed with a temporal bone fracture.
As the Spring Festival was approaching and it was inconvenient to be hospitalized alone, Ms. Guo decided to return to her hometown for treatment. On January 8, Ms. Guo brought the film to the county hospital. To her surprise, the doctor ordered CT again. "The same examination items and the same examination parts, why can't I recognize it when I switch to a small hospital and have to do it again?" Ms. Guo was full of doubts. The doctor at the county hospital told her that she needed to see dynamic images, so she had to obey the arrangement. In the end, the two inspections turned out to be exactly the same.
Ms. Guo’s experience is not unique. Repeated examinations have always affected patients' sensitive nerves. Problems such as repeated examinations when changing hospitals or even changing campuses or departments make some patients very angry. In fact, in order to reduce the burden on patients and reduce the waste of medical resources, relevant departments continue to implement and promote mutual recognition of inspection and test results of medical institutions (hereinafter referred to as mutual recognition of medical inspections), and many places have achieved remarkable results. However, there are still concerns among medical institutions and medical staff in some places that they are unwilling or afraid to admit it.
There are hospitals where different departments and campuses do not recognize each other for inspections.
In July 2023, Mr. He from Chongqing felt stomachache after eating seafood. When he visited the gastroenterology department of a hospital near his home, he underwent multiple examinations including abdominal CT, MRI, and blood tests. The results showed that he had intestinal obstruction. The doctor believed that the situation was serious and needed to be transferred to surgery for surgical treatment.
The next day, after Mr. He was transferred to the surgery department, the doctor asked for a re-examination. "The check-up was just completed the day before. Doing it again will not only cost more time and money, but may also delay the condition." Mr. He said.
In fact, as early as 2006, the former General Office of the Ministry of Health issued the "Notice on Issues Concerning Mutual Recognition of Medical Examinations and Medical Imaging Examinations among Medical Institutions" to promote the implementation of a mutual recognition system for medical examinations. Since then, the mutual recognition policy for medical examinations has been continuously improved, and various localities have assisted in the implementation of mutual recognition of medical examinations by formulating policies and building information platforms.
The "Measures for the Management of Mutual Recognition of Inspection and Test Results of Medical Institutions" that will be implemented in March 2022 clearly states that medical institutions and their medical staff should conduct inspections marked with the national or regional mutual recognition mark without affecting the diagnosis and treatment of diseases. Mutual recognition of inspection results, as well as mutual recognition of other inspection and inspection results.
Pu Lei (pseudonym), a doctor at a well-known tertiary hospital, told reporters that if the surgeon believes that Mr. He's condition has changed after a day, the CT and blood routine can be redone, but other examinations generally do not need to be redone.
Mr. Qiu from Nanyang, Henan Province, encountered situations where different campuses of the same hospital required repeated examinations. In August 2023, Mr. He went to a tertiary hospital in Zhengzhou for treatment. After a puncture examination, he was diagnosed with a malignant tumor. The doctor recommended that he be transferred to a new hospital for treatment. Five days later, Mr. Qiu was transferred to the new hospital, and the doctor asked him to do another puncture. "The hospital does not perform punctures on Fridays and weekends. It takes four days to get the results after the puncture is completed, which is equivalent to an extra week of waiting." Mr. Qiu said.
Regarding Mr. Qiu's situation, Pu Lei believes that unless the doctor feels that the puncture result is not satisfactory, for example, the puncture did not reach the part he wanted to see, there is no need to re-examine.
Mutual recognition of medical examinations will help reduce cost burden
Lou Yu, a professor at the School of Civil and Commercial Economics at China University of Political Science and Law, said in an interview with a reporter from Workers' Daily that for patients, mutual recognition of medical examinations can not only save patients time and money, but also reduce the pain caused by some examinations. In addition, it can also save medical insurance costs and reduce medical insurance fund expenditures.
"According to the medical insurance policy, the examination fees of insured persons are mostly paid by individuals and medical insurance funds. Among them, the personal part includes two channels: personal direct payment and medical insurance personal account payment. Medical insurance fund expenses mainly come from insured unit payments and government subsidies. Reduce Repeated examinations mean reducing the cost burden on insured persons, medical insurance funds and the government," Lou Yu said.
"For hospitals, the most direct benefit of mutual recognition of medical examinations is to speed up bed turnover and reduce the situation of not being admitted to the hospital or waiting in line for hospitalization." Pu Lei revealed that his hospital, such as CT, MRI, PET-CT and other images Or data information can basically achieve mutual recognition across the country.
Lou Yu said that in reality, there are many reasons why examination and test results do not recognize each other. “Some are at the technical level of diagnosis and treatment. Different medical institutions and doctors have different understandings of the same condition, adopt different treatment plans, and have different requirements for examinations.” ;Some are at the human level, and individual medical institutions may conduct repeated inspections and excessive inspections in order to obtain higher profits."
Deng Liqiang, executive director of the China Health Law Society and deputy director of Beijing Huawei Law Firm, analyzed that the reason why the same medical institution requires repeated examinations may be because the hospital's medical treatment process is solidified. If a patient needs to undergo a certain operation, he must follow the process. Examination, as for whether the patient has just been examined, the doctor thinks it has nothing to do with him and will not flexibly control it.
"It cannot be ruled out that some medical staff may take defensive medical actions and ask patients to re-examine themselves in order to avoid practicing risks," Deng Liqiang added.
Take multiple measures to promote mutual recognition of medical examinations
Although the mutual recognition system for medical examinations has been continuously improved in recent years, and many places have established mutual recognition mechanisms, Pu Lei believes that there is still a long way to go for mutual recognition of medical examinations. "The main reason is that the testing levels of different hospitals vary greatly. At present, mutual recognition of medical testing is still limited to items with less impact from human factors."
In Pu Lei's view, medical institutions should break the information barriers between different hospital districts and departments, and achieve timely mutual recognition of in-hospital inspection and test results. Relevant departments should help grassroots medical institutions update hardware equipment in a timely manner, strengthen training for inspection and inspection personnel, unify technical and quality control standards, and promote cross-institutional mutual recognition of more inspection and inspection items.
"Currently, mutual recognition of medical examinations is still somewhat subjective." Lou Yu said that on the one hand, there are no clear legal provisions on what repeated examinations are and who determines them; on the other hand, some repeated examinations may involve multiple It is difficult to identify the autonomy of medical institutions and doctors in prescribing, which is also one of the factors that hinders the further implementation and promotion of mutual recognition of medical examinations.
In response to the problem of repeated examinations caused by generating income, Lou Yu suggested promoting payment by patient group and point method. Based on historical data, the diagnosis and treatment plan is divided into several payment groups according to the amount of medical resources consumed. The same payment group no matter how much the medical institution actually spends Medical resources and medical insurance funds are paid according to unified payment standards, which makes medical institutions lack the motivation to conduct excessive inspections and repeated inspections.
"The ideal mutual recognition model for medical examinations is to establish a medical community, coordinate multiple medical institutions in the region or nearby to form a medical service community, and adopt the same diagnosis and treatment plan and mutual recognition mechanism within the community to enhance medical service capabilities and improve medical insurance. The efficiency of fund use will optimize the medical experience of insured persons," Lou Yu said.
Deng Liqiang said that mutual trust between doctors and patients is an important requirement to further promote mutual recognition of medical examinations. Doctors will no longer worry about getting into disputes and will prescribe fewer defensive examinations. Patients will save time and money, and doctors can treat patients with peace of mind. (Worker Daily reporter Tao Wen)