Take medicine "can not give or take an injection, injection will not infusion" of the world health organization (who) medication principle, in China have been reversed. Driven by the interests of all parties, China became the world's leading "infusion powers".
The state food and drug administration has issued a warning, as early as 2007 children under the age of two, in principle, without the use of anti cold medicine. As for through transfusion treatment for colds, is hard to imagine that in the United States.
Infusion "put up a charge platform", pull the related industries, has formed a complete chain of interest. Infusion products of any "technical improvement" - even if in a cork - means that millions or even billions of market.
"How can literally to the National People's Congress report that?"
10.4 billion the possibility of a large number from the hospital. And usually the hospital Numbers than the enterprise.
When a nurse will infusion needle into the scalp, 1 year old son cried, Beijing residents Li Wenjuan (not her real name), dull ache in his heart, but her comfort myself: the child's illness will get better soon.
On January 13, this is Beijing children's hospital, Li Wenjuan is the son of one of the hospital every day infusion of 3000 patients. And many (perhaps most) children, because of his cold here to seek treatment.
Li Wenjuan didn't know it, infusion will let her children face many risks. Chinese hospital association, the national rational drug use monitoring office loyal sun says experts, the state food and drug administration has issued a warning, as early as 2007 children under the age of two, in principle, without the use of anti cold medicine. As for through transfusion treatment for colds, is hard to imagine that in the United States.
Infusion is not a new problem in China. ", in fact, can take medicine injection, injection will not infusion "of the world health organization (who) principles, in the reality has been reversed. Within a decade, with the reform of China became the world's leading "infusion powers".
Infusion problems caused by the Chinese people strong focus, because of the national development and reform commission zhu zhixin, deputy director of years ago on the 18th session of the standing committee of the 11th National People's Congress revealed a few Numbers: 2009, 10.4 billion in our medical infusion bottle, equivalent to 1.3 billion people each lost eight bottles of liquid, far higher than international level of 2.5 to 3.3 bottles...
In statistics about the livelihood of the people in China, the per capita indicators are mostly behind the international average level. , however, is rare in the field of medicine and health care. Before "infusion eight bottles per person", another popular theory is that China's per capita usage of antibiotics, is 10 times in the United States.
On January 11, the ministry of health spokesman deng haihua said, will through the reform of public hospitals to improve "infusion excessive" problem, and considered the actual approved "the infusion bottle" 8 per person.
However, in the medical and health system, "eight bottles of" per capita has caused a backlash. The ministry of health of the rational use of drugs, deputy director of expert committee member Wu Yongpei told the southern weekend reporter, he was deeply suspicious of the authenticity of the digital.
"I don't know where is this number, I think not." Wu Yongpei said.
Wu Yongpei told the southern weekend reporter, after zhu zhixin said he had, he had to call a large infusion domestic corporations to verify in person, the other party told him that the company in 2009, a total of 2.21 billion bags infusion products, its production accounted for 27.9% of national output. Wu Yongpei calculated that the infusion production of the products is 7.92 billion bags, digital is far lower than the zhu zhixin said.
Wu Yongpei didn't explain the origin of the market share Numbers, and to our reporter revealed that the manufacturer's name.
Wu Yongpei said, in the context of the doctor-patient relationship nervous, as director of the national development and reform commission, the health care work of leadership, saying such things zhu zhixin "should not".
"How can literally to the National People's Congress report this? Do you have any basis in science?" Wu Yongpei said, "you can tell him, if he agree, I would like to debate with him."
Southern weekend reporter, called the national development and reform commission, the secretariat, hope contact zhu zhixin I interview about infusion, was declined.
As research infusion industry many years of industry experts, China medical equipment engineering association secretary-general Gu Weijun for 10.4 billion bags of digital basic recognition. Because zhu zhixin part-time, director of the reform of the state council office of Gu Weijun speculation, 10.4 billion the possibility of a large number from the hospital, and usually hospital Numbers than the enterprise.
Despite questions about digital accuracy, but Wu Yongpei also acknowledged that China is indeed excessive "infusion" problems, single for patient groups, infusion volume per capita is higher than developed countries more than two times.
Annual production capacity: 11 years increased four times
China's infusion products although the quantity is big, but export ratio is extremely low, the vast majority of in patients in China.
Gu Weijun said, China chemical industry association statistics, 1998 production quantity is 1.9 billion bottles, infusion combined with hospital infusion 4.5 billion bottles, but a total of 2.4 billion bottles per person is less than two bottles. When enterprise's goal is to expand production and cut down the price, in order to catch up with foreign average (2 to 3 bottles), meet the needs of the domestic patients.
Results since then, China's infusion dose by leaps and bounds, an average annual growth rate of nearly 20%, infusion and injection of antibiotics and become, tablet tied for the pharmaceutical industry is one of the five agents, etc. Southern weekend reporter from a about infusion market analysis report to read the words like this:............ In 2001, an upsurge of renovation, construction and expansion of infusion production line across the country... When the output reaches 3.1 billion bottles, namely an increase of 30% over the previous year.
From 1998 to 1998, just 11 years, China's infusion production grew by more than four times, the per capita level beyond abroad more than two times.
China's pharmaceutical enterprises has always been to "do not" much-maligned, infusion industry was an exception, however, in recent ten years, several infusion giants have been rising in China. Which established in 1996, sichuan koren group in a short span of ten years, with annual output of 2 billion bags (bottle) become the world's largest producer of infusion. Gu Weijun said, however, China's infusion products although the quantity is big, but export ratio is extremely low, the vast majority of in patients in China.
Besides infusion products themselves, infusion pulling a number of related industries. According to Gu Weijun, in addition to the 407 infusion production enterprises in China, there are dozens of infusion packaging materials production enterprises, dozens of equipment production enterprise, hundreds of infusion production enterprise, literally hundreds of powder injection and infusion with production enterprises. Any "technical improvement and infusion products" - even if in a cork - means that millions or even billions of market.
Beijing children's hospital, vice President of the former Hu Yiji witnessed the hospital transfusion decades of change: he had become a children's hospital patients a day, 2000 people, infusion of 100 people, however, is usually a very sick man. Infusion from treatment to give medicine method, now the children's hospital medical system every day, 6000 patients, half of them want to infusion.
Risky way of drug delivery
Risk exists in the infusion process of almost all links.
On the evening of November 28, 2010, "per capita eight bottles of" news that less than a month before, 5 years old children Xia Chensen abnormal when infusion in zhangjiagang city first people's hospital, after the death in the rescue process.
By experts investigation, Xia Chensen infusion exception is likely caused by a drug compatibility taboo - there are two kinds of medicine cannot be added to the salt water at the same time.
Within 10 days Xia Chensen is zhangjiagang city first people's hospital of the second infusion after the patients deaths, on November 19, a 53-year-old patients after infusion in the hospital, just out of the hospital that is suddenly fell down dead.
Due to the ministry of health and state food and drug administration has no related statistics, no one knows how many people die each year from across the country due to the infusion caused by adverse drug reactions. From zhengzhou city food and drug administration, however, the corresponding figure for the adverse reaction monitoring center or that the seriousness of the problem: in 2009 the center received ten thousand cases of adverse drug reactions report, intravenous administration (iv) accounted for 84.8%.
Channels through adverse drug reactions in loyal sun, statistical data, is only the tip of the iceberg - because of concerns about medical disputes and reputation damaged, hospitals often are reluctant to report will be the truth.
Medicine, in fact, there is no disagreement: drug directly into the veins, infusion this delivery way is full of risks. Take medicine "can not give or take an injection, injection will not infusion" to become the world within the scope of the consensus.
Shanghai doctor Chen Xiaolan said, risk exists in the infusion process of almost all links, except maybe bring many adverse drug reactions and compatibility taboo, for patients, the operation of the medical staff (piercing process, dripping speed and dosage), and the quality of brine (syrup), the quality of infusion sets and syringes, are likely to lead to serious consequences. Once appear problem, and there are very few with batches of infusion and liquid for testing.
Compared with the pure salt or sugar water, some therapeutic infusion products may contain more risks. 2006 hin eph (clindamycin phosphate glucose injection) is one of the typical events, the therapeutic infusion products caused the 11 patients died, after the state food and drug administration that the drug is not according to the original approval process. However, the personage inside course of study to the southern weekend reporter said, in fact not the drug should be approved for infusion products.
Besides, to a "safe" for the characteristics of traditional Chinese medicine, after making into infusion products, also often become deadly killers, such as ShuangHuangLian, heartleaf houttuynia herb, zedoary turmeric oil and other TCM injections in recent years, frequent problems. Because of security problems, the state food and drug administration review center have to start to review at the end of 2009 TCM injections ShuYeXing drugs.
The majority of patients in China, however, no one tell them these are not hard to understand risk, as was the case with Li Wenjuan, the idea of people only - infusion of good fast.
The doctor all into a "bottle"?
Infusion "set up a platform for charging.
Why are Chinese people in the mind has such a strange idea? When they are, is through what way in patients with brain?
In an interview with the southern weekend reporter, a number of medical sources said excessive fluids are both doctors. Loyal sun says, in infusion, the doctor and the patient is "a may play, a may get", while Gu Weijun infusion is regarded as "social problems", is the current fickleness in the society common caused the misunderstanding of "infusion good fast". In addition, there is saying, give patients injections medical staff is no more, "I don't call him (intravenous drip), he will beat me".
Law and medical ethics community, however, some people hold different views about this. Health law scholars ZhuoXiaoQin thinks, the infusion is irresponsible blame on patients. "The doctor-patient relationship, with overall is passive, not misleading as a description of the medical staff infusion does not result in patients with misunderstanding, and even a few patients adhere to unnecessary transfusion, medical personnel not doing their duty, and it will only be on transfusion risk."
Qiu, a researcher at the Chinese academy of medical ethics experts infusion excessive development to today this situation, this is partly because patients awareness of the problem, but the main reason is that medical institutions and medical personnel chasing interests.
"Medicine for the medical mechanism of public hospitals, are widely thought to be caused by infusion of excessive institutional factors. Sun faithfully believes that as a hospital, infusion for patients is not the purpose of transfusion itself, but lies in the combination. Loyal sun, estimates that, unlike several years ago, is very few in the current transfusion pure salt, sugar, water, more than 90% of drug combinations, including antibiotics accounted for a proportion.
Chen Xiaolan fluids is described as "put up a charging platform", not only can charge by dosing for medicine, can also charge to observe (although not necessarily any real observation), ZhuSheFei, fluids, etc.
Shanghai hospital chief physician ma hua (a pseudonym) told the southern weekend reporter, its are in the hospital infusion is directly related to drug kickbacks bonuses and commissions. Infusion for doctors are rarely pure salt and sugar water, often used in combination with other drugs, can large dose use of antibiotics, which commissions are high; For nurses, the bonus payment is linked directly with infusion m, so the nurse also hope that the doctor rolled infusion, some in order to let the doctor behind the dosing infusion to the doctor.
Chen Xiaolan have experience greatly, in the mid - 1980 - s, she recalls, when she study in a hospital, the hospital discovered a doctors give patients injections because often, have been colleagues ridiculed as "bottle". Yet a decade later, Chen Xiaolan found that most doctors became a "bottle". Chen Xiaolan worry, in the present environment, and if limiting fluids, some doctors have not medication.
Who's the boss no infusion?
Enterprise production how many bottles of (iv), medical staff will take how many bottles, ordinary people have to lose how many bottles.
Chen Xiaolan in 2006 to become the Shanghai medical insurance bureau hired several supervisors "society", one of the health bureau at the meeting, once Chen Xiaolan infusion problem put forward their opinions, shouldn't think medicare reimbursement of those unnecessary transfusion therapy. Results a health bureau said: if the patient infusion should be decided by the doctor. Chen Xiaolan thinks: should be decided by the condition.
Chen Xiaolan thinks, transfusion itself are the result of the principle of medical personnel in violation of the drug abuse, and health and hospital management, drug safety, health and other departments inaction and encourage the spread of this phenomenon.
In sun loyal view, infusion flood behind, there is an important institutional factor - the lack of clinical pharmacists jobs. In the United States, established the system of clinical pharmacists in the 1960 s, to oversee the doctor rational use of drugs. And this system in our country is still in the exploration, the loyal sun view, if the system can be successfully established, will effectively control infusion of abuse.
In Chen Xiaolan's opinion, the previous medical system of China, had a "chemist" this important post, its main duty is on drug safety checks. If doctors prescribe insecurity, unscientific infusion, so "chemist" review can be returned to the prescription, the practical function is the control of clinical pharmacists.
In the 1990 s, however, hospital "chemist" into "licensed pharmacists", its original function. So, the Chinese hospital rarely to see pharmacy prescription back phenomenon in drug safety problems.
In Gu Weijun terms, the current hospital pharmacists acted as a "mover" in a sense, the main is to ensure that the hospital drug supply, clinical pharmacists from abroad career orientation.
In recent years, the abuse of antibiotics has caused the great attention of the ministry of health and state food and drug administration, and taken many measures, however, for the same problem of the infusion of abuse, is almost without any control. In sun loyal impression, both the ministry of health and state food and drug administration, has never been alone infusion too much hair file.
As frequent infusion quantity increase sharply and transfusion safety problems, mainly in Shanghai some hospitals have set up "the intravenous drugs allocation centre", the main content is within the hospital set up independent institutions, dispensed under the pharmacists to participate in the focus, to ensure the safety of medical staff and patients.
This approach in practice, however, are mixed. Opponents argue that because of the clinical pharmacists system failed to establish, the essence of this practice is more a "service fee" of pharmaceutical affairs. This fee once approved, is likely to be in the hospital internal set up a new encouragement mechanism of infusion.
And promote the practice of hospital, mostly by the enterprise contributive establish "the intravenous drugs allocation centre", according to China youth daily reported that a couple of hospitals in the implementation of the reform in xinjiang, appear this kind of phenomenon: hospital had sign a contract with company, build dispensing center the latter support the former, the former must use this enterprise production infusion products, and to achieve a certain number.
An unnamed professionals believe that the practice, coincides with the pharmaceutical market a unique phenomenon: not demand determines production, but production needs.
The state food and drug administration has issued a warning, as early as 2007 children under the age of two, in principle, without the use of anti cold medicine. As for through transfusion treatment for colds, is hard to imagine that in the United States.
Infusion "put up a charge platform", pull the related industries, has formed a complete chain of interest. Infusion products of any "technical improvement" - even if in a cork - means that millions or even billions of market.
"How can literally to the National People's Congress report that?"
10.4 billion the possibility of a large number from the hospital. And usually the hospital Numbers than the enterprise.
When a nurse will infusion needle into the scalp, 1 year old son cried, Beijing residents Li Wenjuan (not her real name), dull ache in his heart, but her comfort myself: the child's illness will get better soon.
On January 13, this is Beijing children's hospital, Li Wenjuan is the son of one of the hospital every day infusion of 3000 patients. And many (perhaps most) children, because of his cold here to seek treatment.
Li Wenjuan didn't know it, infusion will let her children face many risks. Chinese hospital association, the national rational drug use monitoring office loyal sun says experts, the state food and drug administration has issued a warning, as early as 2007 children under the age of two, in principle, without the use of anti cold medicine. As for through transfusion treatment for colds, is hard to imagine that in the United States.
Infusion is not a new problem in China. ", in fact, can take medicine injection, injection will not infusion "of the world health organization (who) principles, in the reality has been reversed. Within a decade, with the reform of China became the world's leading "infusion powers".
Infusion problems caused by the Chinese people strong focus, because of the national development and reform commission zhu zhixin, deputy director of years ago on the 18th session of the standing committee of the 11th National People's Congress revealed a few Numbers: 2009, 10.4 billion in our medical infusion bottle, equivalent to 1.3 billion people each lost eight bottles of liquid, far higher than international level of 2.5 to 3.3 bottles...
In statistics about the livelihood of the people in China, the per capita indicators are mostly behind the international average level. , however, is rare in the field of medicine and health care. Before "infusion eight bottles per person", another popular theory is that China's per capita usage of antibiotics, is 10 times in the United States.
On January 11, the ministry of health spokesman deng haihua said, will through the reform of public hospitals to improve "infusion excessive" problem, and considered the actual approved "the infusion bottle" 8 per person.
However, in the medical and health system, "eight bottles of" per capita has caused a backlash. The ministry of health of the rational use of drugs, deputy director of expert committee member Wu Yongpei told the southern weekend reporter, he was deeply suspicious of the authenticity of the digital.
"I don't know where is this number, I think not." Wu Yongpei said.
Wu Yongpei told the southern weekend reporter, after zhu zhixin said he had, he had to call a large infusion domestic corporations to verify in person, the other party told him that the company in 2009, a total of 2.21 billion bags infusion products, its production accounted for 27.9% of national output. Wu Yongpei calculated that the infusion production of the products is 7.92 billion bags, digital is far lower than the zhu zhixin said.
Wu Yongpei didn't explain the origin of the market share Numbers, and to our reporter revealed that the manufacturer's name.
Wu Yongpei said, in the context of the doctor-patient relationship nervous, as director of the national development and reform commission, the health care work of leadership, saying such things zhu zhixin "should not".
"How can literally to the National People's Congress report this? Do you have any basis in science?" Wu Yongpei said, "you can tell him, if he agree, I would like to debate with him."
Southern weekend reporter, called the national development and reform commission, the secretariat, hope contact zhu zhixin I interview about infusion, was declined.
As research infusion industry many years of industry experts, China medical equipment engineering association secretary-general Gu Weijun for 10.4 billion bags of digital basic recognition. Because zhu zhixin part-time, director of the reform of the state council office of Gu Weijun speculation, 10.4 billion the possibility of a large number from the hospital, and usually hospital Numbers than the enterprise.
Despite questions about digital accuracy, but Wu Yongpei also acknowledged that China is indeed excessive "infusion" problems, single for patient groups, infusion volume per capita is higher than developed countries more than two times.
Annual production capacity: 11 years increased four times
China's infusion products although the quantity is big, but export ratio is extremely low, the vast majority of in patients in China.
Gu Weijun said, China chemical industry association statistics, 1998 production quantity is 1.9 billion bottles, infusion combined with hospital infusion 4.5 billion bottles, but a total of 2.4 billion bottles per person is less than two bottles. When enterprise's goal is to expand production and cut down the price, in order to catch up with foreign average (2 to 3 bottles), meet the needs of the domestic patients.
Results since then, China's infusion dose by leaps and bounds, an average annual growth rate of nearly 20%, infusion and injection of antibiotics and become, tablet tied for the pharmaceutical industry is one of the five agents, etc. Southern weekend reporter from a about infusion market analysis report to read the words like this:............ In 2001, an upsurge of renovation, construction and expansion of infusion production line across the country... When the output reaches 3.1 billion bottles, namely an increase of 30% over the previous year.
From 1998 to 1998, just 11 years, China's infusion production grew by more than four times, the per capita level beyond abroad more than two times.
China's pharmaceutical enterprises has always been to "do not" much-maligned, infusion industry was an exception, however, in recent ten years, several infusion giants have been rising in China. Which established in 1996, sichuan koren group in a short span of ten years, with annual output of 2 billion bags (bottle) become the world's largest producer of infusion. Gu Weijun said, however, China's infusion products although the quantity is big, but export ratio is extremely low, the vast majority of in patients in China.
Besides infusion products themselves, infusion pulling a number of related industries. According to Gu Weijun, in addition to the 407 infusion production enterprises in China, there are dozens of infusion packaging materials production enterprises, dozens of equipment production enterprise, hundreds of infusion production enterprise, literally hundreds of powder injection and infusion with production enterprises. Any "technical improvement and infusion products" - even if in a cork - means that millions or even billions of market.
Beijing children's hospital, vice President of the former Hu Yiji witnessed the hospital transfusion decades of change: he had become a children's hospital patients a day, 2000 people, infusion of 100 people, however, is usually a very sick man. Infusion from treatment to give medicine method, now the children's hospital medical system every day, 6000 patients, half of them want to infusion.
Risky way of drug delivery
Risk exists in the infusion process of almost all links.
On the evening of November 28, 2010, "per capita eight bottles of" news that less than a month before, 5 years old children Xia Chensen abnormal when infusion in zhangjiagang city first people's hospital, after the death in the rescue process.
By experts investigation, Xia Chensen infusion exception is likely caused by a drug compatibility taboo - there are two kinds of medicine cannot be added to the salt water at the same time.
Within 10 days Xia Chensen is zhangjiagang city first people's hospital of the second infusion after the patients deaths, on November 19, a 53-year-old patients after infusion in the hospital, just out of the hospital that is suddenly fell down dead.
Due to the ministry of health and state food and drug administration has no related statistics, no one knows how many people die each year from across the country due to the infusion caused by adverse drug reactions. From zhengzhou city food and drug administration, however, the corresponding figure for the adverse reaction monitoring center or that the seriousness of the problem: in 2009 the center received ten thousand cases of adverse drug reactions report, intravenous administration (iv) accounted for 84.8%.
Channels through adverse drug reactions in loyal sun, statistical data, is only the tip of the iceberg - because of concerns about medical disputes and reputation damaged, hospitals often are reluctant to report will be the truth.
Medicine, in fact, there is no disagreement: drug directly into the veins, infusion this delivery way is full of risks. Take medicine "can not give or take an injection, injection will not infusion" to become the world within the scope of the consensus.
Shanghai doctor Chen Xiaolan said, risk exists in the infusion process of almost all links, except maybe bring many adverse drug reactions and compatibility taboo, for patients, the operation of the medical staff (piercing process, dripping speed and dosage), and the quality of brine (syrup), the quality of infusion sets and syringes, are likely to lead to serious consequences. Once appear problem, and there are very few with batches of infusion and liquid for testing.
Compared with the pure salt or sugar water, some therapeutic infusion products may contain more risks. 2006 hin eph (clindamycin phosphate glucose injection) is one of the typical events, the therapeutic infusion products caused the 11 patients died, after the state food and drug administration that the drug is not according to the original approval process. However, the personage inside course of study to the southern weekend reporter said, in fact not the drug should be approved for infusion products.
Besides, to a "safe" for the characteristics of traditional Chinese medicine, after making into infusion products, also often become deadly killers, such as ShuangHuangLian, heartleaf houttuynia herb, zedoary turmeric oil and other TCM injections in recent years, frequent problems. Because of security problems, the state food and drug administration review center have to start to review at the end of 2009 TCM injections ShuYeXing drugs.
The majority of patients in China, however, no one tell them these are not hard to understand risk, as was the case with Li Wenjuan, the idea of people only - infusion of good fast.
The doctor all into a "bottle"?
Infusion "set up a platform for charging.
Why are Chinese people in the mind has such a strange idea? When they are, is through what way in patients with brain?
In an interview with the southern weekend reporter, a number of medical sources said excessive fluids are both doctors. Loyal sun says, in infusion, the doctor and the patient is "a may play, a may get", while Gu Weijun infusion is regarded as "social problems", is the current fickleness in the society common caused the misunderstanding of "infusion good fast". In addition, there is saying, give patients injections medical staff is no more, "I don't call him (intravenous drip), he will beat me".
Law and medical ethics community, however, some people hold different views about this. Health law scholars ZhuoXiaoQin thinks, the infusion is irresponsible blame on patients. "The doctor-patient relationship, with overall is passive, not misleading as a description of the medical staff infusion does not result in patients with misunderstanding, and even a few patients adhere to unnecessary transfusion, medical personnel not doing their duty, and it will only be on transfusion risk."
Qiu, a researcher at the Chinese academy of medical ethics experts infusion excessive development to today this situation, this is partly because patients awareness of the problem, but the main reason is that medical institutions and medical personnel chasing interests.
"Medicine for the medical mechanism of public hospitals, are widely thought to be caused by infusion of excessive institutional factors. Sun faithfully believes that as a hospital, infusion for patients is not the purpose of transfusion itself, but lies in the combination. Loyal sun, estimates that, unlike several years ago, is very few in the current transfusion pure salt, sugar, water, more than 90% of drug combinations, including antibiotics accounted for a proportion.
Chen Xiaolan fluids is described as "put up a charging platform", not only can charge by dosing for medicine, can also charge to observe (although not necessarily any real observation), ZhuSheFei, fluids, etc.
Shanghai hospital chief physician ma hua (a pseudonym) told the southern weekend reporter, its are in the hospital infusion is directly related to drug kickbacks bonuses and commissions. Infusion for doctors are rarely pure salt and sugar water, often used in combination with other drugs, can large dose use of antibiotics, which commissions are high; For nurses, the bonus payment is linked directly with infusion m, so the nurse also hope that the doctor rolled infusion, some in order to let the doctor behind the dosing infusion to the doctor.
Chen Xiaolan have experience greatly, in the mid - 1980 - s, she recalls, when she study in a hospital, the hospital discovered a doctors give patients injections because often, have been colleagues ridiculed as "bottle". Yet a decade later, Chen Xiaolan found that most doctors became a "bottle". Chen Xiaolan worry, in the present environment, and if limiting fluids, some doctors have not medication.
Who's the boss no infusion?
Enterprise production how many bottles of (iv), medical staff will take how many bottles, ordinary people have to lose how many bottles.
Chen Xiaolan in 2006 to become the Shanghai medical insurance bureau hired several supervisors "society", one of the health bureau at the meeting, once Chen Xiaolan infusion problem put forward their opinions, shouldn't think medicare reimbursement of those unnecessary transfusion therapy. Results a health bureau said: if the patient infusion should be decided by the doctor. Chen Xiaolan thinks: should be decided by the condition.
Chen Xiaolan thinks, transfusion itself are the result of the principle of medical personnel in violation of the drug abuse, and health and hospital management, drug safety, health and other departments inaction and encourage the spread of this phenomenon.
In sun loyal view, infusion flood behind, there is an important institutional factor - the lack of clinical pharmacists jobs. In the United States, established the system of clinical pharmacists in the 1960 s, to oversee the doctor rational use of drugs. And this system in our country is still in the exploration, the loyal sun view, if the system can be successfully established, will effectively control infusion of abuse.
In Chen Xiaolan's opinion, the previous medical system of China, had a "chemist" this important post, its main duty is on drug safety checks. If doctors prescribe insecurity, unscientific infusion, so "chemist" review can be returned to the prescription, the practical function is the control of clinical pharmacists.
In the 1990 s, however, hospital "chemist" into "licensed pharmacists", its original function. So, the Chinese hospital rarely to see pharmacy prescription back phenomenon in drug safety problems.
In Gu Weijun terms, the current hospital pharmacists acted as a "mover" in a sense, the main is to ensure that the hospital drug supply, clinical pharmacists from abroad career orientation.
In recent years, the abuse of antibiotics has caused the great attention of the ministry of health and state food and drug administration, and taken many measures, however, for the same problem of the infusion of abuse, is almost without any control. In sun loyal impression, both the ministry of health and state food and drug administration, has never been alone infusion too much hair file.
As frequent infusion quantity increase sharply and transfusion safety problems, mainly in Shanghai some hospitals have set up "the intravenous drugs allocation centre", the main content is within the hospital set up independent institutions, dispensed under the pharmacists to participate in the focus, to ensure the safety of medical staff and patients.
This approach in practice, however, are mixed. Opponents argue that because of the clinical pharmacists system failed to establish, the essence of this practice is more a "service fee" of pharmaceutical affairs. This fee once approved, is likely to be in the hospital internal set up a new encouragement mechanism of infusion.
And promote the practice of hospital, mostly by the enterprise contributive establish "the intravenous drugs allocation centre", according to China youth daily reported that a couple of hospitals in the implementation of the reform in xinjiang, appear this kind of phenomenon: hospital had sign a contract with company, build dispensing center the latter support the former, the former must use this enterprise production infusion products, and to achieve a certain number.
An unnamed professionals believe that the practice, coincides with the pharmaceutical market a unique phenomenon: not demand determines production, but production needs.
An unnamed professionals believe that the practice, coincides with the pharmaceutical market a unique phenomenon: not demand determines production, but production needs. "From this point of view, if there is no strict use restrictions and supervision, enterprise production how many bottles of (iv), the medical staff will take how many bottles, ordinary people have to lose how many bottles." The source said.
This is some industry experts as a "win-win" enterprises and hospitals, but critics worry that the losers will be the patient and the country.
"The doctor told us that risk" - transfusion room site observations
Author: southern weekend interns LiuKuan southern weekend reporter will wood group from Shanghai source: southern weekend
Talk about infusion, the patient's reaction is generally "expensive". "The highest use of cefepime hydrochloride for injection for Ann" a course of 6 teams, need more than three hundred pieces.
This month 13 at 9 p.m, southern weekend reporter came to the Shanghai district central hospital "this infusion room", understand the hospital infusion. This is one of the secondary hospital, the author randomly selected in Shanghai, because fame than 3 armour hospital, secondary hospital reimbursement ratio than regional hospital, so how is the patient less hospital.
In contrast to many department desolate scene, the hospital on the second floor "rehydration room" lively abnormalities. Rehydration outdoor surface has an automatic teller machines, dedicated to selling children infusion dedicated fixed plate, a five yuan, by the Shanghai "nursing innovation research" research and a university hospital. According to the Posting flyers, such "fixed board" can prevent cross infection, but according to the personage inside course of study says, is to prevent children touch my arm to infusion.
"Rehydration room" occupies the second floor, divided into two parts, the adult transfusion and infusion in children. The former has more than two hundred seats, which has nearly one hundred seats in the hall also added many chairs, zhang with a "+" the word number on it, this is normal infusion, additional seats to prepare for more transfusion patients. Children rehydration area there is a room hung with "the injection room" sign, but two hours, I didn't see a patient in an injection.
Patients in the middle of the long queues formed the nurse station, turn several curved, at least more than one hundred people. They are the outpatient service, holding the doctor prescribed medicine and two list, one blue and one red one red list is written in the "intravenous dosing vouchers", indicates that most of them is not a simple rehydration, but through intravenous dosing treatment. In line at the end of Mr Zhang told me: "into the dispensing at least an hour, take a good number to sit on the seat, at least a quarter of an hour to have nurses to injection." Fairly good "now, more people over the weekend, some old people line up to exhaustion, can only sit on the ground."
Nurses have four nurses, they are very busy, work is the charge list of patients and drugs, in infusion with salt water or sugar water labeled, pry injection drugs with forceps, metal bottle caps through one side of the conveyor belt to a pharmacy. Patients with seat number to wait for the nurse. Because the patient always waiting in line, the nurses also moment can't stop. A patient told me, because too busy too tired, the nurses often rotate, she almost every time he comes to infusion will see new faces.
Dispensing room also has four medical personnel, they are responsible for injecting drugs into infusion bag. In order to make timely dissolve drugs, and a dedicated instrument to vibrate. Solution with good later, concentrated to around ten bags, from another sent out at the exit. And then by a nurse wheeled car according to the number in turn give patients injections.
Infusion area infusion area was full, especially children, every child has more than one accompanied by parents, because the seat is not enough, some take small chairs, some can only squat down beside it. Accompanied her daughter's ms xu, told me: "there is not much people, to children's hospital last week, from registration to see a doctor spent five hours, so we choose the hospital in the patients less."
Patient lose medicine is given priority to with antibiotics, reporters interviewed 24 people, found they although patients with colds, urinary tract infections, asthma, bronchitis, pneumonia and other diseases, but drugs are similar, there are 17 people used the cefepime hydrochloride for injection for Ann, four people celebrate toxin was used. A mother surnamed zhang told me that her daughter, the crane is penicillin, because last time hanging hook for cephalosporin five days later, found that have no effect.
Because liquid can only add one drug for each bag, so a lot of the patient's iv poles have different colors of several bags of liquid. According to the medical staff health bureau has a regulation, to ensure drug safety, the same bag in the liquid is not allowed to add two or more drugs.
Because the patient is much, disposable infusion sets and disposable syringe quantity is very big, just one hour, I was twice to see workers moved in several cases of infusion sets. Infusion of medical garbage can, there is a nurse specialized processing used infusion.
Talk about infusion, the patient's reaction is generally "expensive". "The highest use of cefepime hydrochloride for injection for Ann" a course of 6 teams, need more than three hundred pieces. Ms xu told me that the mycoplasma pneumonia, the daughter of hanging water is 15 days, spend at least more than one thousand pieces, with social security card, can be part of a discount.
Despite the complaints, but patients is generally believed that infusion will let their disease good faster. According to the study of 24 patients, there are 19 direct infusion is listening to the advice of a doctor, is his own initiative infusion of five patients. In 19 patients, listening to the opinions of physicians may have four ever asked the doctor to take medicine or an injection, and other treatment, and the doctor's advice is: infusion "good fast" and "avoid into chronic diseases", etc. Have three days of hanging water Mr Sheng to review, the doctor suggested to him "lose three days again, consolidate cement".
Five reason to ask for transfusion patients is also "good infusion faster". When asked about the infusion may bring risk, all respondents said the doctor didn't tell us.
This is some industry experts as a "win-win" enterprises and hospitals, but critics worry that the losers will be the patient and the country.
"The doctor told us that risk" - transfusion room site observations
Author: southern weekend interns LiuKuan southern weekend reporter will wood group from Shanghai source: southern weekend
Talk about infusion, the patient's reaction is generally "expensive". "The highest use of cefepime hydrochloride for injection for Ann" a course of 6 teams, need more than three hundred pieces.
This month 13 at 9 p.m, southern weekend reporter came to the Shanghai district central hospital "this infusion room", understand the hospital infusion. This is one of the secondary hospital, the author randomly selected in Shanghai, because fame than 3 armour hospital, secondary hospital reimbursement ratio than regional hospital, so how is the patient less hospital.
In contrast to many department desolate scene, the hospital on the second floor "rehydration room" lively abnormalities. Rehydration outdoor surface has an automatic teller machines, dedicated to selling children infusion dedicated fixed plate, a five yuan, by the Shanghai "nursing innovation research" research and a university hospital. According to the Posting flyers, such "fixed board" can prevent cross infection, but according to the personage inside course of study says, is to prevent children touch my arm to infusion.
"Rehydration room" occupies the second floor, divided into two parts, the adult transfusion and infusion in children. The former has more than two hundred seats, which has nearly one hundred seats in the hall also added many chairs, zhang with a "+" the word number on it, this is normal infusion, additional seats to prepare for more transfusion patients. Children rehydration area there is a room hung with "the injection room" sign, but two hours, I didn't see a patient in an injection.
Patients in the middle of the long queues formed the nurse station, turn several curved, at least more than one hundred people. They are the outpatient service, holding the doctor prescribed medicine and two list, one blue and one red one red list is written in the "intravenous dosing vouchers", indicates that most of them is not a simple rehydration, but through intravenous dosing treatment. In line at the end of Mr Zhang told me: "into the dispensing at least an hour, take a good number to sit on the seat, at least a quarter of an hour to have nurses to injection." Fairly good "now, more people over the weekend, some old people line up to exhaustion, can only sit on the ground."
Nurses have four nurses, they are very busy, work is the charge list of patients and drugs, in infusion with salt water or sugar water labeled, pry injection drugs with forceps, metal bottle caps through one side of the conveyor belt to a pharmacy. Patients with seat number to wait for the nurse. Because the patient always waiting in line, the nurses also moment can't stop. A patient told me, because too busy too tired, the nurses often rotate, she almost every time he comes to infusion will see new faces.
Dispensing room also has four medical personnel, they are responsible for injecting drugs into infusion bag. In order to make timely dissolve drugs, and a dedicated instrument to vibrate. Solution with good later, concentrated to around ten bags, from another sent out at the exit. And then by a nurse wheeled car according to the number in turn give patients injections.
Infusion area infusion area was full, especially children, every child has more than one accompanied by parents, because the seat is not enough, some take small chairs, some can only squat down beside it. Accompanied her daughter's ms xu, told me: "there is not much people, to children's hospital last week, from registration to see a doctor spent five hours, so we choose the hospital in the patients less."
Patient lose medicine is given priority to with antibiotics, reporters interviewed 24 people, found they although patients with colds, urinary tract infections, asthma, bronchitis, pneumonia and other diseases, but drugs are similar, there are 17 people used the cefepime hydrochloride for injection for Ann, four people celebrate toxin was used. A mother surnamed zhang told me that her daughter, the crane is penicillin, because last time hanging hook for cephalosporin five days later, found that have no effect.
Because liquid can only add one drug for each bag, so a lot of the patient's iv poles have different colors of several bags of liquid. According to the medical staff health bureau has a regulation, to ensure drug safety, the same bag in the liquid is not allowed to add two or more drugs.
Because the patient is much, disposable infusion sets and disposable syringe quantity is very big, just one hour, I was twice to see workers moved in several cases of infusion sets. Infusion of medical garbage can, there is a nurse specialized processing used infusion.
Talk about infusion, the patient's reaction is generally "expensive". "The highest use of cefepime hydrochloride for injection for Ann" a course of 6 teams, need more than three hundred pieces. Ms xu told me that the mycoplasma pneumonia, the daughter of hanging water is 15 days, spend at least more than one thousand pieces, with social security card, can be part of a discount.
Despite the complaints, but patients is generally believed that infusion will let their disease good faster. According to the study of 24 patients, there are 19 direct infusion is listening to the advice of a doctor, is his own initiative infusion of five patients. In 19 patients, listening to the opinions of physicians may have four ever asked the doctor to take medicine or an injection, and other treatment, and the doctor's advice is: infusion "good fast" and "avoid into chronic diseases", etc. Have three days of hanging water Mr Sheng to review, the doctor suggested to him "lose three days again, consolidate cement".
Five reason to ask for transfusion patients is also "good infusion faster". When asked about the infusion may bring risk, all respondents said the doctor didn't tell us.
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