Experts blunt: pacemakers are not medical "luxury goods"
Release date: 2014-11-19
A pacemaker is a medical electronic device. The ultimate consequence of cardiovascular disease is often arrhythmia, heart failure or sudden cardiac death, and the implantation of cardiac pacemakers is an important means of preventing these serious consequences, and even the only effective means.
The incidence of arrhythmia in China is similar to that in developed countries. More than 400,000 patients worldwide are implanted with pacemakers every year, but China has implanted more than 10,000 cases each year. There are about 800 pacemakers installed in every million people in Europe and America, and only 35 in China. In remote areas of China, this figure is even lower.
Viewpoint 1: Pacemaker treatment meets basic medical needs
"The problem is that people don't know enough about pacemakers. Hospital conditions and doctors' techniques also limit the application of implantable devices in China. In addition, many local governments don't invest enough." Chinese Medical Association Electrocardiogram and Professor Zhang Wei, director of the pacing club and director of the Arrhythmia Center of the Fuwai Cardiovascular Hospital of the Chinese Academy of Medical Sciences, told reporters.
“Some people think that a pacemaker is a medical luxury. This is not the case. A pacemaker is a medical device used to save lives. It is not necessary to have a pacemaker, depending on the ability to pay for medical expenses. The medical insurance policy involving cancer treatment has been relatively perfect, but for arrhythmia pacemaker implantation treatment, the medical insurance policy is very limited. It should be known that arrhythmia is a disease that can be fatal at any time, and the implanted pacemaker is The only effective treatment, drug treatment can only be relieved for a while. Therefore, implanted pacemakers are in line with the concept of basic medical care, the government must consider it." Chairman of the Chinese Medical Association Cardiac Electrophysiology and Pacing Branch, Wuhan University People Professor Huang Congxin, the president of the hospital, stressed.
In recent years, a group of cardiovascular disease experts in China have repeatedly called for the establishment of a basic medical device system. “The government has established a basic drug system. For medical devices that can effectively treat major diseases and are urgently needed by patients, the government should also develop a basic medical device system and achieve full coverage of basic medical devices.†Professor Zhang Wei emphasized that “from the heart The beater is very complicated, there are many specifications and models, there are single-chamber, double-cavity, and more high-grade three-chamber pacemakers. We call on the government to assume at least the reimbursement of ordinary single-chamber pacemakers in patients with arrhythmia in basic medical care. Proportion. It is gratifying that through continuous popular science propaganda, in some areas in the past two years, simple single-chamber pacemakers have been included in the scope of medical insurance reimbursement, and the proportion of reimbursement has been appropriately increased."
Point 2: "Retracting" the pacemaker treatment
"Used and used a good pacemaker depends on three aspects of popular science propaganda, reimbursement system, and training mechanism." Professor Huang Congxin emphasized.
It is understood that at present, there are more than 1,000 medical institutions capable of performing ordinary cardiac pacemaker implantation in China. What is this concept? Professor Zhang Wei told reporters: "This means that only 7% of the tens of thousands of medical institutions in the country can carry out ordinary pacemaker implantation, and the technical coverage is very low. In addition, there are more than 100 in the country. Home pacemaker implant surgery training base, each training base can only train 2~3 professional doctors per year, and only 200 professional doctors can be trained every year in the country, which is far from enough compared with clinical needs. We call for the promotion of cardiac pacemaker implant surgery training, and we hope that the health administration will 'relax' the pacemaker implant surgery."
Professor Zhang Wei explained that according to the regulations, only the top three hospitals can carry out cardiac pacemaker implantation. From a technical security point of view, this rule is completely correct. However, this provision is unreasonable from the perspective of serving patients. Because county hospitals cannot perform cardiac pacemaker implantation, a large number of patients must go to large hospitals for treatment, which will bring higher risks to many patients with cardiovascular diseases, and patients in remote areas still face many practical difficulties.
“We found that some patients with arrhythmia had repeated onset and hospitalization when they followed the local doctors in Tengchong. They were sent to the hospital for infusion after each fainting, and were discharged after the symptoms were relieved until they were relapsed and sent to the hospital for infusion. I have not been able to receive pacemaker implant treatment." Professor Zhang Wei told reporters that "Tengchong local medical institutions do not have the qualification to install pacemakers. And local patients go to Kunming's large hospital to treat more than an hour. It takes 3 days to drive. Serious heart disease patients from Tengchong to Kunming are both dangerous and very difficult. Therefore, the health administrative department should seriously consider releasing the restrictions on cardiac pacemaker implantation and implanting pacemakers. Surgical sinking to a county-level medical institution. As long as you can get a professional doctor and a county-level medical institution with relevant medical equipment and conditions, you should encourage pacemaker implantation. Otherwise, many cardiovascular patients may be forever. There is no effective treatment."
Source: China Medical News
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