The large hospital of patient's demand blowout can't bear the heavy load The expert proposes hierarchical medical treatment

The large hospital of patient's demand blowout can't bear the heavy load The expert proposes hierarchical medical treatment
After designing the extension project of the People's Hospital of Jiangsu Province of 3000 10000 persons, berths of the clinic of day to lay a foundation recently, the construction project is moving forward on schedule at present. The total floor area of hospital after extending will reach 348,000 square meters, it is nearly 3 times of the scale of existing building. So far, Nanjing area " heavyweight " Province and city enter all by hospital " Expand " While going on, among them the province institute of traditional Chinese medicine, Nanjing drum-tower hospital, the first hospital of Nanjing,etc. main body building extended in advance will already be bound or completed soon. A great deal of large hospitals " The upgrading of scale " ,Draw the attention of people to a realistic problem: The large hospital " Expand " ,Relieve and see the doctor the ugly disease expensively, OK?
Patient's demand " Blowout "
The large hospital can't bear the heavy load
The morning of December 23 of last year, two inpatient areas of department of nerve internal medicine of the People's Hospital of the province. The old man of 84 -year-old Pan JiQing is lying in one corridor of inpatient area add the bed temporarily because of the brain stem and is water is hung. The old man's daughter tells reporters, because the inpatient area berth is in short, the daddy has lived for 10 days, not waiting until the formal berth yet, people come and go on the corridor, it is " convenient " , it is very inconvenient to wash and gargle etc.. Reporter see, live, add to include several patients bed with old man. The relevant persons in charge of this institute tell reporters, every inpatient area of the hospital is in full state, rate of utilization is above 108% berth every day, many overstocked patients can not live in. The clinic appears especially " Blowout " State, day the intersection of door and emergency call that design originally quantity 3500-4000 person, now often in 10000 about person, need dilatation urgently.
In the ambition medical ward of the hospital of the drum-tower of Nanjing, the reporter sees, has added 12 temporary sick beds on the corridor, been arranging to doctor's guards' room gate all the time. "We have already lived in the outside hotel for seven or eight days, have come every day and asked which day to live in, doctor can always say it has to wait a few days, there are really too many people lining up. " From northern Jiangsu strand the intersection of patient and Li loud to change misery to reporter, the 12 -year-old daughter suffers from worry, broke out suddenly a few days ago, introduced to Nanjing through the acquaintance, had never expected that can not live in the hospital at all. "Three people of one family live in the hotel, spend more than 200 every day. " Li says in helplessness. This head of the department Wang Dong enters to say: "Questions such as the security, personal secrets, cross infection with bed patient,etc. are difficult to control, also initiate doctors and patients' dispute easily. "
Vice President of drum-tower hospital perilous peak Chen say hospital clinic builds to the eighties of last century, can only hold 2000 persons, but the actual clinic quantity of every day has already been up to more than 8000 persons now, really can't bear the heavy load.
The first hospital in Nanjing faces the same trouble. "Ministry of Public Health stipulates, the hospital can't exceed 10% adding the bed, in fact can not do at all, ward add bed throughout the year in 20% about, winter respiratory medicine, cardiovascular dept.(internal medicine), 40 sick bed that check and ratify, want, live size 60-70 patient in fact. " Ding Feng, Vice President of institute, this say the intersection of patient and " the one difficult to ask bed " ,The hospital is very helpless too.
Scale though " Double "
May not necessarily solve and see the doctor expensively and difficultly
It is reported, Nanjing area is " expanding " at present Large for hospital, scale generally on the existing basis " whether it is curved when abducting by piece not to double " . If after the institute of traditional Chinese medicine of the province extends, the medical area of house will be expanded to 180,000 square meters by 70,000 square meters at present, will become the largest hospital of system integration of national Chinese medicine when the time comes. After the drum-tower hospital extends, the total floor area will reach 300,000 square meters too, it is equivalent to 3 existing drum-tower hospitals.
"The scale of large hospital ' expands ', to relieving the contradiction of high-quality medical resources in short supply at present, there are very positive meanings. " Association's Deputy Chairman of Chinese hospital, Tang WeiXin of association's president of provincial hospital of Jiangsu think, large hospital diagnose the illness difficult to look for expert mainly letting classic see the doctor difficult at present, it is certain to be beneficial to to extend to enlarging the high-quality medical resource effect. After the large hospital extends, berths generally increase by a relatively large margin, this pair relieves patients " it is difficult to be in hospital " Also will be very helpful.
"But large the intersection of hospital and to relieve common people diagnose the illness what advantages does it have yourly dilatation, will even play reaction. " Tang WeiXin analyzes, the large hospital checks, uses medicine, treats the grade relatively high, general Xiao small disease Mao reach large hospital it thinks to be can't cheap. The more important is, large hospital because compensation mechanism imperfect, easy " excessive medical treatment " And increase the patient and diagnose the illness and bear. At present, government great to change to large input of hospital, this mean, see the doctor expenses lower what does it get off while being impossible in large the intersection of hospital and the link.
The large hospital " Expand " Can the blind problem exist? It is introduced, 2007 national hygiene working conferences propose controlling the large hospital to develop scale strictly promptly, until " whether large hospital how on earth is scale loud and relatively suitable" ,In the industry none defines the statement too so far. "However, the scale of large hospital ' expands ' should not be the goal that we pursue. " Tang WeiXin points out, a lot of patients examine into the large hospital for the first time at present, makes the large hospital overstaffed, come community examine for the first time, form climate, large the intersection of hospital and door emergency call quantity will inevitablely drop, the impatient will reduce to some extent too. To this, there should be sober understanding in every large hospital, will have had " nearly anxiety " ,Also there should be foresights, so as not to present the question that resources leave the waste unused in the future.
"The hospital scale has been expanded, the berth has increased, but if talents can not catch up with, common people check, go to a doctor and time that operation wait can long, it may be more difficult to see the doctor. " The person in charge of the large hospital of a third grade in Nanjing says, it can be bought that the instrument and equipment are rich, but talents especially senior experts can not be trained out for the moment.
And the president thinks, after the hospital scale is expanded, if the management of various fields can not catch up with, the efficiency of seeing the doctor will be influenced too.
Relieve the trouble of seeing the doctor
The outlet is still here " Hierarchical medical treatment "
Can't draw the equal sign briefly while extending and relieving and seeing the doctor the ugly disease expensively in the large hospital, where on earth to relieve the worried outlet of seeing the doctor? The managerial expert of the hospital thinks, the more important thing is that should be according to the thinking that schemes confirm of the medical reform, implement " hierarchical medical treatment " .
The expert explains, the so-called " hierarchical medical treatment " ,Confirm the division of labour of all kinds of hospital rationally, the large hospital mainly solves the critical difficult disease, general Xiao Mao's small disease, common disease, frequently-occurring disease enter the community, it will be of much good that this pair relieves and sees the doctor the ugly disease expensively. Experts such as Tang WeiXin,etc. think, going to a doctor in the large hospital at present, patient in hospital, there is over half that can be solved in the community at least. The reason why patient like, run large hospital, until medical insurance level high wiping out policy form a complete set and the intersection of community and doctor watch at present Disease
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