Construction of hospital at county level Need overall planning

Construction of hospital at county level Need overall planning
Premier Wen Jiabao points out in the government work report made at the second session of the 11th National People's Congress, in the following 3 years, state revenue support 2000 more houses of construction of hospital at county level. In the medical organizations at all levels of our country, the function of the county hospital is very important. Build up the county hospital, let peasants see serious disease runs away on the way, enters the big city, lighten the financial burden of peasant and patient, not only peasants' will, also a focal point of the next medical reform. What problems exist in developing in the county hospital? Recently, the reporter finds while visiting Heng County of the Guangxi Zhuang Autonomous Region and hospitals of two counties of Yang Shuo - -
Staff reporter Actor Chi takes place and admires not the snow reporter Lu GuiJi oldly
Have joined and shut peasants more County hospital berth pressing
Impatient more, crowded,county is that hospital see first view at Heng County of reporter. There are patients to lie on the sick bed in the corridor receiving treatment in every inpatient area. In the inpatient area of tumour, because three of corridor were not sheltered from, lie in the corridor adding the patient in bed like living in the open. "The berth is in short, have no way, can only let the patient live in the corridor. " County director Nong Zhen has and cannot help but says.
From Heng County to more than 100 kilometers of Nanning, the whole county has a population of 1,150,000. The hospital of Heng County county is a second first rate hospital and international Emergency Assistance's network hospital, there are 563 technical staff of hygiene, make 302 berths.
Normally, as the county hospital, the hospital of Heng County county is not very small in view of scale. "But population increases fast, after especially starting the new rural cooperative medical service in 2006, the idea of seeking medical advice that peasant's young disease towed serious disease and shouldered has changed, some medical demands have been activated. " Shake have introduction while being agricultural, in recent years, annual the intersection of clinic and with keep 6% - 11% growth rate in hospital amount quantity of institute this. The statistics show, implement newly and agriculturally after shutting, the berth rate of utilization of the hospital of Heng County county is from about 86% in 2005, improve to 116.95% in 2008; 2008, clinic quantity up to 279982 person, reach 26702 person in hospital amount, 95% patient join, shut peasant. "Operations in hepatobiliary surgery of the hospital cranium brain can be done now, launched 66 ambition surgeries last year. Peasants needn't basically get to Nanning to diagnose the illness. Though the real open berth has already been up to 500, is in hospital the berth is still in more short. "
In the intersection of Yang Shuo and county, new and agricultural jointly start, the intersection of county and the intersection of hospital and clinic, and number increase year by year in hospital. Comparing in 2005 with shutting newly and agriculturally of 2008, clinic person, the person and operation example time had increased by 9.3%, 21.6%, 22.07% respectively in hospital. This Wang MingMing, president of institute, thinks, the new agricultural implementation that shuts makes the service utilization ratio of the medical organization at county level improve, but expose the question with insufficient service ability of medical organization at county level at the same time.
It is reported, by 2008, a thousand people berths of every Heng County are 1.52, people berth of every Yang Shuo county a thousand is 1.43, average level well below a thousand people and 2.83 of berth in every the whole country in 2007; Two the intersection of county and every a thousand people defend the intersection of skill and personnel, count, lower than the whole country 3.66 average of people too. As the local hygiene service " The tap " County hospital,is it in conformity with peasant's medical demand to last service ability enormous challenge.
Give play to " tap " Function faces a great deal of difficult problems
When being interviewed by reporter, the medical workers of the hospitals of two counties say, the action that the central government should take out the fund and build the county hospital well especially lets them encouraged very much. The development of the hospital of county at present has been really met " The bottleneck " ,Need the government badly to support.
Short of fund, the medical apparatus of house is outmoded and deficient
Hospital, county of Yang Shuo, enclose with hills on three sides, build the intersection of cement and the intersection of prefabricated board and three floor of structure in will it be will it be the end the seventies last century and form distinct drop by building by luxurious magnificent hotel by town by county. The reporter sees, the wards of the county hospital, consulting rooms are narrow and small, the wall paints different, ceramic tile not of uniform size in the corridor, have left the trace mended many times.
"The most difficult one has no money. " The intersection of president and MingMing Wang introduce, hospital build on 1939, the intersection of town and commune hospital and institute of traditional Chinese medicine, county of Yang Shuo, incorporate the intersection of Yang Shuo and county into behind the hospital will it be will it be the first day of the lunar month such as Yuanyang July 2001, such problems as improving, insufficient, medical apparatus of house of business is deficient that the hospital does not still face infrastructure. In 11814 square meters of only business houses of this institute, 5756 square meters are the dilapidated house of C grade. The reporter sees, this institute cures the skill department to disperse in in-patient dept. and outpatient building, the patient will run back and forth while checking. The only one heart electricity guards the apparatus and several stomaches washing machine in the emergency department. This head of the department says, if two heart emergency cases come at the same time, will delay rescuing. Only a biochemical apparatus in the blood screening test lab, in case of repair, can't test in two or three days. The anaesthetizing machines, one of mirrors, Ultrasonography B are all exceeding the time limit " On active service " ,A black-and-white Ultrasonography B bought in 1996 is being still used now.
As the medical treatment of the whole county and technological instructing center of the business, the hospital at county level is undertaking basic medical treatment and task which the critical acute disease patient rescues. But there is no ICU in these hospitals of two counties at present, it is an important factor to lack funds. At present, the hospital of Yang Shuo county has already had a debt of 19,147,000 yuan, current liability is 9,439,000 yuan among them, long-term debt is 9,708,000 yuan. The hospital of Heng County county in debt is up to 21,720,000 yuan. "Have no way, can only owe the loan of the bank and does not return, medicine which enters the pharmaceutical factory is towing and does not pay the bill first. " Wang MingMing says.
It is insufficient to work out, it is unstable to cure personnel's team of the skill
Find, increase strength become the intersection of hospital and the intersection of voice and strong problem one of in reporter interviewing China. The presidents say, the strength tightens the stability that has already influenced the technological team at present.
It is reported, the present strength of hospitals of two counties was booked 10 years ago at least. The intersection of hospital and on duty the intersection of personnel and 773 at present, county of Heng County, authorize, work out, be made 1994 by 411, made 302 berths and booked in 1996. In recent years, the business of the hospital is being developed constantly, but is curing skill personnel and berth and is being worked out and has not increased. Shook and had and said agriculturally, the graduate recruited after 2005 had never entered arranging, hospital want, recruit the intersection of graduate student and graduate of education last year, work out anybody apply for straight either.
The hospital of Yang Shuo county is worked out and perplexed too. Unless at present on duty for 370 people in hospital, last 256 people,before engage by 114 people. Institute run director Yin say engage in the personnel taking seven eight people before the every year, so annual hospital want, recruit, engage personnel before the more than 10. Corey put forth effort to train after engaging personnel before some, but because can not work out or leave. The information which will recruit the midwife will be hung out on the net in 2008 in the gynaecology and obstetrics of this institute, nobody comes to apply for so far. "If work out the problem and does not solve, every clinical department of the hospital will face the state of the gap between generations of technological team. "
It is reported though hospital engage the intersection of personnel and insurance all kinds of give, they see public institution of institute of traditional Chinese medicine work out still. Solve, work out, " whether casual labour all, where pay the bill where does it go more " .
Need issuing the relevant supporting policy badly
The county hospital was regarded as the rural tertiary health care service network " The tap " ,Must strengthen, this has already been a common understanding. But OK strengthen, need supporting policy.
Construction criterion of the hospital of classifying and making the county. The concerned learders of Municipal Health Bureau in Gui Lin think, the country pays attention to the construction of the county hospital at present, the developing of the hospital has offered some policy support to the county. But the development of different regions of the western and eastern of our country is uneven, the development and construction of the county hospital, need to classify and make different construction criteria according to local social economic conditions and crowd's demand. Should classify, make the intersection of county and the intersection of hospital and basic construction criterion according to the intersection of area under one's jurisdiction and quantity and economic level of people, each have a requirement in respects such as floor area, berth, personnel, offering subject,etc., can't make it rigidly uniform.
Make the medical organization at county level and offer the subject norm as soon as possible. It is reported, because there is no norm at present, many hospitals launch the new project by every possible means, the functional demand between the medical organizations is indeterminate. For example, every general hospital, healthcare hospital for women children introduce the same surgical project, cause the wasteful use of resources. The concerned learders of Municipal Health Bureau in Gui Lin think, it is necessary to define indispensably that offers the subject norm, fund or apparatus support that the indispensable subject country offers; And hospital launch subject go beyond normal, country refuse, put into or not little and absorbed. If the hospital regards it as project that new growth engines offer, the capital source should be raised independently and solved.
The presidents still think, when the country is making and making a diagnosis the subject norm, should fully consider local disease table situations and the patient's demands. For example, the hospital of county in the past has not mostly launched the blood completely, but need the patient completely of blood to increase now, if the intersection of county and hospital can't launch, need patient of blood completely has to run away Luis reach the urban hospital do.
Nong Zhen, director of Heng County county is the deepest to this thoughts and feelings. He say Heng County hepatocarcinoma, the intersection of nasopharyngeal carcinoma and high person who take place, radiotherapy considered to be therapeutic method good to nasopharyngeal carcinoma. This courtyard of radiotherapy buildings obtained the health and epidemic prevention station of the Guangxi Zhuang Autonomous Region to " build hygiene of project design and examine the award " on December 2, 1999, cobalt - 60 treating machines, installation, simulation making a reservation machine after cobalt - 60 are equipped now, and get the department of public health and " radiate and make a diagnosis the licence ". Radiotherapy department begin, set up so far 2001, succeed 1600 more than example, patient of radiotherapy, already, treat efficient to more than 95%, some patients have already surviving exceeded 5 years. At present, original single cobalt - 60 treating machine nears half-life, need upgrading the radiotherapy apparatus linear accelerator badly. Let, it shakes have a awkward one to be while being agricultural, linear accelerator belong to the intersection of Class B and large-scale medical apparatus, generally dispose the hospital above city level, the hospital at county level is very difficult to be disposed and permit. In the face of the patient in need of radiotherapy, shake agriculturally and appeal for related departments' making policies more flexibly according to the actual conditions.
There should be rigidity standards to solve the treatment of medical worker of medical organization at county level. At present, the graduate is unwilling to get to the basic unit on one hand, the team of talent at the basic level appears out of stock on the other hand, the main reason is that the treatment is lower, its one's own value can not be reflected. The reporter interviews to know, the annual per capita income of these medical workers of hospitals of two counties is fewer than 30,000 yuan. Some subsidies of policies and regulations because the hospital does not have money that can't be implemented. The medical worker thinks, solve the medical worker treatment at the basic level, it is unrealistic to take the money by the state finance, but there should be rigidity standards in the country. So can supervise the local government to implement the funds, solve the treatment problem of the medical worker of medical organization at county level conscientiously.
The country sets up the county hospital talent's training base. The presidents think, the county hospital should give play to " tap " in rural medicine and health work well Function, the medical worker engineering level is essential. At present, the county hospital is that each shows his special skill, contact and receive a training of the organization and give a medical worker and go out refresher training by oneself, the expenses are all undertaken by the hospital too. The hospital of county of the outlying district has no ability to send medical worker to the hospital of big city and receive a training and study at all, the economic pressure is too large. If hospital, county of Yang Shuo, expenditure train funds reach 370,000 from 2006 to 2008, train rural medical worker's expenditure of 100,000 yuan; Expenditure staff training funds were up to 1,100,000 yuan from 2006 to 2008 in the hospital of Heng County county. The presidents propose, the country should set up training base of the talents of hospital of some counties and talent's training project according to the training, organize the county in a planned way every year the medical worker of the hospital to the refresher training of the base, so as to propose the professional skill of the medical worker in Gao County hospital. Meanwhile, are set up medical worker's training base of two grades in the village by the area or city
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