浙江省公立医院特需医疗服务状况的调查与探讨

Investigation and discussion of the special needs medical service in 62 public hospitals in Zhejiang Province

目的通过对公立医院开展特需医疗服务情况的调查，探索其健康发展的途径，为制定与完善相关政策提供参考依据。方法采取分层抽样和典型调查结合，并发放问卷的形式，对浙江省62家国有性质的医院2004—2006年特需医疗服务的情况、开展的项目及存在的问题、今后发展的方向进行调查。结果特需医疗服务的收入、工作量在逐年增加；50％以上的公立医院开展了专家门诊、口腔正畸、高等病房等特需服务项目；所有的医院管理者均认为公立医院有必要开展特需医疗服务，76．42％管理者认为公立医院开展特需医疗服务的区域应独立设置，46．30％管理者认为其应独立核算，85．76％的管理者认为其价格应依循市场，政府只须加强监管。结论目前形势下公立医院开展特需医疗服务无可避免，但应对此在服务项目、床位等方面加以限制，场所和财务应独立设置和核算。

Objective To find out and research after the approach of virtuous operation of the Special Needs Medical Service （SNMS） in public hospitals by the investigation of the implementation of SNMS in publie hospitals. The research can be consulted to consummate the interrelated policy by the government. Methods The methods of samples study from different levels and representatives surveys were carried out in the study in 62 stated-owned hospitals in Zhejiang Province from 2004 to 2006, The findings were compared and analyzed by statistics. Results The earning and the workload had been increased year after year. The SNMS such as expert consultation, correcting irregularities of the teeth, high-price wards were opened in more than 50% of public hospitals. All the managers of the hospitals investigated in the research deemed that it was necessary that the SNMS should be opened. 76.42% of the managers thought the special fields should be opened in public hospitals. 46.30% con- sidered independent accountability should be carried out. 85.76% reckoned that the price of the SNMS should depend on the market and be supervised by the government. Conclusion Presently, it is inevitable for opening SNMS, but the items, beds should be restrieted, and rooms and revenues should be set up and calculated independently.