随着社会主义市场经济体制和国家医疗保险制度的确立,医院之间竞争将更加激烈,中小型医院如何在体制变革中主动适应并进一步发展,这是我们必须思考的问题。笔者就新形势下中小型医院建设中应注意的倾向性问题谈几点意见: 1 专科项目投入防止抓大放小,盲目攀比 大多数中小型医院在地理环境、交通文化,特别在医院规模、人才、技术、设备和财务方面,和城市大医院都有着很大差距。因此,在专科项目投入时必须防止脱离实际的抓大项目,抓大工程,否则,就会事与愿违、劳民伤财。一要在大型设备购置时充分论证,如果符合医院及当地经济实际和市场需要,必然会取得可观的效益回报,反之,成本都难以收回。二要根据医院规模,因地制宜地开展专科技术建设。中小型医院大多数地处地县级市区,和城市大医院相比,没有充足的技术力量,更难有压倒优势的市场吸 With the establishment of the socialist market economic system and the national medical insurance system, the competition between hospitals will become more intense. How small and medium-sized hospitals actively adapt to and further develop in the process of institutional changes is a question that we must consider. The author discusses several opinions on the tendency of attention in the construction of small and medium-sized hospitals in the new situation: 1 Specialist project investment to prevent catching up, and blindly comparing to the majority of small and medium-sized hospitals in the geographical environment, traffic culture, especially at the hospital scale, Talent, technology, equipment, and finances are very different from those in large urban hospitals. Therefore, when the specialist project is invested, it must prevent disengagement from the actual large-scale projects and take major projects. Otherwise, it will be counterproductive and labor and people will be hurt. First, it is necessary to fully demonstrate the purchase of large-scale equipment. If it meets the actual needs of the hospital and the local economy and the market, it will inevitably achieve a considerable return on efficiency. On the contrary, the cost will be difficult to recover. Second, according to the scale of the hospital, special technical construction should be carried out according to local conditions. The majority of small and medium-sized hospitals are located in the county-level urban areas. Compared with large urban hospitals, there is not enough technical force, and it is even more difficult to have an overwhelming market advantage.