在近十年的医院改革实践中,医院建设中的“疲乏现象”已越来越被管理者们所认识。陈旧落后的“小卫生”观念、多头分散的卫生管理体制以及在改革中医院本身所暴露的种种问题,严重阻碍了城市医院改革的进一步深化和发展。本文试图对目前城市医院建设中疲乏现象的主要表现与成因,以及城市医院改革的基本设想提出看法,以期引起讨论。 In the hospital reform practice in the past decade, the “fatigue phenomenon” in hospital construction has been increasingly recognized by managers. The backward and outdated “small health” concept, the long scattered management system for health, and the various problems exposed by the reformed hospital itself have seriously hampered the further deepening and development of urban hospital reform. This article tries to put forward opinions on the main manifestations and causes of the current fatigue in urban hospital construction and the basic assumptions of urban hospital reform, with a view to arousing discussion.