医改备忘录之四 医疗机构改革的背景与进展

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建国近50年来,尤其是改革开放20年来,我国医疗机构取得了巨大的发展,医疗服务能力得到全面的提高。到1997年,我国有各级各类医疗机构约30万家,其中医院16376家,卫生院51535家,疗养院554家,门诊部3984家,诊所、卫生保健所、医务室225490家 (包括私人诊所125264家),专科防治所、站1893家;全国医院、卫生院共有床位290.29万张,平均每千人口为2.41张;全国共有医生198.49万人,共有护师、护士119.82万人,平均每千人口分别为1.65人和0.99人。医疗卫生事业的长足发展,为满足人民群众日益提高和多样化的医疗服务需求,保障人民健康,促进社会经济发展做出了重大的贡献。但是,我国现行医疗卫生体制是在计划经济条件下建立并适应计划经济体制发展起来的,随着社会主义市场经济体制的逐步建立与完善,对于社会经济发展和医学模式转变的要求已经很不适应。当前,医疗卫生体制改革滞后已经成为医疗卫生事业健康、协调、持续发展的严重障碍。 In the past 50 years since the founding of New China, especially in the two decades since the reform and opening up, the medical institutions in our country have made tremendous progress and the medical service capabilities have been fully improved. By 1997, China had about 300,000 medical institutions of all levels, including 16,376 hospitals, 51535 hospitals, 554 nursing homes, 3,984 clinics, and 225,490 clinics, health centers and medical clinics (including private clinics 125264 Home), specialist prevention and treatment stations, stations 1893; the national hospital, hospital a total of 2,992,900 beds, an average of 2.41 per thousand population; a total of 19849000 doctors across the country, a total of nurses, 119.82 million, average per thousand population Respectively 1.65 and 0.99. The rapid development of medical and health undertakings has made a significant contribution to satisfying the ever increasing and diversified medical needs of the people, safeguarding people’s health and promoting social and economic development. However, the current medical and health system in our country was developed and adapted to the planned economic system under the conditions of a planned economy. With the gradual establishment and improvement of the socialist market economic system, the requirements for social and economic development and changes in the medical model have become very inadequate . At present, the backward health care system reform has become a serious obstacle to the healthy, coordinated and sustainable development of the medical and health undertaking.
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