上海市卢湾区医务人员在区政府各有关部门支持下 ,自 1994年起在全区建立社区特困老人医疗服务的社会救助网络。 4年来 ,特困老人年人均门诊 3 9次 ,年人均受访视 2 2次 ,78 1%的患病特困老人疾病好转或稳定 ;年均住院利用率 5 4% ,89 5 %的患大病特困老人住院治疗后疾病痊愈或好转出院。特困老人次均门诊费用较劳保公费老人组下降 32 1% ,日均住院费用和次均住院费用分别较医保老人组下降 2 1 5 %和 30 4%。作者认为 ,卢湾区特困老人医疗服务的社会救助网络是一项操作性较强、行之有效的社区特困老人医疗保障体系 ,实施后取得了良好的社会反响。医疗经费的控制使用保证了网络的正常运行 Medical staff in Shanghai’s Luwan District, with the support of the relevant departments of the district government, have established a social assistance network for community-based medical services for the elderly in poverty since 1994. In the past four years, the per capita average outpatient visits for the elderly have been 39 times. The per capita interviews have been viewed 22 times, and 781% of the sick and sick elderly have improved or stabilized; the average annual hospitalization utilization rate is 54%, and 89.5% have suffered severe illness. After the elderly were hospitalized, the disease was cured or improved. The average cost of outpatient visits per person to the special hardshiped elderly was 321% lower than that of the public pension group, and the average daily hospitalization fee and the average cost of hospitalization decreased by 21.5 % and 304% respectively. The author believes that the social assistance network for medical services for the elderly in need in the Luwan District is a well-operated and effective community-based medical insurance system for the elderly, and it has achieved good social repercussions after implementation. The use of medical expenses to ensure the normal operation of the network