知名医院患者“爆棚”社区医院门可罗雀 Famous hospital patients“Befriending the”Community hospital there is few visitors

破解“看病难”需依法配置医疗资源 crack“See a doctor difficult”Should be in accordance with the medical resources allocation

　　胡胜凡从排队挂号的人群中挤了出来，额角挂着细密的汗珠。尽管此时才早上7点，入秋后的北京气温也不算高，但胡胜凡的背心处仍然湿透了，毕竟挂号大厅里的人太多。

HuShengFan from queue up to register the crowd out，The frontal hung close sweat。Although at this time to morning 7 o 'clock，Autumn in Beijing after the temperature is not high，But HuShengFan vest place still wet through，After all registered the people in the hall too much。

　　这里是北京一家医院，挂号大厅里里外外站满了人，排队挂号的队伍曲曲折折绕了几个圈。看着焦急排队的人，胡胜凡心里的石头算是落了地，边用装着病历本和化验单的塑料文件袋扇着风，边给身旁的人讲着挂号注意事项。

This is a Beijing hospital，Registered in the hall was filled with people standing，Queue up to register team tortuous around a few ring。Look at the lines are anxious，HuShengFan heart stone is down the earth，The side USES the pack BingLiBen and laboratory sheet plastic file packet fan wind，Side to side of the people speak the registered matters needing attention。

　　胡胜凡带着妻子从山东德州老家赶到北京看病，已经有9天了。“看个病真是难，到北京的大医院看病更难。”胡胜凡说。

With his wife HuShengFan from shandong Texas their hometown to Beijing to see a doctor，Has nine days。“See a disease is really difficult，To Beijing big hospital more difficult。”HuShengFan said。

　　“看病难”不是胡胜凡一人的感受，在这家医院等着挂号排队的人脸上，除了焦急、毛躁，很少看到轻松的表情。

“See a doctor difficult”Not a HuShengFan the feelings of people，In the hospital waiting for registered the lines face，In addition to anxiety、short-tempered，Seldom see comfortable expression。

　　尽管卫生部要求医院开通网上、电话预约挂号，尽管医保的覆盖面在不断扩大，尽管药价正在下降，但在老百姓眼里，“不敢生病”才能真正避免“看病难”。

Although the ministry of health asked hospitals open the online、Telephone make an appointment，Although medical insurance coverage is on the rise，Although prices are down，But in people's eyes，“Dare not sick”Can really avoid“See a doctor difficult”。

看病与“遭罪”无异 The doctor and“suffer”Is the same as

　　胡胜凡的妻子得的是肾病，在老家看了一年多，花了不下3万元，可病没见好。胡胜凡急了，决定带着妻子上北京的大医院瞧瞧。临出门前，他特地查了早上到北京的车次。

HuShengFan wife's kidney disease，In their hometown to see more than a year，Spent not less than 30000 yuan，Can disease didn't get better。HuShengFan nasty，Decided to take his wife on Beijing's big hospital to see see。Before going out in the，He specially checked the morning train to Beijing。

　　到了北京，连落脚的地方都没找，胡胜凡和妻子直接到了医院，但是当天的号还是没了。胡胜凡买了几份报纸，在挂号大厅附近阴凉处找了个地方，两口子就这么“安顿”下来。“我知道北京大医院挂号麻烦，准备将就一晚上，第二天看完病，早点回家，节省费用。”胡胜凡说，但是他的算盘落空了。

Came to Beijing，Even the footing didn't find，HuShengFan and his wife to the hospital directly，But the size or didn't。HuShengFan bought some newspaper，In the registered hall found a place near the shade，Couple so“settle”down。“I know Beijing big hospital registered trouble，Ready to do a night，The second day watching the disease，Home early，Cost saving。”HuShengFan said，But his abacus has fallen to the ground。

　　排了一晚上，胡胜凡终于挂上了号，也带妻子看了病，但是得做两个检查，而且检查结果还不能当天出来。“没办法，只能在北京待着。我们俩商量了半天，还是没舍得花钱找地方住。说不准以后还得花多少钱。”胡胜凡说，在北京的8个晚上，他都是和妻子在门诊部门口过的。“门诊部外面有屋檐，可以挡雨”。

Row a night，HuShengFan finally hung up the number，Also took his wife to see the disease，But must do two inspection，And check out the results were not the day。“Can't，Can only stay in Beijing。We were both discussed half a day，Still didn't treat oneself to find place to live。Can't say for certain later have to spend how many money。”HuShengFan said，In Beijing, eight in the evening，He is and his wife at the door at the outpatient department and the。“Clinic outside have eaves，Can stop the rain”。

　　和胡胜凡夫妇一起，“住”在门诊大厅外面的，还有不少人。其中一名是来自河北廊坊的妇女，因为妇科病，在这里已经待了7天。这名妇女告诉记者，挂号费时间、等结果费时间。“要是有钱，能够找人的话，也不用这么累”。

And HuShengFan couple together，“live”In the outpatient service hall outside，There are many people。One of them is from hebei langfang women，Because gynecopathy，Here has spent seven days。The woman told reporters，Registration time、Results such as time-consuming。“If rich，Can get someone to words，Also need not so tired”。

　　这名妇女说的“有钱”、“找人”，就是找号贩子、找专家。“有个从北戴河来的女的，带她儿子看病，好像是胆囊炎，给了号贩子1000元钱，直接去找专家看的。”

The woman said“rich”、“For someone”，Is to find number dealers、Find experts。“A woman from beidaihe to，Take her son to see a doctor，Seems to be cholecystitis，Give the number dealer 1000 yuan，Go straight to the experts for the watch。”

　　这名妇女所言不虚，尽管相关部门一直在严厉打击号贩子，但效果微乎其微。在这家医院，“不要相信号贩子……”之类的话，从负责巡视的医务人员手中的喊话器中不断传出，但在特需门诊挂号大厅门口，一名拄着拐杖的中年妇女，仍然直截了当地向排队挂号人群兜售着他们的“服务”。

This woman's claims，Although the relevant departments have been severely hit number dealers，But the effect very little。In the hospital，“Don't believe that number trafficker...”Words like，Responsible for the tour from the hands of the medical staff in the megaphone keeps coming，But in the special consultation clinic registered at the door of the hall，A middle-aged woman on crutches，Still flatly to queue up to register the crowd touting their“service”。

专家云集大医院 The expertise gathered large hospital

　　记者调查发现，如果撇开看病费用高的因素，“看病难”现象是相对的。相较于知名医院门庭若市的情形，一些社区卫生服务中心乃至一般的三甲医院，几乎可以用门可罗雀来形容。

Reporter survey found，If the doctor put aside the high cost of factors，“See a doctor difficult”Phenomenon is relative。Compared with famous hospital kind of situation，Some of the community health service center and general hospital，To be able to be used almost there is few visitors to describe。

为什么会出现如此鲜明的对比？ Why is there such a sharp contrast？

　　“小医院看不好病。”胡胜凡的回答非常直接。

“Small hospital see bad disease。”HuShengFan answer very direct。

　　在湖北省鄂州市的一家社区卫生服务中心，一名医生告诉记者，来这里看病的主要是两类患者：一是感冒发烧之类的小病；二是高血压等慢性病。

EZhouShi in hubei province, a community health service center，A doctor told reporters，Come here to see a doctor are mainly two kinds of patients：One is the cold has a fever and so on ailment；The second is chronic hypertension, etc。

　　“其实，患者不去小医院也情有可原。”这名医生自嘲道，首先，小医院没有专家，像社区卫生服务中心更多的是快退休的医生；另外，小医院没有大设备，一流先进的检查设备，只有知名大医院才有。即便一些地级市的三甲医院购置了先进设备，如果没有比较出名的医生，患者还是不会去。

“In fact，Patients do not go to the small hospital is excusable。”The surgeon self-mockery way，First of all，Small hospital not experts，As community health service center more is fast retired doctor；In addition，Small hospital no big equipment，First-class advanced inspection equipment，Only the famous big hospitals have。Even if some of the ministry of 3 armour hospital bought advanced equipment，If there is no comparison famous doctor，Patients still won't go。

　　鄂州市的于先生就遇到了这样的情形。于先生夫妻双双下岗，没有固定收入，但是他们的孩子却一直病痛缠身。收入微薄的于先生不敢进大医院，带着孩子到当地一家三甲医院，医生看了之后说，带着孩子去武汉的大医院吧。揣着从亲友处借来的5万元钱，于先生带着孩子去了武汉，在武汉一家知名医院做了脊椎微创手术。

EZhouShi in Mr. Met such a situation。In both husband and wife Mr Laid-off，No fixed income，But their children has been saddled with pain。The low income in sir dare not into the hospital，Take the child to a local hospital，The doctor says after see，Took the children to wuhan's big hospitals。Chuai from relatives and friends place borrowed 50000 yuan，Mr. To take their children to the wuhan，A well-known in wuhan hospital to do the spinal minimally invasive surgery。

　　但是这次手术并没有完全断了病根。接下来的日子，于先生还需要时刻关注孩子的病情，如果有反复，还需要再坐长途车到武汉去检查。

But the surgery and not completely broken at the source of the trouble。The next day，Mr. To still need to pay close attention to the child's illness，If there is a repeated，Still need to sit coach to wuhan to check。

　　就像胡胜凡说的，“并不是大家都想挤大医院，跑远路看病，病人也遭罪，实在是小地方治不好”。

As HuShengFan said，“Not everybody wants to squeeze big hospitals，Run long way to see a doctor，The patient also suffer，It is a small place not cure”。

药价高治不起 High prices can't afford to cure

　　对于鄂州市的于先生来说，给孩子看病还难在药价太高。给孩子做完手术，借来的钱已所剩无几。但是，后期治疗还需要打针，“我现在只能给孩子打国产的针，虽然效果比进口药差不少，但是便宜，进口药一针一万多元，国产只要3000多元。但就算是用国产的，我现在也快供不起了。”于先生说，现在已经把一个月打一次改成3个月打一次了。

For EZhouShi for Mr. In，Give children a doctor also is the high prices。Give children finish operation，Borrowed money is running out。but，Later treatment still need an injection，“Now I can only give your child play domestic needle，Although the effect JinKouYao difference than many，But cheap，JinKouYao a needle ten thousand multivariate，Domestic as long as 3000 multivariate。But even with homemade，I now also not to be able to supply the fast。”Said Mr. In，Is now a month once into three months a times。

　　有类似遭遇的病人还有不少。老家在湖北省的刘先生，因儿子、儿媳都在北京工作，去年年初就跟妻子一起来了北京。没料到的是，去年7月份，谢先生被查出患有胃癌。考虑到老家无人照料，谢先生的儿子硬是让父亲留在北京做手术。手术做完了，前前后后花了近30万元。为了让父亲少遭点罪，在术后化疗初期，谢先生的儿子一直选择的是副作用小的进口药物。但是高昂的药费让这个本还算殷实的家庭难以承受，化疗一段时间后，药物改成了国产的，化疗周期也从一个星期变成了半个月。

Have a similar experience of patients and many。Their hometown in hubei province's Mr. Liu，For the son、Daughter-in-law are working in Beijing，At the beginning of last year came to Beijing with his wife。Didn't expect is，In July last year，Thank a gentleman was diagnosed with stomach cancer。Considering the home unattended，The son of a gentleman just let father stay in Beijing for surgery。After the operation，Up and down spent nearly $300000。In order to let the father was less point sin，In the early postoperative chemotherapy，The son of a gentleman always chosen is side effect little imported drugs。But high expenses for medicine let this this fairly substantial family is difficult to bear，Chemotherapy after a period of time，Drug into a domestic，Chemotherapy cycle also from a week into a half a month。

　　其实，并不是大病的花费高，即使是小病，进了医院也可谓花钱如流水。在北京一家媒体工作的田丰前不久因肺炎到一家医院的门诊输液治疗，医生给他开了一种抗生素，一瓶300多元，加上其他的药物，一天就得500多元。如此连续7天，加上检查费用，田丰治一个肺炎就花了近4000元。

In fact，The cost of a serious illness is not high，Even slight illness，Into the hospital is spend money like water。In a Beijing media work ford recently due to pneumonia to a hospital outpatient transfusion treatment，The doctor gave him opened an antibiotic，A bottle of 300 multivariate，Plus other drugs，One day have to 500 multivariate。So for seven days，Plus inspection fee，TianFengZhi a pneumonia is spent nearly $4000。

依法分配资源 Allocate resources according to law

看病，这个在群众生活中难以避免的事情，为何难？ The doctor，The masses life difficult to avoid things，Why difficult to？

　　中国政法大学法治政府研究院副院长王敬波认为，“看病难”背后的主要原因在于，医疗机构被过快地推入市场，政府部门应当承担的提供基础医疗服务的责任没有得到实现。

The rule of law government research institute of China university of politics and law, vice President of the WangJingBo think，“See a doctor difficult”The main reason behind，A medical institution too quickly to be put into market，Government departments shall undertake to provide basic medical service responsibility not be carried out。

　　“关键问题还是在医疗体制上。”卫生法专家、北京中医药大学教授卓小勤在接受《法制日报》记者采访时说，医疗资源的相对紧缺造成了目前的“看病难”。所谓相对紧缺，是指优质医疗资源集中在大医院，求医者人满为患，而社区医院则显得医疗资源相对闲置。

“Key problems or in the medical system。”Health law experts、Beijing university of Chinese medicine professor ZhuoXiaoQin in accepting《Legal daily》reporters，The relative shortage of medical resources caused by the current“See a doctor difficult”。The so-called relative shortage，Refers to the high quality medical concentrate resources in major hospitals，QiuYiZhe packed，And community hospital medical resources will be relatively idle。

　　卓小勤认为，医疗体制上的问题集中体现在两个方面，一方面是诊疗流程不合理，一方面在于对基层医疗投入不足。

ZhuoXiaoQin think，Medical system problems embodied in two aspects，On the one hand is diagnosis and treatment process is not reasonable，On the one hand is the primary care inadequate investment。

　　“在我国，患者生病后可以自主选择医院，不管大病小病都往知名医院涌，诊疗流程没有很好地控制。在一些西方国家，都规定患者生病后，必须先经签约家庭医生或在社区医疗机构诊治，如果的确需要转入大医院就诊的，才会出具转院手续。在这种诊疗流程下，各个环节的医疗资源都得到了充分的利用。”卓小勤说，像我国目前的状况，知名三甲医院的门诊日流量超过1万人，而社区医疗机构无人问津。

“In our country，After the illness patients can independently choose the hospital，Whether a serious illness ailment to famous hospital chung，Diagnosis and treatment process is not well control。In some western countries，All patients with provisions after the illness，Must be signed by the family doctor or in community medical institutions make a diagnosis and give treatment，If you really need to change over to the big hospital，Will issue a hospital formalities。In this kind of diagnosis and treatment process flow，Each link of medical resources have been fully utilized。”ZhuoXiaoQin said，Like the situation in China today，Well-known 3 armour hospital MenZhenRi flow more than 10000 people，And community medical institutions go unattended。

　　卓小勤分析说，这种诊疗流程的不合理，导致恶性循环的出现——大医院越做越强，专家向大医院集中，不断添置医疗设备；而同时，基层医疗机构得不到有力地扶持，医疗人才少，医疗设备也缺乏。

ZhuoXiaoQin analysis said，This kind of diagnosis and treatment process is not reasonable，Led to the emergence of a vicious cycle -- big hospital more do strong，Experts to the big hospital concentration，Continuously acquire medical equipment；At the same time，Basic medical institutions is not effectively support，Medical talent less，Medical equipment also lack。

　　北京大学国家发展研究院经济学教授、著名医改专家李玲也曾表示，我国每年有60万医学毕业生，仅10万人穿上“白大褂”，也就是说每年有近50万医学人才流失，而与此同时，我国基层医疗卫生人员则相当匮乏。

Beijing university institute of national development economics professor、Famous medical experts LiLing also has said，Our country every year 600000 medical graduates，Only 100000 people put on“white”，This is to say that every year close to 500000 medical talents loss，And at the same time，The rural medical and health personnel is shortage。

　　卓小勤认为，要解决“看病难”，必须改变目前的医疗体制，从法律的层面重新配置资源，规定就诊流程。一方面要通过法律、政策明确加大对基层医疗资源的投入，让基层医疗机构拥有先进的设备，实现基层医疗资源的共享，避免医疗设备重复购置的弊病。在此基础上，通过法律的形式规定首诊必须经过社区医疗机构，经社区医疗机构确诊需要转入大医院的才能到大医院就医。同时放开医疗管理，允许医生尤其是专家自己开办诊所。这样，可以避免专家集中在大医院的现象，让专家有更多的机会给更多的患者诊治。而且，在基层医疗资源充足并实现共享的前提下，独立经营的医务人员可以借用基层医疗机构的设备进行诊治，避免医疗资源的浪费。(记者 余飞)

ZhuoXiaoQin think，To solve“See a doctor difficult”，Must change the present medical system，From the legal level reconfigure resources，Provisions medical process。On the one hand to pass laws、Policy clear intensify the grassroots medical resources input，Let the grassroots medical institutions have advanced equipment，To realize the resources sharing of basic level medical treatment，Avoid repeat purchase medical equipment of the disease。On the basis of，Through the form of law provisions first diagnosis must pass a community medical institutions，The community medical institutions diagnose needs to change over to the big hospital to the hospital。At the same time let go of medical management，Allow the doctor especially experts start your own clinic。this，Can avoid experts concentrated in large hospital phenomenon，Let the experts have more opportunities to more patients make a diagnosis and give treatment。and，In primary care enough resource and realize the sharing of the premise，Independent management of medical personnel can borrow grassroots medical institutions to make a diagnosis and give treatment equipment，To avoid the waste of medical resources。(Reporters flying more than)