近日，卫生部要求开展评审“回头看”，2011年后新增的240多家三级医院被视为无效，要求省级卫生行政部门不得为新增的三级医院颁发证书和等级标识，已发给的要立即收回。三级医院评审存在什么问题？医院等级评审制度意义何在？调查发现，除了“三甲”，需要“回头看”的还有医院等级评审制度本身。

recently，The ministry of health requirements to carry out evaluation“Look back”，2011 years later add more than 240 tertiary hospital be regarded as invalid，The provincial administrative department of health shall not request for the new tertiary hospital certificate and grade identification，Already send to immediately recover。Tertiary hospital evaluation exist what problem？What is the meaning of the rank of the hospital system？Survey found，In addition to“top”，need“Look back”And rank of the hospital evaluation system itself。

　　□批量评审 - batch review

　　乡镇医院挂上“三甲”招牌 Township hospital hang“top”signs

　　1998年，我国暂停医院等级评审工作。2011年，卫生部重启等级评审，随后，各地医院掀起“争级上等”的热潮。

In 1998,，Our country stop rank of the hospital evaluation work。In 2011,，The ministry of health to restart grade evaluation，then，Around a hospital“For superior level”upsurge。

　　“全民皆兵，整个医院都在为评级做准备。”正在为晋级努力的北京市垂杨柳医院副院长王永光说，这对不少医院是头等大事。

“A soldier，The whole hospital in preparation for rating。”For promotion is to ChuiYangLiu Beijing vice President of the hospital WangYongGuang said，The many hospital is a top priority。

　　“即使掉两层皮，也得冲进‘三甲’！”重庆一位“三级乙等”医院院长的“狠劲”道出不少同行的心声。

“Even if off two layers of skin，Also get rushed into the‘top’！”Chongqing a“Level 3 b, etc”Of the President of the hospital“HenJin”What a lot of peer heart。

　　除省市级医院外，一些县级医院也加入进来。

In addition to the ﹑ provincial hospital，Some hospital joined at or above the county level。

　　卫生部医管司评价处处长刘勇近日透露，自2011年以来，全国晋升三级的240多家医院中，一半左右为县级医院，有些10万人口的县就配置一家“三甲”医院，甚至乡镇卫生院也挂上“三甲”。

The ministry of health medical tube department evaluation marshal, recently revealed，Since 2011，The national promotion level 3 more than 240 in the hospital，About half at or above the county level for hospital，Some 100000 population county is a configuration“top”hospital，Even township health center also hung up“top”。

　　2011年3月，浙江省卫生厅公布新一轮“三甲”医院名单，全省26家医院申报，21家通过，通过率达80.8%。同样在这一轮评审中，广东省东莞市厚街医院等多家镇级医院晋升“三甲”。

In march of 2011，Zhejiang provincial health bureau announced a new round“top”Hospital list，The province declared 26 hospitals，21 home through the，Passing rate reaches 80.8%。Also in this round of evaluation，Guangdong province houjie hospital, a number of other ZhenJi hospital promotion“top”。

　

　□紧急叫停 - emergency stop

　　评审结果须报卫生部核准 Evaluation results shall be submitted to the ministry of public health approval

　　有条件的医院纷纷评“三甲”，没有条件的创造条件，起码也要挤进三级。为此不少医院不断圈地扩建、大手笔引进设备。

Conditional hospital evaluation in succession“top”，No conditions to create conditions，At least also to squeeze into level 3。Therefore many hospital continuously enclosure expansion、Adopting imported advanced equipments。

　　刘勇认为，这种状态容易破坏整个医疗服务网络，如果当地的就医量无法支撑医院的正常运转，就会造成医疗资源的浪费，还可能对控制医疗费用等造成负面影响。

, think，This state easy to destroy the whole medical service network，If the local medical quantity cannot support the normal operation of the hospital，It will cause the waste of medical resources，May also to control the medical expenses caused negative influence。

　　此次卫生部要求开展评审“回头看”，就是针对部分省份评审缺乏规划、尺度过松、三级医院数量攀升等现象。卫生部专门下发《关于规范医院评审工作的通知》要求，对新增的三级医院省级卫生行政部门不得发给证书和等级标识，已发给的要立即收回。各地“三甲”医院及规划新增三级医院的评审结果，须报卫生部核准。

The ministry of health requirements to carry out evaluation“Look back”，In view of the partial provinces is the lack of planning、Scale too loose、Tertiary hospital quantity up wait for a phenomenon。The ministry of health issued by special《Hospital evaluation work on regulating the notice》requirements，For new tertiary hospital provincial health administrative departments shall not issue certificate and grade identification，Already send to immediately recover。around“top”Hospitals and planning new tertiary hospital evaluation results，It must be reported to the approval of the ministry of health。

　　

□新闻背景 - news background

　　“三甲”是医院最高等级 “top”Hospital is the highest level

　　医院等级评审启动于1989年，综合医院按任务和功能，由低到高分为一、二、三级，其中三级医院定位是向几个地区提供高水平专科性医疗卫生服务和执行高等教育、科研任务的区域性以上医院。而每级则根据医疗水平及设施条件等，又分甲、乙、丙三个等级。“三级甲等”是目前我国医院的最高等级。

Rank of the hospital evaluation was launched in 1989，General hospital according to the task and function，From low to high as a、two、Level 3，The tertiary hospital positioning is to provide high level several areas ZhuanKeXing medical and health services and implement higher education、Scientific research tasks more than regional hospital。And each level is, according to the medical level and facilities condition, etc，And points a、b、Propyl three levels。“Three level of first-class”At present in our country is the highest level of the hospital。

　

　□利益驱动 - driven

　　晋级意味着更多收费更多病源 Promotion means more charge more pathogenic

　　三级医院收费标准比二级高出约30%，还能吸引来更多的医疗人才和病源，这样医院才能进一步发展。

Tertiary hospital fees standard about 30% more than 2，Can also bring more medical talents and pathogenic，So the hospital to further development。

　　“三甲”，意味着最好的医疗条件、医疗技术和医疗服务，但其意义并不只此。“‘三甲’这块金字招牌，吸引着优质资源，对医院极具诱惑力。”北京一位“三甲”医院院长说。

“top”，Means that the best medical conditions、The medical technology and medical service，But its significance not only this。“‘top’The gold-lettered signboard，Attracting high quality resources，On hospital provides allure extremely。”Beijing a“top”Hospital dean said。

　　只要晋升到“三级”，就意味着收费标准可以更高。卫生部《医院分级管理办法》明确，医疗收费应与医院级别挂钩。级别不同，门诊挂号、住院床位收费等都应有所不同，以适当拉开档次。据悉，三级医院收费标准比二级高出约30%。

As long as the promotion to“Level 3”，Means charging standards can be higher。The ministry of health《Hospital grading management measures》clear，Medical fee should be and hospital level hook。Different levels，Clinic registered、Hospital beds charges should be different，In an appropriate open class。It is reported，Tertiary hospital fees standard about 30% more than 2。

　　“三级”意味着政策更优，可以购置更加高端的设备，享有更多的科研项目资源。如卫生部明确要求，申报国家临床重点专科建设项目的专科所在医院应为三级医院。

“Level 3”Means that the policy is more superior，Can purchase more high-end equipment，Enjoy more scientific research project resources。Such as the ministry of health is clear about the request，Declared national clinical key subject construction project specialized subject hospital should be in tertiary hospital。

　　“三级”还意味着更大的平台、声誉，能吸引来更多的医疗人才和病源。王永光说，患者就医都有趋高心理，有了三级医院的标签，自然会成为患者选择的重要依据。医院有了病源，进一步的发展就有了基础。

“Level 3”Also means more platform、reputation，Can attract to more medical talents and pathogenic。WangYongGuang said，Patients go to a doctor to have high psychological，A tertiary hospital label，Nature will be an important basis for patients to choose。The hospital had pathogenic，Further development had the foundation。

　　然而，医院等级评审背后，不仅仅有着不平等的待遇，还存在着一些更为复杂的因素。“有的评审组到地方，都得警车开道！”一名地方官员说。

however，The rank of the hospital behind，Not only has no equal treatment，There are some more complicated factors。“Some board of review editors to place，Have to motorcades！”A local official said。

　　此外，医院等级评审多与其行政级别相关，在评选“三甲”时，省级医院比市级医院更有优势。

In addition，The rank of the hospital with relevant administrative level，In the“top”when，Provincial hospital have more advantages than the municipal hospital。

　　另有专家指出，政府主导的评级在基层容易变味。医学论坛丁香园上一位网友说：“评级花钱就能过，我们医院花了几百万，那么多问题都能解决。”

Other experts pointed out that，The government leading rating in the basic unit easy off-odor。Medical BBS clove garden on a net friend said：“Rating money can live a，Our hospital spent millions，So many problems to solve。”

　

　□制度争议 - system dispute

　　引入第三方认证机构 The third party certification body

　　针对目前医院评审中暴露出来的问题，一些业内人士提出质疑，目前的评级制度还有无存在的必要？对医院又该如何分类管理？

In view of the present hospital evaluation in the problems exposed，Some in the industry questioned，The current rating system there are no existence is necessary？On hospital and how to classification management？

　　对评级持肯定态度者指出，分级管理宏观上推动了医疗服务网络的形成，微观上鞭策了医院个体的成长。江西广济医院院长史希杰坦言，等级评审过程比较繁琐，从申报到评定结果出来耗时一年，但通过评审，医院的业务水平和内部规范化管理确实上了一个台阶。

A positive person for rating points out，Classification management on macroscopic promoted the formation of medical service network，On microscopic spur the hospital the development of individual。JiangXiGuang to hospital dean ShiXiJie said，Level review process is complicated，From the declaration to the evaluation results out take a year，But through the review，Hospital business level and internal standardization management really stepped to a new level。

　　也有不少医生抱怨，尽管评审的初衷是为促进医院发展，实际上却逼迫医院、医生做了大量医疗以外的事情。为了评级，一些医院比规模、拼设备、拼人财物、拼贷款甚至大量造假。

There are many doctors complain，Although the evaluation of original intention is to promote the hospital development，In fact but persecuted hospital、The doctor made a lot of medical outside of the things。In order to rating，Some hospitals than scale、Spell equipment、Spell tightening、Spell loans even a large number of fraud。

　　“医院的分级认证，不是管理行为，是一种服务行为，应该引入第三方的认证机构。既然是一种服务，等级认证不应该由一个部门垄断。”北京大学政府管理学院教授顾昕说，“发展多元化的认证体系，在认证过程中引入竞争，相互促进，这样才是完善我国医院评级制度的一个根本方法。”

“The hospital grading the authentication，Not management behavior，Is a kind of service behavior，Should the third party certification institution。Now that is a kind of service，Rank the authentication should not by a department monopoly。”Beijing university professor of school of government GuXin said，“The development of diversified the authentication system，In the authentication process introducing competition，Promote each other，This is the perfect our country's hospital rating system a basic method。”

　　曾在德国、荷兰留学的王永光说，在国外，医院只有类别之分，没有等级之分，有排名也是第三方的评价。他建议，基本医疗不应分三六九等，只按专科专项管理，收费标准在同一地区也应一致。

Was in Germany、The Dutch study abroad WangYongGuang said，In foreign，The hospital only categories of points，No grades，Have also ranked third party assessment。He suggested that，Basic medical not part of one's job 369, etc，Only according to the special management specialized subject，Charging standard in the same region also should agree。

　　本版文字据新华社电

This text according to xinhua