济宁“帮扶式托管”医改试验 jining"Supporting type managed"Medical test

“救活”了运转困难的基层医院，最早试验者低调退出 "life"The operation difficult basic-level hospitals,The earliest experimenter low-key exit

　　去年2月17日晚，央视《新闻联播》报道了济宁金乡县人民医院托管当地一家乡镇卫生院的医改新举措。2分36秒的新闻，成为金乡乃至整个济宁市的骄傲，也引来了政府和社会的广泛关注。一个多月后，济宁市卫生局下发文件，要求12个县市区分别开展这种县级医院对街镇卫生院的帮扶式托管的试点工作。在此项医改新规实施一年多后，本报记者回访发现，有的地区仍在进行着托管试验，但在一年的托管合约到期后，最早进行此项试点的金乡县人民医院，却未选择续约托管。

Last February 17, late,CCTV[News broadcast]Reported that the people's hospital of jining jinxiang hosting a local villages and towns reform, the hospital new measures.Two points 36 seconds of news,Become jinxiang and even the entire jining pride,Also attracted extensive attention of the government and the society.A little more than a month after,Jining city health bureau issued documents,For 12 in the hospital wing respectively at or above the county level township health centers across the supporting type managed pilot work.In this reform, the new gauge implementation after more than a year,Our reporter found that pays a return visit,Some areas are still on trusteeship test,But in a year of trusteeship contract expires,Earliest the pilot jinxiang people's hospital,Did not choose a custody.

窘迫过往 Distress past

　　在金乡县肖云镇卫生院门口，至今仍挂着两块牌子，分别是红色的“金乡县人民医院肖云分院”和金色的“肖云中心卫生院”。

In the XiaoYun jinxiang township health centers,Still hung two pieces of brand,Respectively is red"Jinxiang people's hospital XiaoYun sorting"And golden"XiaoYun center health center".

　　虽然是去年8月份才调任肖云中心卫生院任职院长，但袁波却对这个基层卫生院的历史颇为熟悉。“位置偏，条件差，底子薄。”掰着指头，他向记者介绍。

Although it is last August to transfer XiaoYun center health center office director,But YuanBo but to the grassroots health center history quite familiar with."Position partial,Condition difference,undeveloped."Break with his finger,He introduces to the reporter.

　　据介绍，距金乡县城23公里的肖云镇，地处金乡最南端。这里不仅和济宁鱼台、菏泽单县毗邻，也是鲁苏两省的交界地。

According to introducing,Distance jinxiang county town of 23 km XiaoYun town,Is located in the southernmost tip jinxiang.Not only YuTai and jining/Heze shan county is adjacent to the,Is lu Sue the provinces of hui.

　　除了地理位置的偏僻和交通不便，医疗条件更成为制约这家基层乡镇卫生院的“死穴”。有老职工介绍说，因为长时间没有患者，这里的手术室破旧不堪，形同虚设，推门看到的是厚厚的灰尘，医生甚至哆哆嗦嗦不再敢上手术台了。此外受人才、资金、设备等瓶颈问题困扰，2011年之前，只能依靠药品差价和有限的医疗收入勉强维持运转，54名在职人员，每月数百元的收入，甚至难以维持生活。

In addition to the geographical position of the remote and traffic inconvenience,Medical conditions more restricted the base of rural hospitals"Die hole".There is old worker said,Because of long time no patients,The operating room worn out,eroded,Push the door see is the thick dust,The doctor even compound shiver no longer dare to talk on the operating table.In addition by talents/funds/Equipment bottleneck problems,2011 years ago,Can only rely on drug price difference and the limited medical income scrape by operation,54 on-the-job personnel,Hundreds of yuan monthly income,Even difficult to maintain life.

　　在这种窘迫状况下，当地居民看病成了难题。据袁波介绍，当时病患流失外地情况严重，诸多患者都流向了距肖云仅16公里的江苏丰县的医院。“患者减少，使得当地医院的发展更加举步维艰，已经形成了一个恶性循环。”

In this distress condition,Local residents the doctor became a difficult problem.According to YuanBo introduced,When patients from loss of severe cases,Many patients are flow from the XiaoYun only 16 kilometers of jiangsu FengXian hospital."Patients to reduce,Make the development of the local hospital more crippled,Has formed a vicious cycle."

　　而位于济宁市高新区的柳行社区卫生院，曾经的窘境比肖云更加严重。

And is located in jining city high-tech zone of LiuHang community health center,Once the quandary than XiaoYun is more serious.

　　这所始建于上世纪70年代的基层医院，也曾有过风光的历史，但因多种原因，却一度解体。自1988年便在这家医院工作的郑仁昌告诉记者，2005年前后，因负债严重，入不敷出，这座五层的医院被承包给了个人，包括他在内的43名在职人员也被遣散回家，每月仅能领取60%的基本工资。

This was founded in the 1970 s basic-level hospitals,Also had the history of the scenery,But for a variety of reasons,But once the disintegration of.Since 1988 and in the hospital work ZhengRenChang told reporters,Before and after 2005,Because of the serious liabilities,Cannot make ends meet,The five layers of hospital were contracted to individuals,Including his 43, on-the-job personnel have also been sent home,Monthly can only receive 60% of the basic wage.

　　“仅靠那点工资根本没法活，好多医生都不得不打起了零工补贴家用。”郑仁昌回忆说，在被承包给个人后，医院的设备更是少得少，丢得丢。“最后已是破败不堪，有的房间甚至被用做了厕所。”

"Only on the point wage couldn't live,Many doctors have to play up the odd jobs subsidies household."ZhengRenChang recalls,In contract to the individual after,The hospital equipment is more little less,Lost lost."The last is worsening,Some room to even be used as a lavatory."

　　不同的地方，相似的窘境。郑仁昌告诉记者，在柳行医院停业期间，院方曾接触过多家医院，谋求出路，但没人愿意接收这样的烂摊子。而为了满足本地居民的医疗需求，减少患者外流现象，金乡县也在做着努力。

Different places,Similar dilemma.ZhengRenChang told reporters,In LiuHang hospital during the closure,The hospital had contact with too many hospitals,Seek a way out,But no one is willing to receive such a mess.In order to satisfy the local residents needs of medical treatment,Reduce patients outflow phenomenon,Jinxiang also doing the hard.