我国居民就诊流向对看病难看病贵的影响

分析了1990—2005年卫生部门医疗机构就诊流向和费用水平的变化，发现居民就诊明显向大医院集中，而大医院每门诊费用水平远高于基层卫生机构，就诊流向不合理是造成“看病难、看病贵”的重要因素。根据不同就诊流向标准，文章提出高、中、低三个调整方案，可分别节省门诊费用406．87亿元、286．76亿元和195．10亿元；并提出了相应的政策建议，为基本卫生保健制度的设计提供参考和依据。

Study on impact of patients flow on inadequate and overly expensive medical services

This article analyzed the trends of outpatients flow among medical facilities from 1990 to 2005. The result shows that outpatients flow concentrated to hospitals at higher level, meanwhile, the expenditure per outpatient visit of hospital at higher level was much more than that of medical facilities at the root level. Thus, unreasonable outpatients flow is one of the main causes of inadequate and overly expensive medical services. The author proposed high, middle and low dispersal plan based on different outpatients flow standard, which will reduce outpatient expenditure by 40.69, 28.68 and 19.51 billion yuan respectively. Author also made related policy recommendation that would provide the basis and reference for Essential Health Care Scheme design.