Medical system of U.S.A. that I understand

Medical system of U.S.A. that I understand
Medical system of U.S.A. that I understand
The subsidiary brave author of land of Rui Jin hospital of medical college of Shanghai Communications University is during studying in Los Angeles, have the honor in the most loud public hospital CountyHospital of the whole city ' Los Angeles prefecture sets up the hospital) With one of the largest private hospitals - -The medical center of UCLA university works. Have a close-range knowledge of operation of U.S.A.'s medical system. Public hospital - -The assurance of basic medical treatment is in the large Los Angeles area, thousands of of medical organizations spreading over each corner in the cities and towns, but there are two the city center is equivalent to public medical organizations of the tertiary first rate hospital of our country: CountyHospital (Los Angeles prefecture sets up the hospital) With ChildrenHospital (Los Angeles children's hospital) . They have undertaken the basic medical task in Los Angeles city center area 80%, have the characteristics that all public hospitals possess on it: Press close to common people's stratum very much in the geographical position. Liang hospital from Downtown ( City center) Only 10 minutes. Different from Shanghai, the basic residents in the centre of Los Angeles are black person and immigrant in Latin, near the perimeter and take Asian descendants as the core, all belong to common people's stratum. Such site selection has helped crowd of the basic unit the most go to a doctor. It can be free of charge to see the doctor. Here to say public hospital diagnose the illness, need money, but patient finish watching disease or finish, can refuse to pay bills check. Regard setting up the hospital in the prefecture as the example, the patient often a serious illness patient spent money treating and curing by the government or does not have any illegal immigrants of insurance etc.. They need to treat and cure but the impossible crowd who bears the hospitalization cost. The method of U.S.A. is to handle their disease and do the essential inspection, give them a bill after the service, whether but paying decides by patient or not. I have seen several African and Mexican borderland patients putting the magnetic resonance bill into the litter basket gracefully personally. All expenditure is undertaken by the government. These two hospitals belong to the project of the Los Angeles municipal government. The expenses of all of hospitals, especially the most expensive manpower expenditure is by the budget appropriations of government finance, it does not influence the medical worker income or not whether the patient pays. But because there is no money in the government, the hospital scale is being compressed constantly. The prefecture sets up the hospital there are 2000 berths when being most brilliant, only about 800 pieces now, and in reducing constantly. Purchase a very large portion of the service. The largest feeling is that the medical worker here is to set up the hospital in the prefecture and go to work " The multinational army " . Everybody comes from all corners of the country, and divide into and belong to different departments and different companies. For example the magnetic resonance is checked and finished by service company of a medical diagnosis, all apparatus and technicians are company's employees. They finish, check according to contract that sign with hospital, but magnetic resonance diagnose doctor to hold by the intersection of University of Southern California and doctor of medical college concurrently. Because the chartering the service outside of a large number of, the management cost of the hospital is very low. Such hospital, only there are 3 people in the nursing dept., only there are 2 people in Human Resource Department, there is no logistic administrative department. The resident is the subject strength of the clinical work of the hospital. Because the medical talent's manpower of U.S.A. has very expensive cost, the prefecture sets up the hospital as one of the affiliated hospitals of University of Southern California, task of undertaking his more than 80% of the residents and training. This respect can let the resident touch a large number of clinical cases (a large number of free medical care guarantee the hospital does not lack patients, and there is a very large number of number) ,Having guaranteed the clinical teaching resources, but the more important thing is, resident's salary has relatively low income, the expenses which employ an attending physician of training are worth 10 residents. Its direct consequence is that the resident becomes main medical strength that the prefecture sets up the hospital, account for the intersection of doctor and total more than 90% of working time its working times ' According to website's statistical data inside the hospital) . Seeing the doctor can meet a Fellow ' Chief resident) Even if run into Huatuo. But because of the high standard and strict requirement of U.S.A.'s medical education, overall medical quality is still guaranteed. The hospital serves and can not begin to talk about humanization, can only say that " resolve adequate food and clothing " . A gate in hospital knows anything is " It is not the humanization " . According to U.S.A. " anti-terrorism bill ", all patients and relatives need to carry on the safety inspection, the procedure requires that identical with the airport. See so many people take off the trousers, take off the shoes, really think there the large hospital of our country is very courteous. Checking the time of making an appointment very long of some high price. Make pieces of the intersection of head and magnetic resonance make an appointment two very normal in month, make pieces of head CT, wait for two weeks too. Because a lot of patients rotate over from community's hospital, patients will apply for the government to subsidize in order to pay the expenses that may happen before coming to the courtyard. During U.S.A.'s life and work, the most outstanding impression is the people, can see the doctor. No matter Mexican illegal immigrants, or the famous movie star in Hollywood, no matter the Chinese foreign student who has only basic insurance, the senior white collar that the company checked, can go to see doctor. The method, place that just see the doctor are different from medical personnel receiving. So long as the ambulance arrives, security personnel will get on to the emergency ward to send directly, there will be doctors that have a look. The emergency call patient needn't consider the hospitalization cost while going to a doctor, but must take time. I once saw in the emergency ward a Chinese foreign student went to a doctor because of wrist fracture, from 10 o'clock at night on the same day to 8 o'clock the next morning, just a resident came to have a look, assess and come out " Non- critical patient " ,Send several stop the pain slice, have one chief resident come on, give him play one gypsum finally to will it be 10 o'clock the next morning. But patient's nothing complaint, there are " free lunches " after all It is good. Because the funds of government's hospital are extremely limited, and 100% are buried by the government singly, single number management is the most important management. Many departments regard single number management as the duplicate and write into the clause while signing a contract with the hospital. This guarantees money of the government will not be excessively treated and wasted. Annual State Congress will trust the accounting firm to set up expenditures of the hospital and hospitalization cost of each discipline and carry on audit to the prefecture, and submit the financial report to State Congress, in order to determine the hospital budget of new fiscal year. Private hospital - -Chinese's famous American hospitals with the impression of biggest difference of medical systems of China and the United States are all private. No matter Sri Lankan of total institute of Masschusetts, Hopkin, or the medical centre in Harvard, Stamford, Dezhou, all medical organizations controlled by the board of directors, all belong to private hospital properties. In China, one of the best one is all public hospitals, and the non-profit-making hospital. So, the private hospital is the greatest difference in medical systems of China and the United States. As the private hospital, survive and develop its way applicable to all. The large-scale private hospital of U.S.A. must take Want the profit, it is the balance between revenue and expenditure at least. Its main capital source is roughly the following 3: 1. Hospitalization cost which the patient paid. The majority is the fund that an insurance company paid. 2.Reasearch funds and deriving incomes. The first-class hospital of U.S.A. is taking charge of numerous scientific research and development, trial-production and clinical experiment work. Often policy guidance of about the results of study of many centres of several hospitals FDA and financial situation of a great deal of companies, so the input that every large pharmaceutical factory researches and develops in clinical trial and earlier stage is surprising. In addition, government especially basic research of NIH invest and abuse the principal either. Among them a big chunk was undertaken by the laboratory of the large-scale hospital. After medicines and various medical apparatuses are succeeded in developing and put into the market, the repayment of its value is one of the important source of revenue of the private hospital too. 3.Various donations and investment. The countless private foundations of the whole America offer ten billions of fund to the hospital system with the charity organization every year, is used for medical research and helps those patients needing to help it. So, as the president of the private hospital of U.S.A., its primary work is to go to obtain more subsidy. He must be responsible for board of directors and subordinate staff, guarantee a smooth hospital development and progressive in order. Secondly, he needs to excavate the outstanding pace-setter in scientific research in the world, the personnel strength who guarantee every discipline of the hospital is sufficient and high-efficient. Third, plan the developing direction of the hospital. A lot of large president of hospital hold the intersection of medical college and president concurrently, they can from high angle to treat the intersection of hospital and future of development. As to China, directors of U.S.A. do not need to have too many concerns on medical work, the development of concrete discipline does not need to overly worry about either. Medical committee and management system within discipline have guaranteed every speciality can relatively run independently, fully develop freely on condition that violate medical law and hospital contract. In fact, the power of president of the private hospital of U.S.A. is comparatively limited. Because every discipline basically runs independently, there is intact operation system within every subject, many departments have also disposed the large-scale medical apparatus by oneself, many heads of the department all engage and finish corresponding financial affairs and legal affairs with professional accountant and lawyer. The president has too many measures that can intervene the concrete affairs within discipline, mostly carry on the examination of discipline through the form of the contract. The interdisciplinary coordination work is finished by the agent of every discipline, the president's work does not involve very concrete using work such as human rights, also there are no too many interests to tie down, talents are power owners of the private hospital that big shot's Professor and discipline take the lead. The disparity of medical systems of China and the United Stateses is enormous, the defect exists too in the medical system of U.S.A., but can resume to see it is always good.


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