1995年上海开始实行“总量控制、结构调整”后,使得门急诊几十年形成的传统管理模式所产生的矛盾也日益暴露。“总量控制、结构调整”下如何加强门急诊管理,以适应日益激烈竞争的医疗市场,本文对此作一浅析。 1 背景 1.1 1998年上海继续实行1995年推出的“总量控制、结构调整”医改措施,同时加大对药品费用增长的控制力度,使医院医药费用增长与上海的经济发展水平和社会承受能力相适应。上海市卫生局规定“1998年以1997年的医药费总收入为基数,1998年度的全市医药费总收入控制在比1997年递增15％以内,其中药品 In 1995, after Shanghai began to implement “total control and structural adjustment,” the contradictions that have emerged from the traditional management model that has emerged in the emergency department for several decades are increasingly exposed. How to strengthen emergency medical management under “total control and structural adjustment” so as to adapt to the increasingly fiercely competitive medical market? This article gives an analysis of this. 1 Background 1.1 In 1998, Shanghai continued to implement the “comprehensive control and structural adjustment” medical reform measures introduced in 1995. At the same time, it increased the control over the growth of pharmaceutical costs, and increased the hospital’s medical expenses and the economic development level and social affordability of Shanghai. adapt. The Shanghai Municipal Bureau of Health stipulated that “in 1998, based on the total income from medical expenses in 1997, the total income of medical expenses in the city in 1998 was controlled to increase by less than 15% from 1997, including pharmaceuticals.