Sosić Z, Kovacić L
Skola narodnog zdravlja Andrija Stampar Medicinskog fakulteta Sveucilista u Zagrebu.
Lijec Vjesn. 1992 May-Aug;114(5-8):84-6.
The paper is an attempt to answer the question whether the military hospital is necessary or not in such a small country. Some arguments (and contra-arguments) are listed and discussed. Between the others are: (1) the necessity of developing "war" medical skills and knowledge (cannot be developed during peace-time neither in the military nor civil hospitals, and civilian health services are capable to adapt and to fulfill specific war tasks as it was shown in war in Croatia in 1991), (2) the possibility to develop specific, even peculiar, specialties as hyperbaric or space medicine (these are necessary at the airports, navy bases etc, not in military hospitals), (3) specific health needs of the population of soldiers, officers, and their families (as a rule this population is younger and positively selected i. e. healthier than the general population), (4) security reasons (the data are more accessible from the military service in one place than from the scattered civilian health services), (5) privileges in health care for population of soldiers, officers, and their families due to their particular merits (military forces themselves deny this reason; also, separate military health services is not really the privilege due to bureaucracy, and rather narrow choice of services, (6) separate services could be less expensive and more efficient than the civilian one (experiences from the other countries are completely opposite). The conclusion is that, for such expensive parts of health services, as hospital care (spending between 40% and 70% of the total health expenditure), there is the growing need for rational and planned development within the comprehensive and integral healthcare system. Inside such comprehensive system the military hospital does not look like a rational solution.
本文试图回答在这样一个小国是否有必要设立军队医院这一问题。文中列出并讨论了一些论据（及反论据）。其中包括：（1）发展“战争”医疗技能和知识的必要性（无论是在军事医院还是民用医院，和平时期都无法培养，而且民用卫生服务机构有能力适应并完成特定的战争任务，如1991年克罗地亚战争所显示的那样），（2）发展特定的、甚至独特的专业领域，如高压氧医学或太空医学的可能性（这些在机场、海军基地等是必要的，但并非在军队医院），（3）士兵、军官及其家属群体的特殊健康需求（通常这一群体更年轻且经过积极筛选，即比普通人群更健康），（4）安全方面的原因（在一个地方从军事服务获取数据比从分散的民用卫生服务获取更容易），（5）由于士兵、军官及其家属的特殊功绩而给予他们在医疗保健方面的特权（军队自身否认这一理由；此外，由于官僚作风以及服务选择相当有限，单独的军事卫生服务并非真正的特权），（6）单独的服务可能比民用服务成本更低且效率更高（其他国家的经验完全相反）。结论是，对于医疗服务中像医院护理这样昂贵的部分（占卫生总支出的40%至70%），在全面且综合的医疗保健系统内，越来越需要合理且有计划地发展。在这样的综合系统中，军队医院似乎并非一个合理的解决方案。
