Reizenstein P
Department of Medicine, Karolinska Hospital and Institute, Stockholm, Sweden.
Rev Med Chir Soc Med Nat Iasi. 1991 Jan-Jun;95(1-2):151-7.
Attitude studies of patients, their relatives, and sometimes even widows or widowers suggest that about 80 per cent of a small sample of Swedish in-patients are satisfied. However, the discontinuity of patient-staff relations in 69 per cent of out-patients is disturbing. There is a possibility that medical quality in the Swedish non-fee-for-service system is affected negatively by staff inactivity, which could explain slow diagnoses, long median durations of stay, and high cost. A tentative but comprehensive study indicates a theoretical efficiency increase in a large Swedish hospital of about 40, and a realistic increase of about 10 per cent. In the author's view, present attempts at cost reduction rarely achieve an efficiency increase, but they may reduce medical quality. The absence of quality assurance in parallel with cost reduction is criticized, and a WHO recommendation is proposed.
对患者、其亲属，有时甚至是寡妇或鳏夫的态度研究表明，瑞典一小部分住院患者样本中约80%感到满意。然而，69%的门诊患者医患关系不连续令人不安。瑞典非收费服务系统中的医疗质量有可能受到工作人员怠工的负面影响，这可以解释诊断缓慢、中位住院时间长和成本高的问题。一项初步但全面的研究表明，瑞典一家大型医院的理论效率提高约40%，实际提高约10%。作者认为，目前的成本削减尝试很少能提高效率，但可能会降低医疗质量。批评了在削减成本的同时缺乏质量保证的情况，并提出了一项世界卫生组织的建议。
