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教学医院费用一般比非教学医院高。其原因甚多。其中之一是实习医生和住院医生过多地进行一些检查项目,使得病人的费用高于非教学医院。以加拿大蒙特利尔,维多利亚皇家医院四个普通内科病区为例。病人虽由主治医师监督,住院医生和实习医生进行诊治,但全面诊断和开列实验室项目检查则主要由住院医生决定。在三个月中,前瞻性地研究了四个连续周转收治病人的病区,并将其分成A、R两组。入院时由一技术员记载病人年龄、性别及入院诊断,接着逐日记录所有实验室检查、诊断、会诊和用药。病人的单项试验不收费或不详细列表。在所调查的553例病人中,女性253人,男性301人。每月每组男女分布相似,平均住院期及疾病的分类相似,但病情轻重无法估计。
Teaching hospitals generally cost more than non-teaching hospitals. There are many reasons for this. One of them is that the interns and resident doctors carry out some inspection items too much, making the cost of the patient higher than that of non-teaching hospitals. Take the example of four general medical wards at the Royal Victoria Hospital in Montreal, Canada. Although the patient is supervised by the attending physician, the resident doctor and the interns perform the diagnosis and treatment, the overall diagnosis and the examination of the laboratory items are mainly determined by the residents. During the three months, four consecutively revolving patient wards were prospectively studied and divided into A and R groups. At the time of admission, a technician recorded the patient’s age, gender, and diagnosis of admission to the hospital, and then recorded all laboratory tests, diagnoses, consultations, and medications on a daily basis. Individual trials for patients are free or not detailed. Of the 553 patients investigated, 253 were women and 301 were men. The distribution of men and women in each group was similar each month, and the average length of hospital stay and disease were similar, but the severity of illness could not be estimated.