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记者体验:让人望而却步的印度公立医院

2017-09-01 07:01:00   新华网

印度宪法规定,政府为全民提供免费医疗。这意味着在公立医院,包括营养餐在内的所有病患开销都由政府“埋单”。

公立医院的状况在印度尽人皆知:不整洁的病房,肮脏的医院走廊,恶臭的厕所……再加上设施不完善、管理不到位、药品不齐全、医护服务不及时等问题,只有近乎“赤贫”的穷人才会选择免费医疗。城市居民和稍微富裕的农民,宁可选择街边私营诊所,也不愿踏入公立医院的大门。

记者曾造访过德里和孟买部分公立医院。走廊昏暗、房舍破旧、设备老化是这些医院共同面对的难题。即使是在相对先进的全印医学研究院德里分院,如潮的病人也让环境纷乱不堪。而在规模较小的公立医院,连血常规这样的基础化验条件都不具备。病人只能凭处方,在院外私人开办的化验室接受医疗检查,再由公立医院医生依据结果开具处方。

庞大的人口基数和可怜的政府预算,早已让公共医疗卫生体系不堪重负。求助公立医院,更像是病人走投无路时的“最后一根稻草”。

印度2017-18年政府医疗卫生预算仅为4887.8亿卢比(约合520亿元人民币),在总预算中占比2.27%。而这仅有的不到5000亿卢比的资金,面对的是从中央到地方的三级公共医疗卫生服务体系,在庞大人口基数面前,无疑杯水车薪。

如果说恶劣的就医环境和硬件的落后还能忍受,药品短缺则是公立医院更为致命的问题。2016年,记者曾到访新德里市中心的拉姆·马诺哈尔·洛希亚医院。这座始建于1932年的公立医院由印度卫生和家庭福利部直管,属于印度三级医疗卫生体系中最高的中央一级。

即便是在这一首都的高等级医院,药房库存也捉襟见肘,小小的窗口前经常挤满手持处方“碰运气”的病人。而在中小城市和广大乡村,所谓免费医疗,更只能提供“望闻问切”和开具处方的服务,至于取药和后续治疗,病人只得“自力更生”。

公立医院的整体落后催生了印度发达的私营医疗体系。世卫组织报告显示,私营医疗机构收治了全印约80%的门诊病人和60%的住院病人。

对普通印度人来说,头疼脑热时,街边的药店诊所都有坐班医生开方抓药。坦白讲,药价确实不贵,药效也立竿见影。

如果遭遇大病重疾,也有私立大型综合医院24小时开放,其医疗水平、就诊环境和硬件配备比公立医院高出许多,治疗费在国际上也属中低水平。当然,对于数以亿计的印度贫困百姓来说,这样的价格依旧高不可攀。(毕晓洋 白纯 吉特·库马尔)(新华社专特稿)

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