印度亚拉文眼科模式
第8卷第2期
2OO6年4月
眼视光学杂志
ChineJournalofOptome~&opllddo
,1.8No.2
Apr.2OO6
医院管理?
[编者按】印度亚拉文医院是世界卫生组织合作单位，创造了"大规模，高质量，低成本"的眼科医疗模式,
2005年，医院门诊量达163万多，手术超过22万例，其中白内障手术达16万多例，为世界之最.如何有效地
借鉴印度亚拉文的模式为我所用，成为中国眼科界同仁日益热烈讨论的一个话题.本刊特邀印度亚拉文医
院的主要负责人就该模式的特点撰文介绍.
Aravindeyecaresystem:auniquemodel
SrinivasanM,ThulasirajRD2,PreethiPradhan2,V eniG鼓足干劲
《穷人》1.AravindEyeCareSystem;
2.LionsAravindInstituteofCommunityOphdmlmology,Mad urai,India
Itwastheyear19r76.P|IdmasIlreeDr.G.V即kataswa町had
justmthedfromtheC~verlmmntMedicalCollege,Madurai,India astheHeadoftheDepafaneutofI'pIltIlaII∞l0.Ra~erthant.
tlilforarelife,Dr.V.恤detonninedtocontinuethe
workbeⅧd0jl1gattheGovermmntMedicalCollege,especially
删IdliIlgouttotheoommunitytllIoummleyecamps.n1iswasto providequalityeyecaIetotherichandthepoor,alike.37raillion西北工业大学录取分数线
peopl~w~ldwideand6.7millioninIndiaaostimatodtobeblind.
Over80%ofthisisneedless-itcaneitherbepreventedoraI.
H.珀vision恤si唧leyetgrand:toeliminateI蒯essblind.
I眦Withthismission,Dr.Vbamodest11bedclinic,
Im鹊wnintotheworld's latgostproviderofeyecaIe.nli8missionhasdrivenAravindto. wantsprovidingnotonlyhospitalbadeyecaIB.buttowa_n~ad—drtheproblemofblirdnessinacomprehensiveway.眦sis achievedthroughthevariousaspectsoftheAravindEyeCareSystem describedbelow.
1ProvidingcompassionatepatientaIr1e,AravindEyeHospi-
tals监控安装步骤
AravindEyeHospital,aWHOCoUaborafingCont~eforPre. venfionofBlindness,providesanentirerangeofeyecaIervices fromplimaryeyecaIetospecialtycaIewithstate-of-the-artfacili.
ties,throughitsnetworkoffiveeyehospitalswithacombinedbed capacityof36OO8e啦primarilyuthemStatesoflndh.The
收稿日期:2006—02—20；修回日期:2006—03—12
吴晨光
作者简介:sriniⅧmM,Dir∞t0r,AmvindEyeCareSya~m;1一AnnaNa- gax,Madurai一625020,Tamih~lh,India;E—mail:veni@8Hrv划. org;
温柔文案Wetmite:www.aravlad
revelulefromtIleon~dfintofthowhodopayo0V eIsthecostfor
tIletⅡljrdswhodon'tandgeneratesas.~plusforfur~lerm汕
anda甲0I1.
AnAmvinddoctorpfmsbetween30and40cataractsurg—
桑兰criesina5—6hourssuI百cal~88ion.Anaverage01)IltIl0 inIndiapsaround4OOcataractsurgeriesperyear,whilean Amvindsurgeonpsaround2OOOsuchsurgeries
withoutcoin—promisingonquality.Sinceitsirnin1976totheyear2005, AravirMEyeHospitals(authefiveocnlI1U~dtogether)have~mnined
19.5millionoutpatientsandperformedaround2.5millionsurg. cries.ItsllishvolumeofsurgerymskositthelalgosteyecaIe providerintheworld.Aravind'fficiencyocult~fromadoptingap—pmpriatesystemsandprocess.Thinablesittoprovideafford—ableeyecaIerviceitherats1diorilocost.
2BI谢partaersh~with
reached,Conanmi~outreach
oarnet~tormofAravind'sl1igIlvolumeworkisiIsstmcaL~ outreachprogrmnmos.Theamcomprehensivesc抛r】geye campsthatareconductedwithanactiveinvolv圈n瞳吐oftheocmm—l1.
nity.n1ishasledtodevelopingawide~ommurdtynetwork.Widl thesupportofthisnetworkeveryyeararound1500~nSeye campsaIeconductedthatocvel~dapopulationofabout90millionac.
~ou~dngforcloto4O%0faUeyecaIeprovidedintheregion. Around32%ofthetotal鲫哑jlI.0lmedatAmvind,isget.rat- edthroughoutreachc锄p8.AsarIaltenmtiveappt~ch,Amvindis institutingoutpatientcommunityocIltPX~andcomprehensiverI'en. abledprimaryeyecaIBvisionociltPX~inordertoprovidepenmswxa acce88andsustainedeyecaIetotheruralpopulation. Amvindbelievosthatappropriate岫血lgisqI血atalllev. elstoworkasacohesiveteamandthishasbecomeomofthec0re activitiesthatcarriedoutfromtheearlyeighties.HumanRe-
llilg~sDevelopmentatAravindEyeCareSystemhasawidespec. tnmlfromdevelopinggenemlophthalmologiststollyskilledspe. cialists,paramedicstaff,hospitalm缸目eIs,andsupportshaftlike insmanerssmaintetmnc~technicians,outreach.o0n|ina主cd.
At-
8vindEyeHospitalsandLAIC0(LionsAravindInstituteofCommu.
nityOphthalmology)togetheroffem35structuredc0lⅡandmany morecustomdIBsi划c0I嗍throughouttheyear.Tilldate,2250 ophth-'dmologistshavebeentrainedinbdsicoph6~tmologyaswellas invarioussub-specialtios.
一
117—
采茶叶第8卷眼视光学杂志第2期
4风iAravtadModela0bany:Aravtadbsti-
treeofConm-mity0lplIthj|h瑚'0(LAKX))
Asia'8firsteyecarenaiI血institute,I_AICOwastablished intheyearwithamissionto''contributetothepreventionandcon- trolofglobBlblindne~throughteacllilI】g，也liIli】【lg,publications, consultancy,rearchandadvocacyineyecare".1nhmllgI1consul—taneyandcapacitybllildil【lgprogrammes,I_AICOsharesAravind'8 l口【andexperiencewithothereyehospitalsandNGOs. Structuredc0lⅧ砌hdpthelhospitalsdevelopstrategies
andI_AICOalsoguidesthemduringimplementation.Oftenthisin—retentionhasresultodindoubtingtheorganisations'outputwithina
pe0ftwoyears.CurrentlyIAICOiswdngwith205hospitals
8crDssIndiaandotherdevelopingcountries. CommittedtosllariAravind'8a【periel雠,LAIC0withthe
suppo~0fIAPB,hashunchedaneyecaIemⅪg吐oillin~Ie—
s0llrceoerlnB."VIs10N2Oe-res0llrce".lisonlin~cenR'ehasa comprehensiveco~netionofres0llrcesoneyec啪m毗l鹏r吐that wouldbeufultoeyecareproviders.Itsha_r~8valuabletoolsthat helpa8日es8,plan,implementandmanagehighquality,efficient, andsustainableeyecareprogjmnmesinthedevelopingworld.
5B'd$t-ontiers-Arav~mdTlde_叩hIjhah加10Network (ATN)
AcvaluedrivingAmvind'8workistoeIl吕uIeequi钾iIl rvicedelivery.Howevertherealityisthat80%oftheeyecarel"e—soulDe$arelocatedinurbanttleswhereas8O%0fthepatients arelocatedinruralctor.Eyecarel"eSoulPA~beingscarce.ITis viewedasatooltoeq1djprovisionofcompetentc;lreirrespective
0fgeographicallocation.
(~Yrele-ophthalmologyinhospitaltup-Doctomatmultiplelo—cationscandiscusscasandcanlinkupf0rcross—learning.⑥
Tele-ophthalmologyinruralctor-Al~imtinaruralprimmyeye carecentercanaoces8the既pe0faneyespec~llstattheba hospital,throughasimplewebcamandwirelesslink.@Tele-oph—thMmology-Education&Training-Amvindcollaborateswithvarious leadingeyeimtituteslikeWilmereyeinstitute0fJ0|Ⅱl'8Hopl~U—niversity,CornellUnivemi何andColumbiaUniversityaroundthe worldforeducation，缸aiIandrearch.Ⅱoughthiscoll~ora—donthedDc幻IsinAmvindcaIlinteractandsharetheira【perieIloe8 withtheexpellsaroundtheworld.
Amvindhasdevelopedasimple-to-utele-consultationsoft.
(I)eyestalk:facilitmesdoctorsineIlgacondopinion.②
印度亚拉文眼科模式
[关键词】医院管理；眼科模式：亚拉文模式
[中图分类号】C939;R79[文献标识码】A
[文章编号】1008—1801(2006)02—0117—03
1976年,V enkataswamy博士从印度马杜赖的政府医学院
眼科主任的职位上退休，但他并没有去享受安逸的休闲生
活，而是决心继续他原来的光明事业.尤其是通过眼科普查
事业深入到乡村，社区，他要为大众提供高质量的眼科医疗DRAGON:capturesp~imt'8Iedl1ali衄g∞ataremotesiteand adesthoiⅡmge8toa够e88theDRcondition.
6Evidencebadeyecare-AravmdIicRearchFm-
