目的 对医护人员履行自费医疗费用知情告知的情况进行调查与分析.方法 分层随机抽取浙江省某三甲医院40个病区2016年医保患者住院病历480份,并结合半开放式调查问卷,对医护人员自费医疗费用知情告知现状进行调查.结果 知情告知率整体低下,仅床位费的告知率达到70％以上,医护人员认为知情告知的有效履行受主、客观等多因素的影响.结论 医护人员自费医疗费用知情告知履行还存在不到位的情况,需多方联动、多措并举,以提高知情告知率.%Objective: To investigate and analyze the performance of informed consent of self-expense medical expenses by medical staff. Methods: By using stratified random method, a sample of 480 medical records of medical insurance patients was selected from 40 wards of a third class A hospital in Zhejiang province in 2016. Combined with semi-open questionnaire, the performance of medical staff was investigated to do informed consent of self-expense medical expenses. Results: In general, the rate of informed consent was low, and only the rate of informing bed fee was over 70％. Medical staff thought that the effective performance of informed consent was affected by many factors, such as subjective and objective factors. Conclusion: There are still some problems in the performance of informed consent of self-expense medical expenses. It is necessary to take multi-party linkage and multi-measures interventions to improve the rate of informed consent.
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