摘要：医疗建筑改造项目因功能复杂、专业性强且变更频繁，投资管控难度突出。本文系统剖析其多阶段投资失控成因，构建以需求精准管控为核心、全过程多主体协同的投资管控体系。该体系通过决策阶段的精度优化提升前端估算准确性，设计阶段利用BIM技术与医工协同预控方案与施工风险，采购与施工阶段借助契约化与动态监审落实责任与成本控制。某医院急诊抢救室改造项目的实践应用表明，该体系可显著提升投资管控精度，有效防范超概

风险。

关键词：医疗建筑改造；投资管控；全过程管控；多主体协同；BIM技术

Abstract：Renovation projects for medical buildings face significant challenges in investment control and management due to their functional complexity，high specialization，and frequent changes. This study systematically investigates the causes of investment overruns across various stages and establishes a control system centered on precise demand management through whole-process，multi-stakeholder collaboration. The system improves front-end estimation accuracy through decision-stage precision optimization，applies BIM technology and medical-engineering collaboration in the design stage to prevent design and construction risks，and employs contractual measures and dynamic monitoring in the procurement and construction stages to clarify responsibility and enhance cost control. Practical application in an emergency rescue room renovation project demonstrates that this system significantly improves investment control precision and effectively prevents budget overrun risks.

Keywords：medical building renovation；investment control and management；whole-process control；multi-stakeholder collaboration；BIM technology

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