上海市耐多药肺结核患者治疗减免政策实施现况分析

发布时间：2018-06-05 20:38

本文选题：结核 + 抗多种药物性　；参考：《中国卫生资源》2017年05期

【摘要】：目的 :了解上海耐多药肺结核患者的疾病经济负担现状,评价减免补偿政策的效果,为制定更合理的减免补偿措施、切实减轻患者疾病经济负担提供理论依据。方法 :对2011—2013年间确诊并签约进行管理的全部耐多药肺结核患者共287人进行问卷调查、资料查阅,了解其社会人口学特征、诊疗过程及相关的医疗费用支出和减免报销的情况。结果 :减免政策知晓率达99.56%,85.96%的调查对象获得减免,减免额和减免比例的中位数分别为10 311.50元和34.22%。超过半数的调查对象认为减免金额和减免范围不够。所有调查对象的自付比例中位数为60.99%。减免政策实施后,仍有36.84%的患者家庭因治疗耐多药肺结核病产生灾难性医疗支出。结论:减免政策在一定程度上减轻了患者的经济负担,但减免金额少、减免范围小、患者自付比例高、事后报销的方式仍是比较突出的问题。
[Abstract]:Objective: to understand the present situation of disease economic burden of patients with MDR-TB in Shanghai, to evaluate the effect of remission and compensation policy, and to provide a theoretical basis for making more reasonable measures to reduce the economic burden of disease. Methods: a total of 287 patients with MDR-TB who were diagnosed and contracted to be managed from 2011-2013 were investigated by questionnaire, and the data were consulted to find out the demographic characteristics of MDR-TB. Diagnosis and treatment process and related medical expenses and deductions and reimbursements. Results: 85.96% of the respondents got the relief, the median of the reduction amount and the reduction ratio were 10 311.50 yuan and 34.22% respectively. More than half of the respondents believe that the amount and scope of relief is insufficient. The median out-of-pocket ratio of all subjects was 60.99. After the implementation of the relief policy, 36.84% of patients' families still have catastrophic medical expenses due to the treatment of MDR-TB. Conclusion: the relief policy alleviates the economic burden of the patients to some extent, but the amount of relief is small, the scope of relief is small, the proportion of patients' self-payment is high, and the way of reimbursement after the event is still a prominent problem.
【作者单位】：复旦大学公共卫生学院流行病学教研室;上海市疾病预防控制中心科研管理处;上海市疾病预防控制中心业务管理处;上海市疾病预防控制中心结核病和艾滋病防治所;
【基金】：“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项“十二五”课题(2013ZX10004903) 上海市卫生和计划生育委员会面上课题(201440625)
【分类号】：R521

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