结核病与肺部健康杂志 ›› 2014, Vol. 3 ›› Issue (2): 82-85.doi: 10.3969/j.issn.2095-3755.2014.02.002

• 专论 • 上一篇    下一篇

建立新型结核病诊疗服务筹资模式的探讨

刘晓俊, 徐勇, 张培, 周萍, 方正超   

  1. 443000 湖北省宜昌市结核病防治所
  • 收稿日期:2014-05-16 出版日期:2014-04-20 发布日期:2014-04-20

Discussion on establishing new mode of financing for TB diagnosis and treatment services

LIU Xiao-jun, XU Yong, ZHANG Pei, ZHOU Ping, FANG Zheng-chao.   

  1. Institute of Tuberculosis Control in Hubei Province Yichang City, Yichang 443000,China
  • Received:2014-05-16 Online:2014-04-20 Published:2014-04-20

摘要: 收集整理宜昌市肺结核患者2011年1592人次新型农村合作医疗(简称“新农合”)住院医疗费用及722人次医疗保险(简称“医保”)费用,新农合住院医药费报销比率最高达到70.00%,最低为35.52%,门诊全额自费;职工医保对肺结核患者医药费报销达到71.69%;居民医保为53.60%,门诊报销比率仅为20.45%。肺结核患者承担着诊疗费用的大部分,医疗负担仍较严重。结核病防治机构应做好测算与协调,履行政府职责,建立新的结核病筹资机制,充分发挥多方筹资机制在补偿结核病患者医疗费用方面的作用;为保障肺结核患者的利益、推动结核病防治、深化公共卫生均等化而服务。

Abstract: We collected the medical expenses of 1592 cases of TB inpatients covered by new rural cooperative medical care system (referred to as “NCMS”) and of 722 cases covered by medical insurance, found the highest of reimbursement rate for inpatient covered by NCMS was up to 70.00% and the lowest was 35.52%,the outpatient cost for TB patients themselves were full at their own expenses;the reimbursement rate by workers medical insu-rance was up to 71.69% for TB patients, 53.6% for patients covered by resident care insurance, and the outpatient reimbursement rate was only 20.45%. Therefore the TB patients still bear large proportion of cost for TB diagnosis and treatment, the medical burden for them is still heavy. The TB institutions should do the calculation and coordination, perform the government duties, and establish the fund raising mechanism, take the advantage for multi-ways of fund raising system to compensate for TB prevention and treatment, protect the TB patients, promote TB prevention and treatment and further serve for public health equalization.