基于农村医疗保障制度的老年居民慢性病管理理论框架构建  

Chronic Disease Management Theoretical Framework for Elders:Based on Health Security System in Rural China

作　　者：代宝珍[1] 周绿林[1] 余悦[1] 

机构地区：[1]江苏大学管理学院,江苏镇江212013

出　　处：《西北人口》2013年第4期83-89,共7页Northwest Population Journal

基　　金：国家自然科学基金"基于农村医疗保障制度的老年居民慢性病管理模式研究"(71203080);江苏大学高级专业人才科研启动基金资助(12JDG122);中国博士后科学基金(2013M530242);江苏省博士后科研资助计划;江苏省教育厅项目(06SJB630017)

摘　　要：慢性病是我国城乡居民首要死因和疾病负担主要来源,人口老龄化是慢性病患病率持续上升的主要原因。我国农村地区人口老龄化程度严重,老年居民慢性病负担突出。慢性病管理作为有效改善慢性病患者健康状况、降低医疗费用的手段,如何将慢性病管理纳入医疗保障制度是当前全球社会医疗保障领域的研究热点。本文综合国内外慢性病管理相关理论和实践研究成果,构建了基于农村医疗保障制度的慢性病管理理论框架,第一次从理论上明确了社会医疗保障机构在慢性病管理中的重要地位和作用,并以新型农村合作医疗制度(新农合)为切入点,阐明了新农合积极介入慢性病管理的理论上的必要性和可行性,为进一步推动农村医疗保障制度改革提供理论支撑。Chronic diseases are the leading causes of both death and the burden of disease in China. The aging of population is the main reason that keeps the prevalence rates of chronic diseases on a rise. The aging of population is more serious in rural China with heavy chronic disease burden among the elderly. Chronic disease management （CDM） has been proven to be effective in improving health status of individuals with chronic diseases and reducing medical expenses. Currently,the question ＂how can CDM be adopted by social health insurance＂ has been a hot point for research. This study built a CDM theoretical framework of social health insurance system by reviewing domestic and foreign theoretical and empirical researches. It is the first study to theoretically clarify the important role of the social health insurance agencies in CDM. Taking the new cooperative medical scheme （NCMS） into account, this study clarified the theoretical necessity and feasibility for NCMS to actively participate in CDM as an important stakeholder and provided theoretical support for further promoting social health insurance system reform in rural China.

关 键 词：新型农村合作医疗制度 农村 老年居民 慢性病管理 理论框架 

分 类 号：F840.613[经济管理—保险]