全国城乡居民高血压、糖尿病患者门诊用药待遇水平及就医管理研究  

Study on Treatment Level and Medical Treatment Management of Outpatient Patients with Hypertension and Diabetes in China

作　　者：肖熠 张堂钦 邓欣欣 伍红艳 XIAO Yi;ZHANG Tang-qin;DENG Xin-xin;WU Hong-yan(School of Medicine and Health Management,Guizhou Medical University,Guiyang,Guizhou,550025,China;不详)

机构地区：[1]贵州医科大学医药卫生管理学院,贵州贵阳550025 [2]贵州城市职业学院,贵州贵阳550025 [3]贵州医科大学贵州省卫生发展研究院,贵州贵阳550025

出　　处：《中国初级卫生保健》2021年第7期1-4,共4页Chinese Primary Health Care

基　　金：国家自然科学基金项目(71463007);贵州省卫生计生委科学技术基金项目(gzwjkj2017-1-061);贵州医科大学贵州培训项目(GYZXYG-2017-12-635-GY-G公[C99]);贵州医科大学贵州省卫生发展研究院项目(gywf2019-17)。

摘　　要：目的:比较全国各地区关于城乡居民高血压、糖尿病门诊用药的待遇水平及就医管理方式,了解不同地区政策保障机制的异同,提出政策完善的建议。方法:在公开网站搜集全国各地区相应的政策内容,建立EXCEL数据库提取有关内容做比较分析。结果:在现行的待遇标准下,高血压支付限额最高的地区为广西(2000元/年),糖尿病支付限额最高的地区为吉林(3100元/年),全国各地区支付比例保持在50%及以上。在患者的就医管理上,各地区限定了患者享受待遇的医疗机构数量和级别,绝大多数地区选择以二级及以下医疗机构为依托,保障患者的门诊用药。结论:将城乡居民高血压、糖尿病患者门诊用药纳入医保支付这一举措,对减轻我国数亿高血压、糖尿病患者的医疗费用负担起到了积极的作用,但各地区在支付限额上和支付比例上的待遇差别较大,不利于城乡居民公平享受待遇。OBJECTIVE To compare the treatment level and medical treatment management methods of outpatient medication for hypertension and diabetes among urban and rural residents in different regions of China,to understand the similarities and differenc⁃es of the policy guarantee mechanism in different regions,and to put forward suggestions for improving the policy.METHODS Col⁃lect the corresponding policy content from the public website,and establish Excel database to extract the relevant content for compar⁃ative analysis.RESULTS Under the current treatment standard,the highest payment limit for hypertension was in Guangxi(2000 yuan/year),and the highest payment limit for diabetes was in Jilin(3100 yuan/year).The payment ratio in all regions of the coun⁃try remained at 50%or above.In terms of the management of patients’medical treatment,each region had limited the number and level of medical institutions that patients could enjoy treatment.The vast majority of regions chose to rely on secondary and below medical institutions to guarantee patients’outpatient medication.CONCLUSION The medical insurance payment of outpatient medi⁃cation for patients with hypertension and diabetes in urban and rural residents had played a positive role in reducing the medical cost burden of hundreds of millions of patients with hypertension and diabetes in China.However,there were great differences in the payment limit and payment ratio in different regions,which was not conducive to the equitable treatment of urban and rural residents.

关 键 词：高血压 糖尿病 医疗保障 门诊用药 就医管理 

分 类 号：R197.1[医药卫生—卫生事业管理]