我国慢性病可避免住院费用规模及筹资负担分析  

Analysis of the Potentially Preventable Hospitalization Expenditures and Financing

作　　者：辛然 柴培培 万泉 翟铁民 郭锋 李岩 张毓辉 

机构地区：[1]中国医科大学护理学院,沈阳110122 [2]国家卫生健康委卫生发展研究中心,北京100044

出　　处：《中国医疗保险》2023年第8期13-19,共7页China Health Insurance

基　　金：国家自然科学基金资助项目“配置效率视角下慢性病可避免住院费用核算方法及影响机制研究”(72004041)。

摘　　要：目的:核算分析2018年我国慢性病可避免住院费用规模、结构及筹资负担,分析我国医疗资源配置效率。方法:以卫生费用核算为基础,按照可避免住院疾病范围核算分析我国慢性病可避免住院费用总量、构成和筹资负担。结果:2018年我国慢性病可避免住院费用总量为1695.10亿元,占住院费用的8.99%,基本医保支出为1011.41亿元,占住院基本医保支出的10.46%。超七成的慢性病可避免住院费用发生在综合医院,近七成的可避免住院费用发生在慢性阻塞性肺病、糖尿病、高血压,50岁及以上人群是可避免费用的消费主体。从筹资负担看,近三分之一的慢性病可避免住院的医疗收费由个人支付。结论:我国可避免住院费用规模较大,反映出我国可避免住院问题比较严重,应加大对重点疾病、重点人群干预作用;我国慢性病可避免住院消耗了较多的公共筹资资金,同时家庭负担较重;未来应借鉴国际经验,构建我国可避免住院监测指标体系。Objective:The paper calculates and analyzes the scale,structure and the financing burden of potentially preventable hospitalization(PPH)expenditures for non-communicable diseases(NCDs)in 2018 in China,and analyzes the efficiency of medical resource allocation in China.Methods:Based on the System of Health Account and the scope of PPH diseases,the paper calculated and analyzed the scale,structure and financing burden of PPH expenditures for NCDs in China.Results:In 2018,the total expenditures of PPHs expenditures for NCDs were 169.51 billion yuan,accounting for 8.99%of total hospitalization expenditures,while the expenditures of basic medical insurance fund were 101.11 billion yuan,accounting for 10.46%of basic medical insurance fund for inpatient care.Over 70%of PPH expenditures for NCDs occurred in general hospitals,nearly 70%of PPH expenditures were caused by chronic obstructive pulmonary disease,diabetes,and hypertension,and people aged over 50 are the main consumers of PPH expenditures.In terms of financing burden,nearly one-third of PPH expenditures for NCDs were paid by individuals.Conclusion:The scale of PPH expenditures in China is large,PPH issue is serious,therefore we should increase interventions on major diseases and populations.PPH for NCDs in China consumed more public financing funds,and the burden on families is heavier.In the future we should learn from international experience to develop a PPH monitoring indicator system.

关 键 词：可避免住院费用 卫生费用核算 慢性病 筹资负担 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]