我国基层医疗卫生机构心脑血管疾病治疗费用核算分析  

Study on Accounting of Curative Expenditure on Cardiovascular and Cerebrovascular Diseases in Primary Medical Institutions in China

作　　者：柴培培 郭锋 文韬 张玉卓 翟铁民 万泉 张毓辉 CHAI Pei-pei;GUO Feng;WEN Tao(China National Health Development Research Center,Beijing,100044,China;不详)

机构地区：[1]国家卫生健康委卫生发展研究中心,北京100044 [2]延边大学医学院临床医学系,吉林延吉133002 [3]昆明医科大学公共卫生学院,昆明650000

出　　处：《中国卫生经济》2023年第6期40-45,共6页Chinese Health Economics

基　　金：国家自然科学基金资助项目(71874039)。

摘　　要：目的:核算我国基层医疗卫生机构心脑血管疾病治疗费用,分析治疗费用筹资和配置的结构,为优化我国基层医疗卫生机构心脑血管疾病筹资和防控政策提供决策依据。方法:基于“卫生费用核算体系2011”核算我国基层医疗卫生机构心脑血管疾病治疗费用,分析其服务功能分布、人群分布和筹资来源等。结果:2020年,我国基层医疗卫生机构心脑血管疾病治疗费用为955.86亿元,占各机构治疗费用的24.75%,其中超过70%用于60岁及以上老年人,超75%用于原发性高血压、冠心病及脑梗死;心脑血管疾病治疗费用近60%发生在门诊服务;心脑血管疾病治疗费用中的家庭卫生支出占比为21.50%。结论:基层医疗卫生机构在心脑血管疾病防治中发挥了重要作用,应进一步推进基层医疗卫生机构心脑血管疾病防治能力,优化财政投入及医保支付制度,提升对老年人心脑血管疾病及关键危险因素认知水平。Objective:To calculate the curative expenditure for cardiovascular and cerebrovascular diseases(CVDs)in primary medical institutions in China,and analyze its financing structure and allocation,to provide information for policies to optimize the financing and prevention and control of CVDs.Methods:System of Health Accounts 2011 was employed to calculate CVDs'curative expenditure,and analyze the expenditure by health function,beneficiary characteristics and financing schemes.Results:In 2020,CVDs curative expenditure in primary medical institutions in China was 95.59 billion yuan,accounted for 24.75%of curative expenditure.Of CVDs curative expenditure,more than 70%were consumed by people aged 60 and over,and over 75%were used for primary hypertension,coronary heart disease and cerebral infarction;nearly 60%were spent on outpatient care.21.50%of CVDs curative expenditure were financed by out-of-pocket.Conclusion:Primary medical institutions play an important role in the prevention and treatment of CVDs.It needs to strengthen the capacity of CVDs prevention and treatment and optimize the financial input and medical security policy,so as to expand the security level for CVDs and recognizing key risk factors in primary medical institutions.

关 键 词：心脑血管疾病 治疗费用 基层医疗卫生机构 卫生费用核算 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F014.4[经济管理—政治经济学]