我国肺结核患者诊疗费用需求测算研究  

Estimation on direct medical costs of pulmonary tuberculosis in China

作　　者：刘宇红[1] 高孟秋[2] 张立杰 马丽萍[3] 聂理会[2] 姜广路 丁虹琬 李亮[1] Liu Yuhong;Gao Mengqiu;Zhang Lijie;Ma Liping;Nie Lihui;Jiang Guanglu;Ding Hongwan;Li Liang(Beijing Chest Hospital,Capital Medical University/Clinical Center on Tuberculosis,Chinese Center for Disease Control and Prevention,Beijing 101149,China;The Second Department of Tuberculosis,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China;The First Department of Tuberculosis,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China;National Clinical Laboratory on Tuberculosis,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京胸科医院/中国疾病预防控制中心结核病防治临床中心,北京101149 [2]首都医科大学附属北京胸科医院结核二科,北京101149 [3]首都医科大学附属北京胸科医院结核一科,北京101149 [4]首都医科大学附属北京胸科医院国家结核病临床实验室,北京101149

出　　处：《中国防痨杂志》2023年第12期1134-1140,共7页Chinese Journal of Antituberculosis

基　　金：中华预防医学会和比尔及梅琳达-盖茨基金会卫生合作项目“新时期重大传染病防控政策倡导项目”(INV-035022);北京市卫生健康委员会高层次公共卫生技术人才建设项目(学科带头人-01-11)

摘　　要：目的:制定不同类型肺结核患者的临床诊疗服务包,并测算我国肺结核患者直接诊疗费用需求,为提出可行的减轻患者负担的政策建议、倡导多渠道筹资、统筹规划结核病经费提供依据。方法:根据我国现行结核病防治规划、技术规范、指南和临床路径的要求,充分考虑结核病临床需求、各级定点医疗机构诊疗实际情况、未来结核病防控措施的升级及新技术手段的应用,制定不同类型肺结核患者临床诊疗服务包,并根据我国各类肺结核患者数量测算直接诊疗费用。结果:利福平敏感肺结核患者例均诊疗费用为15370元,利福平耐药肺结核患者例均诊疗费用为196585元。全国每年肺结核患者诊疗费用总需求为146.9亿元,每年人均投入10.4元。其中利福平敏感肺结核患者诊疗总费用为107.6亿元(73.2%,107.6/146.9),利福平耐药肺结核患者诊疗总费用为39.3亿元(26.8%,39.3/146.9);门诊诊疗总费用为83.1亿元(56.6%,83.1/146.9),住院诊疗总费用为63.8亿元(43.4%,63.8/146.9)。结论:本研究测算结果为倡导进一步多渠道筹资、统筹规划结核病经费、制定可行的结核病患者医疗保障政策提供了依据。Objective:To formulate clinical service packages required by different types of pulmonary tuberculosis and make estimation on direct medical costs accordingly.Results of estimation will be used to inform policy recommendations on optimized allocation of funds dedicated for tuberculosis prevention,promotion of multi-channel financing as well as further alleviation of financial burden of tuberculosis patients.Methods:According to China’s current tuberculosis prevention and control strategy,technical recommendations and clinical pathways,also in consideration of current capacity and clinical practices in tuberculosis designated hospitals at all levels,adoption and potential upgrade of new control strategy as well as application of new technologies and interventions in the future,this study had formulated different clinical service packages for different types of pulmonary tuberculosis patients and calculated the direct cost incurred by individual patient during diagnosis and treatment as well as total cost of these packages by multiplying the numbers of these different pulmonary tuberculosis patient groups in China.Results:Direct cost for a rifampicin-susceptible pulmonary tuberculosis patient was about 15370 Yuan,that of a rifampicin-resistant pulmonary tuberculosis patient was about 196585 Yuan.The annual budget required to cover the total direct medical cost of all pulmonary tuberculosis patients in China was about 14.69 billion Yuan with an average annual investment of 10 Yuan per capita,of which total medical cost for rifampicin-susceptible pulmonary tuberculosis patients accounts for 10.76 billion Yuan(73.2%,10.76/14.69),that of rifampicin-resistant pulmonary tuberculosis patients was 3.93 billion Yuan(26.8%,3.93/14.69).Of total medical cost,8.31 billion Yuan(56.6%,8.31/14.69)was incurred by outpatient cost;6.38 billion Yuan(43.4%,6.38/14.69)was inpatient cost.Conclusion:The estimates come out of this study have provided promotion of multi-channel financing,overall budgeting and allocation of funds dedicated

关 键 词：结核 肺 费用 医疗 需求估价 

分 类 号：R521[医药卫生—内科学]