部分城市艾滋病门诊特殊病种政策实施的定性研究  

Qualitative study on the implementation of special disease policies for HIV/AIDS outpatients in some cities of China

作　　者：孙玥 胡静坤 康文婷 张广[2] 徐鹏[2] SUN Yue;HU Jingkun;KANG Wenting;ZHANG Guang;XU Peng(The People's Medical Publishing House,Beijing 100021,China;National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Chinese Association of STD&AIDS Prevention and Control,Beijing 100050,China)

机构地区：[1]人民卫生出版社,北京100021 [2]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [3]中国性病艾滋病防治协会,北京100050

出　　处：《中国艾滋病性病》2024年第12期1300-1304,共5页Chinese Journal of Aids & STD

摘　　要：目的了解我国部分城市艾滋病门诊特殊病种政策的实施情况,为今后完善艾滋病门诊特殊病种提供参考和建议。方法在辽宁省沈阳市,江苏省南京市,广东省广州市、惠州市、梅州市,四川省乐山市,重庆市这5个省份7个城市招募HIV/AIDS患者和艾滋病防治工作人员进行一对一的深入访谈,访谈内容包括门诊特殊病种的办理标准、办理流程、报销范围、报销比例、优缺点等。结果本次调查共访谈72人,HIV/AIDS患者9人,艾滋病防治工作人员63人。提取了6个一级主题,15个二级主题。不同城市门诊特殊病种的办理标准不同,办理流程一般有认定申请、审核、登记、定点治疗这4个阶段。门诊特殊病种报销范围不仅包括艾滋病抗病毒治疗药品,还包括治疗所必须的门诊常用检查化验费用,报销比例在不同城市之间存在差异。门诊特殊病种在一定程度上缓解了报销范围小、报销比例低、报销门槛高等问题,但也存在暴露患者隐私、占用其他疾病报销金额、提高医院药占比等问题。结论未来应持续完善艾滋病门诊特殊病种相关政策,简化报销流程、完善隐私保护制度,发挥门诊特殊病种的优势。Objective To understand the implementation of special disease policies for HIV/AIDS outpatients in selected cities in China,and to provide references and recommendations for improving the special disease policies in the future.Methods In-depth interviews were conducted with HIV/AIDS patients and HIV/AIDS healthcare workers in seven cities across five provinces:Shenyang in Liaoning Province,Nanjing in Jiangsu Province,Guangzhou,Huizhou,and Meizhou in Guangdong Province,Leshan in Sichuan Province,and Chongqing Municipality.The interviews content covered topics such as the criteria,procedures,reimbursement scope,reimbursement rates,and the advantages and disadvantages of the special disease policy for outpatients.Results A total of 72 individuals were interviewed,including 9 HIV/AIDS patients and 63 HIV/AIDS healthcare workers.Six primary themes and 15 secondary themes were identified.The criteria for the special disease policy varied from city to city.The process typically involved four stages:application,review,registration,and designated treatment.Reimbursement covered not only antiretroviral drugs for HIV/AIDS treatment but also necessary outpatient laboratory tests and examinations.However,the reimbursement rates differed among cities.The special disease policy has alleviated some problems such as limited coverage,low reimbursement rates,and high reimbursement thresholds.However,challenges remain,including patient privacy,diversion of reimbursement funds to other diseases,and increased drug expenditure in hospitals.Conclusions Future efforts should focus on further improving the special disease policies for outpatients with HIV/AIDS by simplifying reimbursement procedures,enhancing privacy protection,and maximizing the benefits of the special disease policies.

关 键 词：艾滋病 门诊特殊病种 定性研究 

分 类 号：R512.91[医药卫生—内科学]