河南省开封市肺结核住院患者疾病经济负担及医疗保障现状调查

目的：了解河南省开封市住院肺结核患者的疾病经济负担及医疗保障现状,为制定肺结核疾病防控相关政策提供参考依据.方法：利用市级肺结核疾病定点医疗单位的财务软件系统、医保定点医院收费系统、新型农村合作医疗信息平台即时结报系统,统计分析2011-2013年上半年的住院肺结核患者的各项医疗费用和现阶段医疗保障现状.结果：2011-2013年上半年住院肺结核患者的平均住院天数逐年缩短,平均化验检查费、平均治疗费、平均总费用在逐年增加（P＜0.05）,平均药费和床位费等无明显改变.不同医保类别的肺结核患者,实际补偿比例低于目前医保规定的报销比例,尤其是新农合肺结核住院患者的疾病经济负担仍然较重.结论：医疗保险政策对减轻肺结核患者经济负担起到一定作用,但医保部门应进一步规范医生诊疗规范,建立和加强医疗保险政策的有效监督考核机制,提高对新农合肺结核患者的补偿比例,以减轻患者的疾病经济负担.

Survey on the Status of Disease Economic Burden and Medical Security among Pulmonary Tuberculosis In-patients in Kaifeng,Henan

Objective： To investigate the disease economic burden and medical security situation of pulmonary tuberculosis patients, which will provide references to make related national policies. Methods ： Collected information of the in patients with pulmonary tuberculosis by finan- cial software system, medical insurance payment system in designated hospital and the settlement system on medical information platform of new rural cooperative, analyzed the current situation of medical cost and the present status of medical security. Results： In 2011, 2012 and the first half of 2013, average length of hospitalization in patients with pulmonary tuberculosis gradually reduced. The average examination fees, average treatment cost, and average total cost increased year by year （P 〈 0.05）. The average cost of drugs and bed expenses are no obvious change. The actual compensation ratio is lower than the current medical insurance reimbursement ratio with different categories of pulmonary tuberculosis pa- tients in health care, especially the economic burden of new rural cooperative pulmonary tuberculosis patients is heavier. Conclusion ： Medical in- surance policy greatly decrease the disease economic burden of the pulmonary tuberculosis patients, But the administrative department of the medi- cal insurance policy should further standardize the doctor diagnosis and treatment, Establish effective supervision and evaluation mechanism to strengthen the medical insurance policy, raise the proportion of compensation for new rural cooperative patients with pulmonary tuberculosis, in or- der to relieve the economic burden of disease.