2017年成都市龙泉驿区狂犬病暴露预防处置报销率调查分析

目的分析2017年成都市龙泉驿区犬伤门诊狂犬病暴露后预防处置报销率不达标的原因,为科学提高报销率提供依据。方法采用随机抽样,运用统一设计的问卷对抽取的200例接受狂犬病暴露后预防处置但未进行报销的患者进行电话调查,同时现场调研全区20家犬伤门诊的报销政策执行情况。结果全区总体参保率为53.0%(106/200)。社区服务中心/卫生院就诊的患者以41.0%(41/100)的低参保率对应85.4%(35/41)的高社保信息符合率,实现了"低参保、高利用";综合性医院就诊的患者虽有67.5%(54/80)的高参保率却对应70.4%(38/54)的低社保信息符合率,出现了"高参保、低利用";厂矿医院就诊的患者参保率和社保信息符合率居中,分别为55.0%(11/20)和72.7%(8/11)。全区20家犬伤门诊中有6家完成了流程上墙及政策宣传画张贴。受调查的参保患者对报销政策的知晓率为57.5%(61/106),报销材料齐全率为38.7%(41/106)。结论各犬伤门诊应对所有患者100%主动告知报销政策,并在门诊区域广泛张贴宣传资料,提高居民参保率、知晓率、报销材料齐全率,加强建立健全内部管理制度,严格按照文件要求开展报销工作。

Reimbursement status on prevention and treatment of rabies in Longquanyi district of Chengdu city in 2017

Objective To study the reimbursement status and influencing factors on rabies post-exposure prevention and treatment at the rabies exposure prevention and treatment clinics in longquanyi District, Chengdu city of China in 2017. Methods A random sampling method was used.A telephone survey was conducted on 200 patients who received post-exposure prophylaxis for rabies with a unified design questionnaire.The implementation of the reimbursement policy of 20 rabies exposure prevention and treatment clinics in the district was investigated. Results The overall insurance participation rate at the district was 53.0%.Patients in the CHSC/township hospital achieved high social security information compliance rate(85.4%) with low insurance participation rate(41.0%) and patients in general hospitals reached low social security information compliance rate(70.4%) with high insurance participation rate(67.5%).Six out of 20 rabies exposure prevention and treatment clinics in the region had the process and policy posted on the wall. Conclusions One hundred percent of all patients should be informed of the reimbursement policy. In the rabies exposure prevention and treatment clinics area, publicity materials and other methods should be widely posted to improve people′s awareness of reimbursement.The rabies exposure prevention and treatment clinics should establish an internal management system, strictly follow the city′s basic medical insurance policy.