Economic condition, basic medical insurance and medication among patients with severe mental illness in 31 demonstration cities for686 programimplementation

Objective To investigate the economic condition,basic medical insurance and medication of the patients with severe mental illness in regions covered by a central government funded program for treatment and management of severe mental illness patients(“686 program”).Methods We used a unified self-designed questionnaire to collect information on patients with severe mental illness in 31 demonstration cities for “686 program” implementation from 2003 through 2012.Economic condition,basic medical insurance and treatment of the patients were described,and regional differences(eastern,central,western and northeast region)in the situations were also compared.Results Of the 322 783 patients covered by the program in 2012,13.02%had no income,33.25%had a lower income than local minimum living standard,and 53.73%had a higher income than local minimum living standard.There were 21.24%,21.73%,and 45.40%of the patients covered by the medical insurance for urban workers,medical insurance for urban residents,and new rural cooperative medical insurance,respectively,and the proportion of the patients without medical insurance was 11.63%.Only 37.17%of the patients had continuous medication,45.17%had intermittent medication,and 17.66%had no medication history at all.Significant regional differences in economic situation,medical insurance,and medication for the patients were observed among the 4 regions(P<0.01).The economic status of the patients in the Northeast China was the worst,with 64.36%of the patients having no income or the income below the minimum living standard,and a higher proportion(27.30%)of the patients receiving no medication than the other three regions;the highest proportion(18.17%)of the patients without medical insurance was observed in the Central China.Conclusion Generally speaking,patients with severe mental illness in 31 demonstration cities with the implementation of “686 program” have a poorer economic status and a lower coverage of medical insurance than the general population,and most of them have no regular medication,with obvious regional differences in the conditions.