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王佳慧, 尹航, 张鑫, 吴群红, 单凌寒, 李叶, 李晨希, 陈桂英, 陈若卉, 孟祥伟, 李乐. 中国2013年主要慢性病住院患者自付费用与报销费用分析[J]. 中国公共卫生, 2021, 37(4): 623-626. DOI: 10.11847/zgggws1127072
引用本文: 王佳慧, 尹航, 张鑫, 吴群红, 单凌寒, 李叶, 李晨希, 陈桂英, 陈若卉, 孟祥伟, 李乐. 中国2013年主要慢性病住院患者自付费用与报销费用分析[J]. 中国公共卫生, 2021, 37(4): 623-626. DOI: 10.11847/zgggws1127072
WANG Jia-hui, YIN Hang, ZHANG Xin, . Out-of-pocket and reimbursed expenses of inpatients with major non-communicable chronic diseases in China, 2013[J]. Chinese Journal of Public Health, 2021, 37(4): 623-626. DOI: 10.11847/zgggws1127072
Citation: WANG Jia-hui, YIN Hang, ZHANG Xin, . Out-of-pocket and reimbursed expenses of inpatients with major non-communicable chronic diseases in China, 2013[J]. Chinese Journal of Public Health, 2021, 37(4): 623-626. DOI: 10.11847/zgggws1127072

中国2013年主要慢性病住院患者自付费用与报销费用分析

Out-of-pocket and reimbursed expenses of inpatients with major non-communicable chronic diseases in China, 2013

  • 摘要:
      目的  分析中国2013年主要慢性病住院患者自付费用与报销费用,为缓解慢性病经济负担提供政策建议。
      方法  收集2013年第五次国家卫生服务调查中6 978例癌症、糖尿病、心脑血管疾病、慢性呼吸道疾病住院患者相关数据,计算此四类主要慢性病住院患者的自付费用与报销费用。
      结果  在自付费用上,癌症住院患者人均自付费用(城市4 553元、农村5 000元)与总自付费用(465.09亿元)均最高;在报销费用上,癌症住院患者人均报销费用最高(城市7 800元、农村4 800元),心脑血管疾病住院患者报销总费用最高(887.87亿元);在医疗总费用上,癌症住院患者的人均医疗总费用最高(城市13 000元、农村10 000元),心脑血管疾病住院患者的医疗总费用最高(1 485.69亿元);在慢性病整体报销比例上,基本医保中城镇居民基本医疗保险的报销比例最低(54.06 %)。
      结论  癌症住院患者的人均自付费用和人均报销费用均最高,心脑血管疾病住院患者医疗总费用最高;基本医保中城镇居民基本医疗保险的保障力度最弱。

     

    Abstract:
      Objective  To estimate self-paid and reimbursed medical expenses among major non-communicable chronic diseases (NCDs) during 2013 for developing strategies on alleviating disease-related economic burden in China.
      Methods  The data on 6 978 inpatients with cancer, diabetes, cardiovascular or cerebrovascular disease, and chronic respiratory disease were extracted from the Fifth National Health Services Survey conducted in 2013. We also collected the data related to total hospital discharges of the inpatients with the four major NCDs in 2013 from the China Population Statistics Yearbook – 2014 and the China Health and Family Planning Statistics Yearbook – 2014. Then, the self-paid and reimbursed medical expenses of the 6 978 inpatients were analyzed and those for all the hospitalization due to the major NCDs were estimated.
      Results  For the inpatients with the four major NCDs, those with cancer had both the highest calculated self-paid hospitalization medical expense per capita (4 553 and 5 000 yuan RMB for the inpatients from urban and rural regions) and the highest estimated total self-paid medical expense for all hospital discharges in the year (46.509 billion yuan); the inpatients with cancer also had the highest calculated medical expense per capita (7 800 and 4 800 yuan for the inpatients from urban and rural regions) reimbursed by medical insurance reimbursement, but the inpatients with cardiovascular or cerebrovascular diseases had the highest estimated total reimbursed medical expense for all hospital discharges in the year (88.787 billion yuan). The inpatients with cancer had the highest calculated total hospitalization medical expense per capita (13 000 and 10 000 yuan for the inpatients from urban and rural regions) but the inpatients with cardiovascular or cerebrovascular diseases had the highest estimated total medical expense for all hospital discharges in the year (148.569 billion yuan). The inpatients with Urban Resident Basic Medical Insurance (MIUR) had the lowest ratio (54.06%) of hospitalization expense reimbursement compared to the inpatients with other types of basic medical insurance.
      Conclusion  Among the inpatients with major non-communicable chronic diseases, the self-paid and reimbursed hospitalization medical expense per capita are the highest for the inpatients with cancer but the total medical expense is the highest for the inpatients with cardiovascular or cerebrovascular diseases. The ratio of hospitalization expense reimbursement by MIUR is relatively lower than that by other types of basic medical insurance.

     

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