张暹, 施征宇, 朱美红, 余金明. 上海市提篮桥社区结核病治疗费用减免政策实施效果分析[J]. 上海预防医学, 2017, 29(6): 481-485. DOI: 10.19428/j.cnki.sjpm.2017.06.015
引用本文: 张暹, 施征宇, 朱美红, 余金明. 上海市提篮桥社区结核病治疗费用减免政策实施效果分析[J]. 上海预防医学, 2017, 29(6): 481-485. DOI: 10.19428/j.cnki.sjpm.2017.06.015
Xian ZHANG, Zheng-yu SHI, Mei-hong ZHU, Jin-ming YU. Effect analysis on remission policy for TB treatment fee in Tilanqiao community of Shanghai[J]. Shanghai Journal of Preventive Medicine, 2017, 29(6): 481-485. DOI: 10.19428/j.cnki.sjpm.2017.06.015
Citation: Xian ZHANG, Zheng-yu SHI, Mei-hong ZHU, Jin-ming YU. Effect analysis on remission policy for TB treatment fee in Tilanqiao community of Shanghai[J]. Shanghai Journal of Preventive Medicine, 2017, 29(6): 481-485. DOI: 10.19428/j.cnki.sjpm.2017.06.015

上海市提篮桥社区结核病治疗费用减免政策实施效果分析

Effect analysis on remission policy for TB treatment fee in Tilanqiao community of Shanghai

  • 摘要:
    目的分析2006—2016年上海市提篮桥社区结核病患者治疗费用减免情况的变化,评估上海市结核病减免政策的实施效果。
    方法对2006年3月—2016年7月在上海市提篮桥社区管理的309例完成结核病诊疗并参与减免报销的结核病患者治疗费用情况进行采集,对历年可减免费用、减免费用的变化趋势进行统计分析。
    结果原减免政策实施期间,患者可减免费用为(1 021.06±457.67)元,新减免政策实施期间的可减免费用为(2 320.64±1 544.73)元,同比增长1.27倍,新增可减免费用占比为45.19%。2006—2016年,患者的可减免费用整体上涨,新增可减免比例则从2009年的27.62%上升至2010年的46.62%,2016年则为51.05%。门诊就诊的结核病患者新增可减免比例明显低于住院患者。原减免政策实施期间,患者的减免费用为(931.05±465.47)元,减免比例为17.55%;新减免政策实施期间,患者的减免费用为(1 507.80±974.15)元,较原减免政策的减免费用上涨了61.95%,减免比例为15.91%,下降了1.64个百分点。2006—2016年,结核病患者的减免比例总体下降,门诊就诊的患者减免比例明显高于住院患者。
    结论2006—2016年,上海市结核病减免政策的实施对结核病的治疗费用减免有一定的改善,但对患者而言,并没有有效降低患者的疾病负担。建议在后续的减免政策制定上,加强对可减免项目的设置和疾病治疗方案的管控。

     

    Abstract:
    ObjectiveTo analyze the change in cost remission for tuberculosis (TB) patients in Tilanqiao community of Shanghai from 2006 to 2016, and to evaluate the implementation effect of TB remission policy in Shanghai.
    MethodsThe data were collected on treatment costs for 309 TB patients who had completed treatment and participated in the cost remission reimbursement by outpatient registration. The trend of deductible expenses and the remission costs were analyzed by SPSS.
    ResultsDuring the implementation of the original remission policy(ORP), the deductible expense was 1 021.06±457.67 yuan. And it changed to 2 320.64±1 544.73 yuan under the new remission policy (NRP), which had an increase of 1.27 times and the new remission fee ratio was 45.19%. The deductible expenses change curve shown a trend of rising. The new remission fee ratio was 27.62% in 2009 and increased to 46.62% in 2010, then became 51.05% in 2016. The new remission fee ratio for outpatients was significantly lower than that for the hospitalized. During the implementation of the ORP, the remission cost was 931.05±465.47 yuan, and it was 1 507.80±974.15 of the NRP, which increased 61.95%. The remission ratio was 17.55% of the ORP, when it was 15.91% of the NRP which decreased by 1.64 percent. The remission ratio curve showed a trend of downward. The remission ratio for outpatients was significantly higher than that for the hospitalized.
    ConclusionFrom 2006 to 2016, the implementation effect of remission policy on treatment costs of tuberculosis had improved. However, as far as the patients were concerned, it had not much reduced the disease burden of TB patients on the whole. So in the follow-up remission policy, we must increase settings of deductible projects and control disease treatment regimen.

     

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