非京户籍HIV感染者/AIDS病人免费抗病毒治疗的现状问题及对策

Status quo of free antiretroviral therapy provided for people living with HIV/AIDS who are not registered permanent residents in Beijing and related strategic responses

目的了解非京户籍艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人,在京接受免费抗病毒治疗的现状,分析其中的主要问题,为制定异地治疗政策提供参考。方法对北京市卫生行政部门、疾病预防控制中心、定点医疗机构的5名工作人员,以及在京接受免费抗病毒治疗的7名非京籍感染者进行了深入访谈,结合公共经济学,对收集的访谈资料进行定性分析。结果尽管异地治疗的成因复杂,但是目前北京市提供的艾滋病抗病毒治疗及相关服务,对非京籍感染者有吸引力,不过抗病毒治疗药品需求预测困难、感染者身份信息失真、人财资源缺口等问题也随之而来。结论异地治疗的需求无法避免,建议在健康公平的原则下建立转诊机制,完善财政转移支付制度,加强多部门信息沟通,减轻基层工作人员负担。

Objective To understand the status quo of free antiretroviral therapy provided for people living with HIV/ AIDS （PLWHA） who are not registered permanent residents in Beijing and analyze existing problems so as to provide scientific evidence for developing policy to implement antiretroviral therapy among those who move from other provinces. Methods Five staff members from Beijing health administrative departments, centers of disease control and medical institutions, as well as seven PLWHA from other provinces receiving free antiretroviral therapy in Beijing were selected for an in depth interview. All data were qualitatively analyzed in terms of public economics. Results Although the reason why PLWHA from other provinces receive antiretroviral therapy in Beijing is compli- cated, antiretroviral therapy and associated services offered by Beijing health institutions are attractive to them. But it is difficult to predict drug demand and validate the information provided by the receivers, which may result in loss of financial and human resources. Conclusion The demand for antiretroviral therapy among PLWHA from other provinces is inevitable. We suggest that a patient referral mechanism be established based on the principle of health equality,and a system of financial transfer payments be improved, and information communicating between departments concerned be strengthened so as to to reduce the burden of medical staff at grassroots.