我国慢性非传染性疾病卫生费用与筹资分析

Analysis of Expenditure Accounting and Financing for Prevention and Treatment of Non-communicable Diseases in China

目的:通过核算我国慢性非传染性疾病(以下简称慢性病)防治费用,分析中国慢性病防治筹资现状、存在的主要问题以及主要成因。方法:通过对4个省份慢性病防治服务提供、服务消耗以及服务的筹资情况进行调查,结合全国卫生服务调查数据,利用SHA2011核算体系从资金筹集、服务提供和功能使用角度对我国慢性病防治费用进行核算。结果:慢性病防治消耗大量卫生资源,占卫生总费用比重达到近70.00%,预防服务费用仅占全部慢性病费用的1.26%。心脑血管疾病费用所占比重达34.00%,医疗保险补偿水平不高,居民经济负担沉重。结论:医疗保障制度缺乏对慢性病针对性的设计,地方政府承担更多筹资压力,慢性病防治筹资的充足和稳定性受到影响。

Objective： To analyze the financing status and main issues of Non-Communicable Diseases（NCDs） prevention and treatment by estimating China NCDs expenditure on prevention and treatment. Methods： Using the data from field surveys conducted in 4 provinces and National Household Health Survey data to estimate the consuming status of health services and goods, who provided and what schemes paid for the health services and goods under the framework of System of Health Account 2011. Results： Most of the health resources were consumed by NCDs treatment and prevention, expenditure on NCDs accounted for nearly 70.00% of the total health expenditure, but the expenditure on NCDs prevention only accounted for 1.26% of the total expenditure on NCDs. Expenditure on cardiovascular disease accounted for 34.00%. The reimbursement levels of insurance schemes are relative lower and the residents with NCDs are facing heavy economic burden. Conclusion： Social health insurance schemes lack pointed reimbursement policy for NCDs, local government assume more responsibility of health financing which is detrimental to the sufficiency and stability of NCDs financing.