多层次医疗保险体系对糖尿病患者保障状况及其费用补偿机制研究

Status of Multi-level medical insurance system's safeguard for diabetics and study on its expense compensation mechanism

目的对参加不同层次医疗保险的人群进行糖尿病流行病学和费用补偿现况调查,为评价我国现行医疗保险制度在对糖尿病等慢性病控制方面的效果和制定相关政策提供参考。方法采用多级整群抽样方法,共调查不同层次医疗保险人群9871人。结果调查人群中糖尿病患病率为4.47%,糖尿病患病知晓率、接受降糖药物治疗率和空腹血糖控制率分别为41.95%、55.14%和48.11%。其中参加城镇职工医疗保险人群的糖尿病患病知晓率、治疗率和控制率均最高,而其疾病经济负担最轻。结论应加大对参加城镇居民医疗保险和新型农村合作医疗保险的严重慢性病患者门诊诊疗的补偿机制,并将疾病预防、健康教育与慢性病控制结合起来,以利于减轻患者的经济负担,提高居民健康水平。

Purpose The paper aims to investigate the diabetes epidemiology and expense compensation status of people participating in medical insurance at different levels, and provide reference for evaluating the effects of China's existing medical insurance system on control of chronic diseases like diabetes and making relevant policies. Method The multi-level cluster sampling method is adopted, and 9,871 persons at different levels of medical insurance are surveyed in total. Result Among the surveyed people, the prevalence rate of diabetes is 4.47%, and the diabetes awareness rate, the rate of treatment with hypoglycemic agent, and the FBG control rate are 41.95%, 55.14%, and 48.11%, respectively. The three rates of people participating in the medical insurance for urban workers are all the highest, and the economic burden on this group of people is the lightest. Conclusion The patients of serious chronic diseases who participate in the medical insurance for urban residents and the new rural cooperative medical insurance should be provided with increased compensation for outpatient diagnosis and treatment, and disease prevention, health education, and chronic disease control should be combined so as to relieve the economic burden of patients and raise the health level of residents.