基于医保视角的慢性病管理探讨

Discussion on Chronic Diseases Management from Perspective of Medical Insurance

慢性非传染性疾病对我国居民健康造成较大威胁,慢性病管理工作是我国卫生工作的重点之一。我国医保制度已经逐步完善,但也存在较多问题:居民健康素养不高,医保体系亟待完善,分级诊疗难以落实,医保政策不尽合理。笔者提出借鉴国际上创新型慢性病管理框架的经验,推进医保整合,引导慢性病患者进社区,改善初级卫生保健服务,通过将慢性病纳入门诊管理、采用长处方等措施提高慢性病管理效率。

Under the backgrounds of Healthy China strategy,the chronic non-communicable diseases(NCDs)caused a very big threat on the health of residents.Therefore,chronic disease management has always been an important part of China's health policy.China's medical insurance system has been gradually improved,however there were many problems still:the residents’health literacy was not high,medical insurance system needed to be improved,the classification of diagnosis and treatment was difficult to execute,health insurance policy was not reasonable.We should draw on the experience of innovative management framework for chronic diseases,promote healthy lifestyles,improve personal health literacy,promote medical insurance integration,guide patients into the community,improve primary health care services,put chronic disease into out-patient management and use long prescriptions to improve chronic disease management efficiency.