重庆某贫困县居家康复治疗救助政策实施情况及问题探讨

Implementation of a home-based rehabilitation and treatment assistance program in an impoverished county in Chongqing: problems and countermeasures

针对因病致贫的现象,我国健康扶贫的地方创新政策不断涌现。目前健康扶贫的经济扶助政策主要围绕大病住院费用的筹资解决,而少见对大病之后居家康复所维持健康的必要成本,如药品费用予以帮扶。从卫生经济学而言,预防和康复比治疗是对于穷人更有效的卫生投资,也能节省卫生资源开支。围绕大病贫困患者的康复精准帮扶,重庆某贫困县创新"居家康复治疗救助"政策以降低贫困人口医药费用负担。针对执行存在监控力度不足、医方激励不足、患者满意度不够高的问题,围绕大病贫困患者的需求,提出相应对策,包括拓宽补助的多种方式,提高对医生的激励设计,允许报销的合理弹性,加强多部门协同监管。

Innovative health poverty alleviation projects have been developed and implemented in many impoverished counties across China. However, most of these projects have focused on the funding for hospitalization expenses in patients with severe diseases and few of them are designed to assist the payment for maintaining health at home(e.g., the drug costs). From the perspective of health economics, prevention and rehabilitation are more cost-effective health investments for the poor populations, and can save health resource cost as well. A new home-based rehabilitation and treatment assistance program has been implemented in an impoverished county in Chongqing, with an attempt to offer precise health poverty alleviation and lower the medical and drug expenditure. Based on the existing problems with poor monitoring, insufficient incentives among hospitals, and low patient satisfaction, and the demand of poor patients with severe diseases, Countermeasures were proposed, including diversifying mode of subsidies, establishing doctor-based incentive initiatives, allowing flexible reimbursement, and strengthening multi-department collaborative supervision and monitoring.