我国慢性病可避免住院费用变化趋势分析

Analysis on the Trend of Potentially Preventable Hospitalization for Non-communicable Diseases in China

目的:核算分析我国慢性病可避免住院费用变化趋势,为提高我国医疗资源利用效率提供政策依据。方法:以卫生费用核算体系(SHA2011)为基础,按照可避免住院疾病范围,核算分析2016—2020年我国慢性病可避免住院费用总量和结构的变化趋势。结果:从机构流向看,我国慢性病可避免住院费用主要发生在各级医院,县级医院占比不断提高;从人群分布看,可避免住院费用主要发生在慢性阻塞性肺病、心绞痛、糖尿病,心力衰竭、心绞痛、支气管扩张的可避免住院费用仍处于上涨趋势;从年龄分布看,超七成可避免住院费用发生在60岁及以上人群,其中60~74岁人群可避免住院费用增速最快。结论:我国慢性病可避免住院费用仍处于高位,但增速有所放缓;应加强对重点人群和疾病的健康管理,从患者、服务提供及支付方式等多方发力,减少可避免住院的发生;同时构建可避免住院监测指标体系,促进监测和评价指标体系的应用。

Objective To account expenditure on potentially preventable hospitalization(PPH)for non-communicable diseases(NCDs)and analyze its trend,so as to provide policy basis for improving the utilization efficiency of medical resources in China.Methods Based on the System of Health Account 2011 and the determined scope of diseases,the changing trend of the scale and structure of PPH for NCDs in China from 2016 to 2020 was accounted and analyzed.Results From the perspective of health provider,PPHs for NCDs mainly occurred in hospitals,among which the proportion of county-level hospitals was increasing;From the perspective of beneficiary characteristics,the spending occurred in chronic obstructive pulmonary disease,angina pectoris and diabetes,while the spending for heart failure,angina pectoris and bronchiectasis continued to rise;Over 70%of the spending occurred in people aged 60 and above,and the spending of people aged 60-74 increased the fastest.Conclusion PPHs for NCDs is still at a high level,but the growth rate has slowed down.It is necessary to strengthen the health management of key populations and diseases,make efforts from patients,service provision and payment methods to reduce PPHs,and explore the establishment of PPHs in China to promote the application in the relevant monitoring and evaluation index system.