上海市嘉定区1999、2000、2001年60岁以上老年人1万元以上医疗费用的调查与分析

Surveying and Analyzing the Medical Expense over 10 Thousands RMB that the Elderly over 60 Years Old Spend from 1999 to 2001 in Jiading District in Shanghai.

目的 :通过对参加农村合作医疗区级大病风险基金 6 0岁以上老年人 1万元以上医疗费用的调查分析 ,初步了解 6 0岁以上老年人 1万元以上医疗费用的发生情况和趋势 ,提出完善保障老年人高额医疗服务的设想。方法 :对嘉定区 1999、2 0 0 0、2 0 0 1年三年中获得合作医疗区级大病风险基金补偿的 6 0岁以上老年人 1万元以上医疗费用、疾病发生情况、就诊流向 ,以及农村居民基本退休养老情况进行调查分析。结果 :参加农村合作医疗区级大病风险基金 6 0岁以上老年人 1万元以上医疗费用发生人数、医疗费用、补偿金额均逐年上升。但是 ,他们的人均医疗费用和补偿低于整个人群 ,更低于 6 0岁以下人群 ,老年人的高额医疗服务受到经济的制约 ,6 0岁以上老年人 1万元以上医疗费用的疾病发病排列不同于本区出院疾病排列 ,相同疾病在不同级别的医院治疗费用不同。结论 :6 0岁以上老年人是农村的弱势人群 ,他们的经济收入低微 ,对他们的高额医疗费用补偿要实行政策倾斜 ,对相同疾病的治疗要鼓励在能实施治疗的医院进行治疗 ,以保证老年人能看得起病 ,减轻家庭经济负担 ,防止因病致贫情况发生。要有针对性地开展对农村老年人进行健康筛选 ,对他们的慢性非传染性疾病进行干预和预防 ,使他们健康平安地度过晚年。

Objectives. Through analyzing the medical expense over 10 thousands RMB that the elderly over 60 years old spend who participate the risk pool fund for severe disease of cooperative medical insurance at district level to learn the situation and trend of medical expense over 10 thousands RMB among the elderly over 60 years old and to put forward an idea for ensuring medical service with high expense for the elderly. Methods. Surveying and analyzing medical expense over 10 thousands RMB, the diseases, institutions visited and farmers' basic pension among the elderly over 60 years old who have got reimbursement from the risk pool fund at district level from 1999 to 2001. Results. The number of the cases whose medical expense is over 10 thousands RMB, the total medical expense and the reimbursement of medical expense are increasing year by year among the elderly over 60 years old. However, their average medical expense and reimbursement are lower than that of the whole population, especially lower than that of the population below 60 years old. The medical service with high medical expense for the elderly is limited for their economic condition. The ranks of diseases that medical expense is over 10 thousands RMB among the elderly over 60 years old are different from the ranks of inpatient diseases in the same district. The medical expense for the same disease is different in the medical institutions at different levels. Conclusions. The elderly over 60 years old is a risk population in rural areas. Their income is lower. Therefore, for ensuring that the elderly could visit doctor, reducing their families' economic burden and preventing them being poor for diseases, the policies of reimbursement should be favorable to them and encouraging them to visit medical institutions where not only medical service can be supplied for the same disease, but also the medical expense is lower. The health screening should be carried out for them and the non-communicable diseases they are subject to should be prevented and controlled to make them live a happy life during their rest time.