农村精神障碍患者门诊疾病负担调查及救助机制探讨-《西部中医药》

文章信息/Info

Title:: Investigation into the Burden of Outpatient Disease of Rural Patients with Mental Disorder and Financial Assistance Mechanism

作者:: 甘培艳1，杨晋梅1，何武伟2，霍小宁1△，甘培英3，戴春勤4，化得良5，冯子轩1; 1 兰州市第三人民医院，甘肃兰州 730050； 2 兰州市医疗保险局； 3 兰州大学第一医院； 4 兰州理工大学； 5 甘肃中医药大学附属医院

Author(s):: GAN Peiyan1, YANG Jinmei1, HE Wuwei2, HUO Xiaoning1△, GAN Peiying3, DAI Chunqin4,HUA Deliang5, FENG Zixuan1; 1 Lanzhou Municipality the Third People′s Hospital, Lanzhou 730050, China; 2 Lanzhou Medical Insurance Bureau； 3 The First Hospital of Lanzhou University； 4 Lanzhou University of Technology； 5 University Hospital of Gansu Traditional Chinese Medic

Keywords:: mental disorder; rural patients; outpatient disease burden; assistance mechanism

摘要:: 目的：调查甘肃省农村地区精神障碍患者门诊疾病负担状况，为进一步健全精神障碍患者门诊救助机制提供参考依据。方法：采用现场填表、电话访谈、入户调研等方法进行问卷调查，结合精神科及药学专家的测算，进行对照分析和深入研究。结果：468例精神障碍患者年人均门诊经济负担9 523.80元，其中，年人均门诊直接经济负担6 610.10元，年人均门诊间接经济负担2 913.70元。结论：精神障碍患者的疾病特点与长期的、持续的医药费负担是造成农村患者尤其是低（或无)收入家庭“因病致贫”“因病返贫”的主要根源，呼吁引起全社会共同关注，将精准扶贫与合理控费作为减轻患者疾病负担的切入点，增加精神类长期门诊疾病医保报销病种，提高报销比例，进一步建立健全救助机制。

Abstract:: Objective: To provide the reference for further improvement of outpatient assistance mechanism of mental disorder patients by investigating outpatient disease burden of mental disorder patients in rural area of Gansu province. Methods: Questionnaire was performed by using site filling, telephone interview, household investigation and others, analyzed and studied further on the foundation of the budget assessed by the experts of psychiatry and pharmacy. Results: Annual outpatient economic burden of 468 mental disorder patients were 9 523.80 Yuan per capita, among them, annual direct economic burden 6 610.10 yuan per capita, annual outpatient indirect economic burden 2 913.70 yuan per capita. Conclusion: The disease characteristics of mental disorder patients and long-term, persistent medical costs are the main source of causing rural patients, especially low-income (no-income) family,poverty, which deserves the common concern of the whole society, we should take targeted measured in poverty alleviation and reasonable cost control as the breakthrough point of easing the patients′ disease burden, increase the disease of medical insurance reimbursement for long term outpatient diseases, raise reimbursement ratio and further perfect assistance mechanism.