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目的了解目前我国农村基层慢性阻塞性肺疾病(简称慢阻肺)诊治现状及医疗负担和支付方式。方法根据我国卫生部科技教育司2012年完成的“农村基层医疗卫生机构适宜技术应用现状和需求——10省(区市)调研材料汇编”统计上海市等10省市自治区农村基层慢阻肺患者人口学资料,门诊和住院医疗费用及其支付方式,门诊、住院时前5位检查项目和常用药物应用情况。结果 10省市自治区接受调查的慢阻肺患者(包括门诊和住院)共511例,门诊医疗费用:(88.79±118.51)~(5990.00±480.00)元,住院费用(984.70±497.90)~(6407.00±3826.10)元,大部分费用由新农合支付。门诊及住院慢阻肺患者常用的检查项目为心电图和X线胸片等,但是未包括肺功能测定。常用的药物为氨茶碱、氨溴索及各种抗菌药。结论目前我国农村基层慢阻肺诊断治疗很不规范,亟待解决。
Objective To understand the diagnosis and treatment of chronic obstructive pulmonary disease (referred to as chronic obstructive pulmonary disease) in our country at present and the medical burden and payment method. Methods According to “Status and Demand of Appropriate Technologies for Rural Primary Health Care Institutions Completed in 2012 by Science and Technology Education Department of Ministry of Public Health of China - Compilation of Research Materials in 10 Provinces / Districts and Cities” Demographic data for lung patients, outpatient and inpatient medical costs and payment methods, outpatient visits, first 5 check-ups during hospitalization, and commonly used medications. Results A total of 511 COPD patients (including outpatients and inpatients) were surveyed in 10 provinces. The outpatient medical expenses were (88.79 ± 118.51) ~ (5990.00 ± 480.00) yuan, hospitalization costs (984.70 ± 497.90) ~ (6407.00 ± 3826.10) yuan, most of the costs paid by the NCMS. Outpatients and hospitalized patients with chronic obstructive pulmonary disease commonly used ECG and chest X-ray examination items, but does not include lung function tests. Commonly used drugs aminophylline, ambroxol and various antibacterials. Conclusion At present, the diagnosis and treatment of chronic obstructive pulmonary disease in rural areas in China is not standardized and needs urgent solution.