目的:分析四川省不同共病状态下阿尔茨海默病(Alzheimer's disease,AD)的治疗费用现状,为相关卫生政策的优先制定提供参考和依据.方法:采用"卫生费用核算体系 2011"(the System of Health Accounts,SHA 2011)进行分析.结果:四川省AD患者治疗费用总量在2019年为27 728.04万元,占全四川省2019年疾病治疗费用的0.13%.不同共病组治疗费用差异有统计学意义,家庭卫生支出是主要的筹资方案(54.44%),共病指数越高,家庭卫生支出占比越多.治疗费用主要流向医院,随着共病指数增加,治疗费用流向综合医院的占比逐渐上升.女性治疗费用高于男性,低、中、高共病组治疗费用主要分别集中在55～≤59岁、70～≤89岁和≥80岁以上人群.结论:建议优化卫生筹资方案,构建多层次的医疗保障体系.不断健全保障机制,缩小门诊和住院的待遇差异;提高基层卫生机构的服务能力;关注重点人群,做好AD的预防,缓解我国AD疾病整体负担,推动实现健康老龄化.
Study of Alzheimer's Disease Funding,Flows,and Beneficiary Populations in Different Co-morbidity States Based on SHA 2011
Objective:To analyze the current status of Alzheimer's disease(AD)treatment costs under different co-morbid states in Sichuan,and to provide references and basis for prioritizing the formulation of related health policies.Methods:Based on the System of Health Accounting 2011(SHA 2011).Results:The total treatment cost of Alzheimer's disease patients in Sichuan Province in 2019 was 277 280 400 yuan,accounting for 0.13%of the province's disease treatment cost in 2019.There were significant differences in treatment costs among different co-morbidity groups,with family health expenditure being the main financing option(54.44%).The higher the co-morbidity index,the greater the share of family health expenditure.Treatment costs mainly flowed to hospitals,with the proportion of treatment costs going to general hospitals gradually increasing as the co-morbidity index increased.The treatment cost of women is higher than that of men,and the treatment cost of low,middle and high co-morbidity groups were mainly concentrated in the age groups of 55～69,70～89 and 80 years old and above respectively.Conclusion:It is recommended to optimize the financing scheme and build a multi-level medical insurance system.Continuously improve the protection mechanism to narrow the difference in treatment between outpatient and inpatient;improve the service capacity of primary health care institutions;pay attention to key populations and do a good job of preventing AD,so as to alleviate the overall burden of Alzheimer's disease in China,and promote the realization of healthy aging.
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