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中国防痨杂志 ›› 2023, Vol. 45 ›› Issue (3): 248-252.doi: 10.19982/j.issn.1000-6621.20220444

• 专题笔谈 • 上一篇    下一篇

荷兰和美国的慢性病捆绑支付模式对我国结核病付费改革的启示

张婧怡1, 胡星宇2, 高广颖1(), 陈迎春3, 张歆4, 邓茜1   

  1. 1首都医科大学公共卫生学院,北京100069
    2深圳市医疗保障局医药服务管理处,深圳518040
    3华中科技大学同济医学院医药卫生管理学院,武汉430030
    4哈尔滨医科大学卫生管理学院,哈尔滨150081
  • 收稿日期:2022-11-08 出版日期:2023-03-10 发布日期:2023-03-07
  • 通信作者: 高广颖 E-mail:gaogy@nsd.pku.edu.cn
  • 基金资助:
    国家自然科学基金(71874113);中国国家卫生健康委员会-比尔及梅琳达·盖茨基金会结核病防治合作项目(INV004900)

The inspiration of bundled payment for chronic diseases in Netherlands and the United States for tuberculosis payment reform in China

Zhang Jingyi1, Hu Xingyu2, Gao Guangying1(), Chen Yingchun3, Zhang Xin4, Deng Qian1   

  1. 1School of Public Health,Capital Medical University,Beijing 100069,China
    2Division of Medical Services Management Healthcare Security Bureau of Shenzhen Municipality,Shenzhen 518040,China
    3School of Medicine and Health Management, Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China
    4School of Health Management, Harbin Medical University, Harbin 150081,China
  • Received:2022-11-08 Online:2023-03-10 Published:2023-03-07
  • Contact: Gao Guangying E-mail:gaogy@nsd.pku.edu.cn
  • Supported by:
    National Natural Science Foundation of China(71874113);National Health Commission of China-Bill and Melinda Gates Foundation TB Collaboration Project(INV004900)

摘要:

结核病是一种由结核分枝杆菌感染导致的慢性传染性疾病,其诊疗疗程长,往往需要联合用药,对患者个人、家庭,甚至整个社会带来极大负担,亟需采取相应手段予以缓解。而支付方式通过影响供方行为,可以抑制不合理医疗支出,但目前国内较为主流的结核病支付方式并不符合该病的诊疗特点,且尚未达到有效降费的预期目标。由此,作者对国际上较为流行的针对慢性病的捆绑支付模式进行综述研究,系统分析荷兰、美国慢性病捆绑支付的具体做法,在此基础上结合结核病诊疗特点及防治体系,分析捆绑支付对于结核病的适应性,旨在为我国探索适合于当前防治体系的创新型结核病补偿模式提供良好的参考借鉴。

关键词: 结核, 费用和收费, 捆绑支付, 综述文献(主题)

Abstract:

Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis (MTB) infection. TB patients need to take multiple drugs and stay in treatment for a long time, which places a great burden on individuals and their families, and even the whole society. Measures which can reduce the economic burden of disease are urgently needed. The payment system has a restrictive effect on medical expenses by influencing the behavior of the supplier. However, the current payment methods for TB in China are inconsistent with the characteristics of the diagnosis and treatment of the disease, and it has not yet achieved the expected goal of effective fee reduction. In such a general background, the authors summarized and studied the internationally popular bundling payment mode for chronic diseases, systematically analyzed the specific practices of bundling payment for chronic diseases in the Netherlands and the United States, and analyzed the adaptability of bundling payment for tuberculosis based on the characteristics of tuberculosis diagnosis and treatment and the prevention and treatment system, so as to provide a valuable reference for the reform of payment methods for TB.

Key words: Tuberculosis, Fees and charges, Bundled payment, Review literature as topic

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