关键词: 结核,肺/经济学, 门诊医疗, 费用,医疗, 保险,健康,补偿

Abstract: Objective  To identify the reimbursement situation of outpatient medical expenses of pulmonary tuberculosis in different medical insurance systems.  Methods  The data of the reimbursement situation of outpatient medical expenses of pulmonary tuberculosis of 2613 counties/districts in 2009, which came from the final assessment of National Tuberculosis Control  Programme (2001—2010)was utilized to analyse the following questions: whether to reimburse the outpatient medical expenses, whether there was a reimbursement norm, and the ratio/limit of the reimbursement in the New Rural Cooperative Medical System, the Basic Medical Insurance System for Urban Residents and the Basic Medical Insurance System for Urban Employees.  Results  The ratios of the counties/districts, which could reimburse the outpatient medical expenses, of different medical insurance system were 51.1% (1324/2592), 21.8% (561/2575) and 27.5% (705/2568); the ratios of the counties/districts, which had reimbursement norms, were 835% (1106/1324), 70.4% (395/561) and 73.9% (521/705); the medians of the reimbursement ratios were 40% (P₂₅：30%，P₇₅：50%), 50% (P₂₅：40%，P₇₅：60%) and 75% (P₂₅：65%，P₇₅：85%); the medians of the reimbursement limits were 490 Yuan (P₂₅：215 Yuan，P₇₅：600 Yuan), 500 Yuan (P₂₅：100 Yuan，P₇₅：800 Yuan) and 825 Yuan (P₂₅：450 Yuan，P₇₅：2000 Yuan).  Conclusion  With the exception of current free medical policies for pulmonary tuberculosis patients in China, the coverage of reimbursement of outpatient medical expenses of pulmonary tuberculosis remains limited, the ratio/limit of the reimbursement is not enough, and reimbursement norms in the national essential medical insurance system have not been developed yet in some of the counties/districts. The economic burden is still heavy for pulmonary tuberculosis cases.

Key words: Tuberculosis,pulmonary/economics, Ambulatory care, Fees,medical, Insurance,health,reimbursement