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目的:基于吉林省心脑血管疾病卫生费用结果分析吉林省心脑血管疾病卫生费用的筹资现状和存在的主要问题。方法:以卫生费用核算体系2011版(SHA 2011)为基础,从筹资方案、机构流向和服务功能维度对吉林省心脑血管疾病卫生费用进行核算。结果:心脑血管疾病消耗了大量卫生资源,费用总额达71.10亿元。心脑血管疾病费用中公共筹资方案占比最高,为52.21%,其中政府方案占比为28.53%;家庭个人负担较重,为41.25%。不同服务功能、人群和疾病费用的筹资差异很大;门诊服务的家庭个人负担比重高于住院服务;预防服务筹资主要来自于政府方案,占比超过了90%;不同疾病的筹资负担中,原发性高血压、肺源性心脏病和脑梗塞的家庭个人负担较重,家庭个人卫生支出占比在50%以上。结论:现有的医疗保障政策和制度中,缺乏对心脑血管疾病保障方面的有效设计,地方政府应积极承担筹资责任,并确保筹资的充足、稳定和可持续发展,重点加强对耗用卫生资源大和家庭个人负担重的心脑血管疾病的防控。
OBJECTIVE: To analyze the status quo and existing problems of fund-raising for cardiovascular and cerebrovascular diseases in Jilin Province based on the results of health expenditure of cardiovascular and cerebrovascular diseases in Jilin Province. Methods: Based on SHA 2011, health expenditure accounting for cardio-cerebrovascular diseases in Jilin Province was calculated based on the financing plan, organization flow and service function dimension. Results: Cardiovascular and cerebrovascular diseases consume a large amount of health resources, with a total cost of 7.11 billion yuan. Public financing of cardiovascular and cerebrovascular diseases accounted for the highest proportion of programs, accounting for 52.21%, of which 28.53% of government programs accounted for; family heavier burden, 41.25%. The funding for different service functions, population and disease costs varies greatly. The proportion of personal burden on outpatient services is higher than that of inpatient services. The financing of prevention services mainly comes from government programs, accounting for more than 90% of the total. Among the financing burden of different diseases, Hypertension, pulmonary heart disease and cerebral infarction heavier personal families, household personal health spending accounted for more than 50%. Conclusion: In the current medical security policies and systems, there is a lack of effective design for the protection of cardiovascular and cerebrovascular diseases. Local governments should take active responsibility for fund-raising and ensure adequate, stable and sustainable fund-raising, with a focus on health-care utilization Prevention and Control of Cardiovascular and Cerebrovascular Diseases with Large Resources and Families.