【作者】 程艳敏；

【导师】 尹爱田；

【作者基本信息】 山东大学 ， 社会医学与卫生事业管理， 2006， 硕士

【摘要】 随着我国社会经济的发展，人们生活水平的提高，生活方式的改变，各种慢性疾病，特别是慢性非传染性疾病逐渐成为威胁人们健康的主要疾病。根据我国1993年、1998年和2003年的国家卫生服务调查显示，我国慢性病患病率总体呈下降趋势，但是农村地区慢性病患病率却是降中有升。1993年调查的农村慢性病患病率为130.70‰，1998年略下降到118.40‰，2003年又回升至120.50‰。从世界范围来看，慢性病已经给全世界人群的健康和生活带来了巨大的影响，成为世界上最首要的死亡原因。2005年10月3日，世界卫生组织的报告《预防慢性病：一项至关重要的投资》说，预防慢性病的全球行动到2015年可拯救本来将死亡的3600万人的生命。报告预测，每年约有1700万人因慢性病的全球流行而过早死亡。 近年来虽然全国各地都开展了很多关于慢性病的研究，但大都停留在慢性病的流行病学研究上，很少有对慢性病的经济负担，特别是慢性病门诊费用负担进行研究，更缺少对慢性病门诊费用补偿方法的研究。本研究在卫生部贷款办的资助下，对农村居民慢性病门诊费用进行研究，进而探究慢性病门诊费用的补偿方法，研究能否把农村居民慢性病门诊费用纳入大病统筹方案。通过研究，主要回答以下问题：(1)是否应该把农村居民慢性病门诊费用纳入大病统筹基金?(2)应该纳入哪些慢性病?(3)纳入后的合作医疗基金管理情况如何?(4)把农村居民慢性病门诊费用纳入大病统筹，需要建立哪些相关政策和相关制度?本研究的主要目的是为把农村居民慢性病门诊费用纳入大病统筹提供可行性的政策方案和方法。 本研究采取分层抽样的方法，在山东和甘肃两省进行调查。根据社会经济发展状况，我们选取了山东的三个县市(昌乐、龙口和崂山)和甘肃的四个县(山更多还原

【Abstract】 China has been mading significant progress in economy and living standards, and people has been changing their life style. At the same time, chronic diseases, especially chronic non-communicable diseases become the main factor affecting people’s health status. The data of three China National Health Services Survey in 1993,1998 and 2003 show that prevalence rate of chronic diseases of the whole people is declining, but in rural areas it ascended after declining. Chronic diseases have been affecting seriously people’s health and life all over the world. Global action to prevent chronic disease could save the lives of 36 million people who would otherwise be dead by 2015 says the World Health Organization (WHO) report, ’Preventing Chronic Diseases: a vital investment. Approximately 17 million people die prematurely each year as a result of the global epidemic of chronic diseases.Many study projects about chronic diseases have been done. Most of those study projects are about prevalence of chronic diseases, and hardly about economic burden, especially outpatient fee and reimbursing way for that. This study aims to research these in China rural area , and explore whether outpatient fee of chronic diseases of rural residents can be taken into "pooling funds for serious illnesses" or not. This study aims to answer the followed questions: (1) whether outpatient fee of chronic diseases of rural residents should be taken into "pooling funds for serious illnesses" or not? (2) which chronic diseases should be taken into "pooling funds for serious illnesses"? (3) what impacts does it have on funds management? (4) what else correlative system and policy should be build? The main object of this study is to put forward feasible更多还原