基于患者调查的丙型肝炎DAA药物医保政策实施效果评价
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篇名: 基于患者调查的丙型肝炎DAA药物医保政策实施效果评价
TITLE: Effect evaluation of medical insurance policy for hepatitis C DAA drugs based on patient survey
摘要: 目的 为丙型肝炎(以下简称“丙肝”)防治工作的开展以及直接抗病毒(DAA)药物医保支付政策的制定和完善提供参考。方法采用问卷调研的方法对2019-2020年在四川省内某三甲医院进行丙肝治疗并享受成都市丙肝医保政策的患者进行调研,比较DAA药物纳入医保目录前后患者的丙肝治疗情况及对DAA药物医保政策的满意度。结果对644名患者进行了调查研究,有效应答人数共计203例。在治疗方案方面,虽然2019年和2020年就诊的患者在用药方案上存在明显差异(P<0.05),但绝大多数患者在疗程内获得治愈(200例,98.52%),且无明显不良反应发生(193例,95.07%);在经济负担方面,2020年接受DAA药物治疗的患者其自付费用和经济负担明显低于2019年就诊的患者(P<0.05);在患者服务方面,78.82%的患者接受了医保定点医疗机构提供的专家咨询服务,但仍有9.85%的患者未接受医院提供的任何患者服务。在门诊报销政策的满意度方面,2020年就诊的患者在对于DAA药物医保政策的整体满意度(95.37%)明显高于2019年就诊的患者(81.05%)(P<0.05)。结论受访患者使用DAA药物治疗丙肝的效果较好,且对丙肝DAA药物医保政策表示满意,但定点医疗机构在患者服务规范化管理方面还存在不足。
ABSTRACT: OBJECTIVE To provide reference for the prevention and treatment of hepatitis C and the formulation and improvement of medical insurance payment policy for direct-acting antiviral (DAA) drugs. METHODS An questionnaire survey was conducted among the patients who received hepatitis C treatment in a third-grade class-A hospital in Sichuan province from 2019 to 2020 and enjoyed Chengdu medical insurance policy. The patients’ hepatitis C treatment and satisfaction with the medical insurance policy for DAA drugs were compared before and after DAA drugs were included in the medical insurance list. RESULTS A total of 203 patients effectively responded among 644 investigated patients. In terms of treatment plans, although there were significant differences in the treatment plan between patients who saw a doctor in 2019 and 2020 (P<0.05), the vast majority of patients were cured within the course of treatment (200 cases, 98.52%), and there were no obvious adverse reactions (193 cases, 95.07%). In terms of economic burden, the out-of-pocket costs and economic burden of patients treated with DAA drugs in 2020 were significantly lower than those treated with DAA drugs in 2019 (P<0.05); in terms of patient services, 78.82% of patients received expert consultation services from designated medical institutions, but 9.85% of patients still did not receive any patient services provided by the hospital. In terms of satisfaction with outpatient reimbursement policy, the overall satisfaction of patients who saw a doctor in 2020 (95.37%) was significantly higher than those who saw a doctor in 2019 (81.05%)(P<0.05). CONCLUSIONS The surveyed patients with hepatitis C obtain good efficacy after DAA drugs treatment, and are satisfied with the medical insurance policy of DAA drugs, but the standardized management of patient services in designated medical institutions is insufficient.
期刊: 2023年第34卷第08期
作者: 郭一娇;郭昭廷;胡明;冯海欢
AUTHORS: GUO Yijiao,GUO Zhaoting,HU Ming,FENG Haihuan
关键字: 丙型肝炎;直接抗病毒药物;医疗保障;患者满意度;效果
KEYWORDS: hepatitis C; direct-acting antiviral drugs; medicare security; patient satisfaction; effect
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