中国慢病分析与咨询项目策略.ppt

新的医疗服务组织模式-举例 疾病管理项目（DMP） 远程医疗（电子医疗、移动医疗） 不同疾病控制项目间的协调效应 生命全过程策略 资料来源：E. Nolte， M. McKee. 《关怀慢病患者：从医疗系统视角》， 2008。 资料来源：E. Wagner，《慢病管理： 如何才能改善慢病医疗服务？》 1998 如何实施所提出的战略-1 加强政府承诺并改进政府对慢病的应对 制定一个具有明确时间框架，目标清晰，且带经费预算的跨部门中长期规划 改进流行病学监测系统以监测目标的实现情况 实施大规模（以省为单位）的试点 建立一个有效的多部门协调机制 如何实施所提出的战略-2 建立新的机构，承担新的职责 建立能力过硬、充满工作热情的队伍，重点关注不同技能的人员搭配及地域分布 如何实施所提出的战略-3 改善服务的提供 经济激励机制 供方： 按绩效支付 需方：降低医疗保险保费 ；对于参与疾病管理计划（DMPs）的人员，减少/免除病人的共付费用 监管工具 服务许可及认证 选择性签约 守门人制度 开发以实证为基础的指南 如何实施所提出的战略-4 通过制定并使用实证指南与标准，形成一个持续的质量保障文化 通过监测系统、电子病历系统及移动技术的改进来解决信息缺口问题 主要结论总结 政府应该，且能够进行有效的慢病干预 采取多部门的政策和干预措施 卫生体系须在当前医改的基础上重新确定发展方向，进行重新设计 干预实施后，一年到数年内就能看到成效 Analysis has been done at three fronts: projection of NCD in the next 20 years; economic analysis: what are among most cost effective interventions; how to reorient the health sectors to provide services. * * The number of NCD cases (CVDs [myocardial infarction and stroke], COPDs, DM, and lung cancer) among Chinese people over 40 will double or even triple over the next two decades, most of it during the next 10 years (Figure 2). Diabetes cases will be the most prevalent disease While lung cancer cases will increase fivefold. * More than 40% of pop has at least one NCD risk factor. The biggest risk factor is excessive salt intake Between 70 and 85 percent of these people are under age 65. * be seen as an investment into people’s productivity and hence their earnings potential Hours Our estimates Overall 16.0% Urban 21.0% Rural 12.0% Rural Females 7.4% Rural Males 15.0% Urban Females 7.4% Urban Males 22.0% Females 13.7% Males 17.2% * 55% of counties do not have NCD institutions; 15% has no staff working on NCDs; 45% no surveillance; 30% no interventions 85% of THE spent on NCDs. * * From 2010 to 2030, the burden of the four leading causes of ill health – myocardial infarction (MI), stroke, diabetes and COPD – is expected to increase by almost 50 percent. More than 50 percent of disease burden will be caused by CVDs (MI and stroke