The Analysis of Discrepancies in Reimbursement Benefits for Medications under China's Outpatient Security Policy in the Case of Patients with Inflammatory Bowel Disease
- VernacularTitle:以炎症性肠病患者为例的我国门诊保障政策下患者用药报销待遇差异性分析
- Author:
Liting SHEN
1
;
Xu SI
;
Ningjing TANG
;
Zhixin FAN
;
Qiang SUN
Author Information
1. 山东大学齐鲁医学院公共卫生学院社会医学与卫生事业管理学系 山东 济南 250012;国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学) 山东 济南 250012;山东大学卫生管理与政策研究中心(山东省重点新型智库) 山东 济南 250012
- Publication Type:Journal Article
- Keywords:
outpatient security policy;
national negotiated drug;
inflammatory bowel disease
- From:
Chinese Health Economics
2025;44(5):23-26,37
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Taking Inflammatory Bowel Disease(IBD)patients as an example,to explore the impact of disparities in regional outpatient security policies on medication reimbursement benefits for patients,and to provide insights for promoting the reform and development of equal outpatient security policy.Methods:39 cities from 9 provinces in China were selected as research samples to analyze the types,coverage,and benefits of their outpatient security policies.Indicators such as the individual out-of-pocket ratio,deductible,and specified reimbursement rate were used to simulate the actual reimbursement ratio for IBD patients using negotiated drugs.Results:Under the general outpatient coordination policy,the average actual reimbursement rate for medications in IBD patients was 26.36%for residents and 36.47%for employees.Under the outpatient chronic and special disease policy,the average actual reimbursement rate was 42.49%for residents and 50.94%for employees,while patients receiving drug treatment under the outpatient special drug policy have an average actual reimbursement rate of 51.62%(for residents)and 64.92%(for employees).Conclusion:Under China's outpatient security policies,there are significant disparities in reimbursement benefits for IBD patients across different regions.Therefore,it is recommended to strengthen the coordination of outpatient security policies across regions,optimize policy design,and provide patients with more equitable and accessible medical coverage.
