1.Expert Consensus on the Standardization of Outpatient Diagnosis and Treatment of Endocrinology and Metabolism Specialty for Medically Insured Patients with Special Diseases in Chongqing(2025 Edition)
Expert Consensus Group on the Standardized Outpatient Diagnosis and Treatment of Special Diseases Covered by Medical Insurance in Endocrinology and Metabolism(2025 Edition) ; Endocrinology Branch of Chongqing Medical Association ; Diabetes Branch of Chongqing Medical Association
Journal of Chongqing Medical University 2025;50(8):995-1004
With the aging population and the increasing prevalence of chronic non-communicable diseases,the burden of endocrine and metabolic diseases has become substantial and represents a significant portion of medical insurance management and fund expendi-tures.Since the introduction of the basic medical insurance outpatient special disease protection policy in Chongqing in 2002,23 years have passed.During this period,the evidence base for relevant diseases has gradually expanded,and the concepts of diagnosis and treatment,as well as therapeutic technologies,have undergone considerable updates and transformations.The existing medical insur-ance policy urgently needs to be updated to keep pace with modern medical advancements and to provide patients with more advanced and effective medical security services.Therefore,starting from June 1,2025,the Medical Insurance Bureau of Chongqing Municipal-ity will implement a new medical insurance policy reform.To ensure the smooth implementation and operation of this policy,the Endo-crinology and Diabetes Branches of the Medical Association of Chongqing Municipality have organized experts in endocrine metabo-lism and public health.Under the guidance of the Medical Insurance Bureau,these experts have interpreted the new policies related to the diagnostic criteria and reimbursement scope for outpatient special diseases in the field of endocrine metabolism.By integrating the latest guidelines for endocrine and metabolic diseases with the ac-tual medical practice in Chongqing,and through multiple rounds of expert discussions that combine clinical experience with medical in-surance management insights,a consensus has been reached on key aspects such as the reimbursement directory for outpatient spe-cial diseases,optimization of disease diagnostic pathways,and the implementation of standardized diagnosis and treatment protocols.This consensus aims to promote the establishment of a standardized management system.The goal is to enhance the efficiency of medical insurance fund utilization and the rate of disease management achievement,to standardize diagnostic and treatment practices,to curb unreasonable medical expenditures,and to ensure that medical insurance funds are precisely allocated to improve patients'quality of life.This initiative will help achieve full life cycle management of chronic diseases,support the comprehensive implementation of the"Healthy China 2030"action plan in Chongqing,and provide a regional practice reference for the national medical insurance reform.

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