Current Status and Discussion of Hemophilia Aid System / 罕见病研究

Hemophilia is a hereditary bleeding disorder where the only effective treatment is factor replacement therapy. The main contradiction of hemophilia in China is the contradiction between the increasing demand for quality of life of hemophilia patients and insufficient medical insurance, medical treatment and medicine. Expensive treatment costs are the main reason for patients to "be impoverished due to illness" and "return to poverty due to illness". This article analyzes the current status of the hemophilia aid system through the existing literature data and existing patient aid projects. Cooperation of social insurance, social relief and high-quality medical services is critical to a complete hemophilia comprehensive medical aid system, so that hemophilia patients can receive standardized diagnosis and treatment, and try to achieve the close quality of life as normal.

Analysis of basic medical insurance and disease burden of the disabled people under the background of health poverty alleviation / 公共卫生与预防医学

Objective To explore the problems of health poverty faced by a special group of people with disabilities and the difficulties in the practice of health poverty alleviation, so as to provide a scientific basis for the health poverty alleviation of the disabled. Methods A self-made questionnaire was used for one-to-one survey, and a database was established by Excel. SPSS was used for descriptive analysis and horizontal comparison. Results The participation rate of basic medical insurance for the disabled was relatively high (93.40%), and the medical insurance payment was mainly paid by individuals (70.13%). The satisfaction of medical insurance was low (43.12%), and 84.64% of the disabled thought that their medical expenses were high. 45.22% of the families of disabled patients met the universal standard of catastrophic health expenditure. Compared with Shandong Province, the basic medical insurance coverage rate of the disabled in Hubei Province was slightly lower, the satisfaction rate of medical insurance was higher, and the proportion of catastrophic health expenditure of families was larger. The analysis of the results showed that the disabled people with a lower disability level, children and middle-aged with disabilities, the disabled people with less or more family members, and the disabled people without the minimum living subsistence allowances were not satisfied with the medical insurance. Conclusion The basic medical insurance in the two places has alleviated the difficulty of medical treatment for the disabled to a certain extent, but the family burden of diseases of the disabled was still heavy. The level of medical security for people with disabilities should be improved, and their economic burden of disease should be reduced, so as to improve the satisfaction of medical insurance.

Study on the Benefit Incidence Equity and I ts Influential Factors of Drug Welfare for Chronic Disease Patients under the Ba- ckground of Health Poverty Alleviation Policy / 中国药房

OBJECTIVE： To study the benefit incidence equity and its influential factors of drug welfare for chronic diseases patients under the background of health poverty alleviation policy， and to provide reference for precision health poverty alleviation. METHODS： According to the National Natural Science Foundation project “Study on the Optimization of Precision Health Poverty Alleviation Policy Based on the Improvement of Drug Welfare Effects of Chronic Diseases Patients”， the research data of Jiangsu， Sichuan and Zhejiang provinces were used as samples （during Oct. 2016-May 2018）. Taking patients’ personal income as economic measurement index， drug expenditure （including reimbursement） as drug welfare index under government health policy， by benefit incidence analysis， Lorentz curve， Gini coefficient， concentration index， concentration curve and Kakwani index were used to analyze the absolute equity and relative equity of drug welfare benefits of patients with chronic diseases. Anderson health service utilization model was used to incorporate the factors that may affect the distribution of drug benefits among the poor patients with chronic diseases. Multivariate linear regression analysis was used to identify the main influential factors. RESULTS： The absolute fairness and relative fairness of drug welfare distribution in patients with chronic diseases were poor， and there were unfair phenomena that were beneficial to the rich and unfavorable to the poor chronic disease patients. Economic income， education level， types of medical insurance and patients’ health level had effects on drug welfare with statistical significance （P＜0.05）. CONCLUSIONS： The health poverty alleviation policy brings drug welfare to patients with chronic diseases，but there are still unfairness. The policy should be more biased towards the poor people，also more chronic disease “life-saving drugs” and commonly used drugs should be included in the medical insurance catalogue. Health education for chronic diseases in primary medical institutions should be strengthened to improve the health literacy and health of patients with chronic diseases.

Analysis of diseases incurring poverty and its cost burden in Nanyang city of Henan province / 中华医院管理杂志

Objective To investigate the disease types incurring poverty, patient population layout, and cost burden by poor households due to illness. Methods During the time August 17-24,2017, App questionnaires were used onsite for data survey at 2 824 poor hourseholds in Nanyang city of Henan province, in order to learn the impacts of the poverty-causing diseases on the labor capacity of the patients and the cost burdens. Such methods as descriptive analysis, rank sum test and correlation analysis were used for data analysis. Results The survey found that 61.79 percent(1 745 households) of the poor households turned poor by illness, most of them aged 40 to 60 years old. The ten disease categories, namely cerebrovascular diseases, malignant tumor, ischemic heart diseases and mental diseases, constitute top disease causes of poverty. These diseases significantly damage their labor capacity, up to 37.67% of them totally disabled. The self-paid expenses of the patients per year accounted for 57.22% of the total annual expenses. Conclusions Medical insurance policies need to elevate the scope and efforts of medical compensation;public health services need to improve health promotion and health education; government supervision needs to be enhanced to keep minimizing patients′disease burdens.

A discussion on the key problems and system construction of health poverty alleviation in China / 中国卫生政策研究

Health poverty alleviation is an important part of taking targeted measures to help people lift themselves out of poverty, and it is the key link to achieve a Healthy Chinese Strategy.At present, the health problem of the poor in China is becoming increasingly prominent, and as a result, the low health status of the poor has exacerbated the level of poverty, mainly because of catastrophic disease.With this discussion paper, it was revealed that there are many problems in the system of poverty alleviation in China: The protection levels of all kinds of medical insurance are still low;the medical assistance system is still not perfect;the medical service facility of the county medical institutions is poor;the county outside referral rate is high;public health problems in poor areas are more prominent.As suggestions derived from the present discussion, China''s health and poverty alleviation system should adhere to the government led and multi-sectoral coordination of multiple health poverty alleviation.It should also strengthen health care and public health system construction in poverty-stricken areas, and establish a multi-path health security system.