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【技术产业】国外对中国医疗市场化的评论－－
Inequitable and cost-inefficient allocation of scarce resources has been found to be a key problem in the management of heart attack and severe angina patients in China, according to the results of a study announced today at the World Congress of Cardiology in Barcelona, Spain.
"China's health care system has undergone considerable changes toward a 'fee for service' model where access to treatment is affected by a patient's ability to pay," said Professor GAO Runlin, Chairman of the Chinese Society of Cardiology. Professor GAO reported that the level of treatment given to a heart patient in China did not directly equate to the patient's risk of subsequent death or disability.
Researchers, at The George Institute for International Health in Sydney and the Chinese Society of Cardiology discovered that, while effective treatments are often available, the decision to provide more costly treatments in hospital was not determined primarily by the likelihood of clinical benefit, but rather by a patient's socioeconomic status, or ability to pay for services. The study also found that relatively inexpensive drug therapies that are highly effective in reducing the risks of future heart attack were frequently prescribed to patients on discharge from hospital, but a patient's use of these drugs diminished rapidly once they went home.
Coronary heart disease has emerged as a leading cause of morbidity and premature death in China today. As the burden of cardiovascular diseases rise in China, so will the numbers of patients presenting with heart attack and related complications. Statistics from the World Health Organization's Global Burden of Diseases Study predict deaths from cardiovascular diseases in China are likely to quadruple to four million per year by 2020.
"Patterns of current practice in managing Acute Coronary Syndromes, commonly known as heart attack and severe angina, reflect choices made by our clinicians towards prescription of expensive interventions. By identifying the gaps in both treatment and cost-efficiency, steps can be taken to reduce the impact of one the worlds, and China's, leading killers" said Professor GAO.
The results are from the Clinical Pathways for the Management of Acute Coronary Syndromes project (CPACS), which was jointly developed by the Chinese Society of Cardiology and The George Institute for International Health to review how patients suffering from acute coronary syndromes are being managed at hospitals across China.
Data was collected from almost 3000 patients in over 50 hospitals from 18 provinces of China. Patients who were admitted to hospital with a diagnosis of an acute coronary syndrome were assessed during hospitalisation and in the first six months after discharge.
Co-principal Investigator for the CPACS study, Dr Anushka Patel, at The George Institute for International Health, believes that the situation found in China is by no means unique to that country. "The early data indicate that China is confronting similar challenges as those experienced in other countries. There is evidence that guidelines for ACS management can promote cost-effective care and improve patient outcomes. However, in addition to approaches directed at promoting guidelines adherence within hospitals and amongst clinicians, health care system reform is the likely key to future success," Dr Patel stated.
"Many opportunities for improving patient care and for cost-effective allocation of scarce resources for the management of ACS are available in China. These include earlier presentation to hospital, earlier treatment following heart attack, better risk stratification, and reduced length of hospitalisation," added Professor GAO. 认领了 国外对中国医疗市场化的评论——有关心血管疾病
研究指出中国心脏病治疗水平需要提高。
根据西班牙巴塞罗那世界心脏病学会的研究结果，稀有资源的不平衡和成本无效分配是中国心脏病和严重的心绞痛病人管理的一个严重的问题。
“中国的医疗服务系统经受‘服务免费’模式的很大打击，服务免费模式保证病人能支付的起医疗费用。”中国心脏病学会主席高瑞麟教授说。高教授认为中国心脏病治疗水平低不能直接等同于病人有死亡和能力丧失的危险。
在sydney乔治国际医疗研究所和中国心脏病协会的研究者发现，有效的治疗通常有用，要求提供更昂贵的院内治疗的想法还没有批准，因为这不是由临床利益而是由病人的社会经济状况以及对服务的支付能力决定的。研究还发现治疗心脏病高效且相对廉价的药物在医院处方上出现的频率很高，但是病人一旦到家就很少再用。
慢性心脏病是造成死亡和早产儿死亡的主要原因。中国心脏病的复合很重，所以心脏病和并发症的患病率还会增加。世界卫生组织的全球疾病负荷的统计数据表明大到2020年，中国心血管疾病的死亡率将会提高四倍，达到每年四百万。
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作者:admin@医学,生命科学 2011-01-12 17:14
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