| ObjectiveAs the development of human society and economy,improvement of people's living standards and acceleration of the population aging,chronic non-communicable diseases have become the world's most pressing public health problems in the 21st century,which bring a tremendous impact on worldwide people's health and lives. Governments and relevant researchers are seeking for solutions and strategies. Fund-raising of chronic diseases prevention and control is the key to solve the problem, and it has been put on the agenda. A lot of scholars are attracted to focus on the hot issue presently. However, there are not enough studies on the financing models of chronic diseases prevention at home and abroad. The paper aims to use the qualitative and quantitative research methods to analyze the published academic articles related to fund-raising of chronic diseases prevention and control, and find the problems and difficulties on fund-raising of chronic diseases prevention and control in China. Finally, it discusses the multi-channel and multi-level funding models for chronic diseases prevention and treatment in China by using the methods of knowledge integration and knowledge conversion.MethodsIn this study, it involves information science, economics and health service management and other theories and methods to determine the five financing models of chronic diseases prevention in domestic and international countries, then it makes a comparative study on the major financing models of different countries through knowledge integration, finally it analyzes the current situation and the main problems in China and proposes policy recommendation. The main methods include literature research, expert consultation, through in-depth personal interviews and panel discussions to acquire qualitative and quantitative data for this research, and knowledge integration to retrieval all the literatures relevant to the study and make a systematic integration of them.Results(1) Sixty-seven articles were adopted, including 43 English and 24 Chinese articles. One article was the design of case control study, the remaining 66 articles were the current status from 2000 to 2010. There were 22 articles describing financing models of chronic disease prevention and control in China, including 14 cities in China and covering most parts of China. Meanwhile there were 44 articles describing the financing status of chronic disease prevention in the United States, Australia, Canada, Japan, Germany, India and other countries, and a comparison with the situation in China was made. Besides, there were 5 forum presentations, 4 of which were mainly about American companies, health organizations and other non-governmental organizations and associations how to raise money for chronic illnesses. The other one is a non-governmental organization that donated for the prevention of chronic diseases in England.(2) Based on these evidences, it made a systematic evaluation of the main financing sources, the proportion, fairness, payment and other aspects of the five financing models, then it came to conclusion that western countries had established more stable funding models to support the sustainable development of chronic diseases prevention and treatment services. All in all its funding sources are government investment and health insurance (including social health insurance and commercial health insurance), or a combination of both. In China, financing model of chronic disease prevention is mainly user fees. And government investment in chronic diseases prevention and control is a too small share of the total funding, it is far from meeting the needs of chronic diseases prevention and control; personal expense account for large proportion of the total funding of chronic diseases prevention and control, bringing a heavy financial burden on the patients'families and society. Because of the limitation of economy and society development, chronic diseases financing model of commercial health insurance can not be fully realized in China. Chinese medical insurance system is not perfect, it takes a long time to be specific and integrated; we should pay more attention to the donation of individuals, businesses and other non-government organizations.Suggestions(1) Government investment. All levels of government and the Center for Disease Control and Prevention should pay attention to chronic disease prevention and health care, and coordinately distribute money according to existing resources; strengthen the responsibility of government financing to establish a special fund for chronic diseases prevention, insist that the government finance the fixed subsidy for chronic diseases prevention and control, while to ensure the continuity and effectiveness of capital investment; pay more attention to low-income and other disadvantaged groups in rural and urban to improve the fairness of financing.(2) Social health insurance. Reasonably determine the types of chronic diseases in the range of medical insurance, establish a reasonable compensation mechanism for fee; and gradually establish a separate funding mechanism in accordance with the principle of balance of payments.(3) Commercial health insurance. The government should actively guide the commercial health insurance to encourage residents to participate in it; and commercial health insurance authorities should combine with health management institutions and social health insurance institutions in order to fully play its function.(4) Personal expense. To develop a reasonable standard for fee, forming a stable price management system; to establish a centralized, standardized expenditure management system by using revenue and expenditure management system.(5) Donations from non-governmental organizations. To encourage the community investment in chronic diseases prevention and control and broaden the financing channels by learning from foreign experience; develop the community fund-raising channel for chronic diseases prevention and combined it with the health insurance so as to increase the funding levels. |
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