In 2020 Our Country System Don't Chronic Treatment Cost Forecasts

Objective:To cope with the possible rapid rising trend of future Non-Communicable Diseases (NCDs) expenditure and to indicate how expenditure of these diseases may change so as to ensure better regulation and control of NCDs curative expenditure growth. Based on current policy environment, this paper aims to project NCDs curative expenditure driven by factors including population growth, aging, NCDs prevalence, services utilization and expenditure per case and to study methodology of NCDs expenditure projection in China. The study can alert decision-makers, the whole society, and individuals importance of prevention and control of NCDs and necessity of optimizing financing strategy for NCDs. This study also aims to provide scientific evidence for identifying the primary NCDs of prevention and control in the future and for locating the main factors of driving NCDs curative expenditure growth so as to assist decision-makers to take more effective measures to prevent and control NCDs.Methods:The paper firstly projects population, age-adjusted prevalent rates of NCDs, services utilization amount per case and curative expenditure per case in2020based on the respective levels in2010, then applies component-based model to project NCDs curative expenditure by diseases in China in2020. Finally, this paper uses the Logarithmic Mean Divisia Index (LMDI) method to decompose impacting factors of NCDs curative expenditure growth into two demographic factors and three non-demographic factors.Results:China’s population will grow slowly, with an increase of2.82%than in2010, reaching1377.5million in2020. There will be475.85million people living with NCDs in2020. The total age-standardized prevalence rate of NCDs will reach345.45‰, with an increase of0.87times than in2010. Between2010and2020, the total NCDs curative expenditure will increase4996.77billion yuan or4.64times than in2010, reaching6073.277billion yuan in2020. The average annual growth rate is18.89%; the outpatient NCDs curative expenditure will increase4.13times; the in-patient NCDs curative expenditure will increase5.09times. From2011to2020, among various NCDs, the total curative expenditure of diabetes mellitus, diseases of the nervous system, and diseases of the blood and blood-forming organs increase more than other diseases, with an increase of14.46times,12.26times and6.79times respectively; the total curative expenditure of diseases of the circulatory system, musculoskeletal system, congenital anomalies, and malignant neoplasms grow above average, with an increase of5.34times,5.21times,4.36times and4.33times respectively; expenditure of respiratory diseases has the smallest growth, only increase1.07times over the same period. During the projection period, five impacting factors contribute differently to expenditure growth. Changes of NCDs prevalence rate and expenditure per case are the main expenditure driving factors. The contribution proportion of service utilization factor to expenditure growth has decreased in the long run. Demographic changes, especially aging has little impact on the growth of expenditure and remains relatively stable.Conclusion:The projected rapid growth of NCDs curative expenditure in the further will place greater economic burden on government, society and households. In view of the limited health resources and in order to better prevent and control NCDs, we should organize properly. In respect of NCDs prevention and control, we should take all NCDs into account; meanwhile, diseases which have high epidemiologic and financial burden and increase rapidly should be prioritized when decision-making. In terms of financial burden, the curative expenditure of cardiovascular disease and diabetes will account for about50%of the entire NCDs, thus they should be viewed as key diseases to be prevented and controlled. In the future, the prevention of NCDs should be strengthened and government should invest more in preventing the occurrence of NCDs and re-adjust the primary health task from curative services to preventive services so as to regulate rationally NCDs curative expenditure.