On Connection Between Medical Insurance For Urban Workers And Public Health Service In Chronic Disease Management

Chronic diseases not only cause damage to the health of patients, but also lead toloss of working capacity and deteriorating of living standard. In addition, the highmedical cost grows burden on household and society.In basic medical insurance system for urban workers, actions were taken to easeeconomic pressure and improve the life quality of patients with chronic disease. Somepatients with chronic disease have been treated as outpatients with special chronicdisease and management system for outpatient with special chronic disease has beenput into effect. The cost that caused by chronic disease treatment as an outpatient canbe applied for reimbursement in mutual assistance fund according to the proportion ofshare between individual and fund.“Opinions on promoting the equalization of basicpublic health services” issued by Ministry of Health and Ministry of Finance regardhigh blood pressure and type2diabetes as chronic diseases and management ofchronic disease one of nation’s basic public medical service program. It is free for allcitizens provided by medical organization at grass-root level, such as communityhealth service center or station and clinics in town. The medical expense comes fromgovernment budget, it will be paid to medical organization after auditing. However,problems arise during implementing due to management by different department: first,the category of chronic disease are not widely covered by insurance, especially inpublic service program, only high blood pressure and type2diabetes are covered byinsurance and other chronic diseases are excluded; second, the prevention andtreatment of chronic disease can not be coordinated well. Because management ofspecial chronic disease focus on treatment, whereas public medical service focusmainly on prevention and monitoring; third, hospitals and medical organizations atgrass-root level do not cooperate well. Hospitals give treatment only, and communityconcern prevention. How to connect prevention and treatment of chronic disease toease economic and psychological pressure of patient? It is necessary to connectmedical insurance and public medical service.This paper take urban workers with chronic disease in Nanchang as research subjects, and study feasibility of connecting medical insurance and public medicalservice.This paper, guided by efficiency theory and Maslow’s hierarchy of needs theory,firstly states chronic disease management status of basic medical insurance system forurban workers and public medical service based on records and documents, andanalyze both differences and similarities between them and necessity of connection.Then, get a picture from patient of treatment, satisfaction degree and attitude towardsconnection of medical insurance and public medical service. Finally, this paper putforward suggestions for chronic disease management based on domestic and foreignmanagement experience(foreign country, for instance, Japan, Canada,U.S.A.,Singapore, domestic such as Zhenjiang City and Shanghai City) such as toguide by government and establish regulations; to widen category of diseases andscope of diagnosis and treatment; to establish a shared information platform; toimprove recognition of patient; to make non-profit organization work and sharingresource realize, and to explore effective method to improve management of chronicdisease patients. Based all of this, new ways should be find to deal with basic medicalinsurance and public health service, and to achieve resource sharing betweenhospitals and community.