Research On Domestic Chronic Disease Intervention Based On Chronic Disease Trajectory

Chronic disease has become the first cause of death in the world,as the result of industrialization,urbanization,development of health care and increase of life expectancy.As for individuals,chronic disease is not only a huge threat for health,but also the main cause for poverty,especially for poor people who are much more vulnerable to fall into the vicious circle between poverty and chronic disease.As for the country,chronic disease is one of the main challenges for sustainable development,as its negative influence on labor productivity.Under such circumstance,WHO has published World NCD Action Plan to advocate all its members to implement chronic disease interventions,which are evidence-based measures that can effectively prevent and control chronic disease.As the country with the largest population in the world,chronic disease status is quite severe in China,and will be even severer with the aging population.It not only threats the sustainability of medical benefits fund,but also is one of the main causes of poverty.What's more,it dramatically impairs the labor efficiency,which directly damage domestic economic development.With medical security policy in China mainly focusing on negative income compensation,although China has started to formulate the chronic disease prevent and control system across the country,it still has a lot of shortages in practice,such as huge difference between different areas,the interventions mainly focus on several specific chronic diseases,such as hypertension and diabetes,etc.,which have limited the effect of chronic disease prevention and control.Therefore,in order to improve effectiveness of prevention and control towards chronic disease,this thesis tries to explore chronic disease intervention policies which fit all provinces,includes all chronic disease and covers the whole process of chronic disease,as well as to transfer the medical security policy from negative income compensation to positive social support.Based on the current research result of chronic disease interventions,this paper mainly includes the following parts.First,it analyzes theoretic basis for the paper.Second,it analyzes the status quo of domestic chronic disease interventions.Third,according to the chronic disease trajectory,it analyzes different phase interventions.Finally,considering the opportunity of chronic disease interventions in China,it propose policy suggestions for domestic chronic disease intervention,which consists of interventions through the whole chronic disease trajectory and the supporting system.As for the intervention through the chronic disease trajectory,there are 3 phases,for phase 1(beforehand disease),the intervention is mainly about controlling the risk factors,which will be conducted through public policies,media propaganda and interventions in key places.For the phase 2(disease examination),the intervention is mainly about risk group,identifying the risk group by health examination and managing their health conditions.For the phase 3(the post-examination period),the intervention is mainly about patients,offering them chronic disease management,which follows the specific pathway.As for the supporting system,this paper proposes a new support scheme including five aspects,which are creating a positive policy environment,establishing dynamic and shared information system through electronic health record,completing the medical security system,strengthening the primary care system by cultivating general practitioner,general nurse and health management teams,as well as encouraging participants' enthusiasm by formulating incentive mechanism.