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中国的减重与代谢手术和医疗保险支付

Bariatric and Metabolic Surgery and Medical Insurance Payment in China.

机构信息

Department of General Surgery and Bariatric and Metabolic Surgery, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing , Jiangsu, 210029, China.

出版信息

Curr Obes Rep. 2023 Sep;12(3):365-370. doi: 10.1007/s13679-023-00507-2. Epub 2023 Jul 20.

Abstract

PURPOSE OF REVIEW

This paper briefly introduces the status quo of bariatric and metabolic surgery and medical insurance payment in China.

RECENT FINDINGS

Along with China's rapid economic growth, the prevalence of obesity and diabetes is increasing quickly. Because of their high body fat percentage and predominance of abdominal obesity, Chinese people experience metabolic disorders more frequently than Caucasians with the same BMI. Treatments are not medical because there is a lack of social understanding of obesity. Furthermore, obesity has not been accepted as a disease in China and so has not been included in the medical insurance payment system. Therefore, weight-loss medications are not covered by medical insurance. In China, bariatric and metabolic surgery have advanced for almost 20 years, and corresponding guidelines have been developed. However, there are regional and cognitive variations in whether medical insurance covers bariatric surgery or not. Recent research on the financial advantages of medical insurance coverage for weight-loss surgery showed that it conserves healthcare system resources. It will be important to raise public awareness regarding obesity in the future, present more evidence of the clinical efficacy of surgery, and work towards a higher percentage of medical insurance reimbursement for obesity treatment and bariatric surgery.

摘要

目的综述

本文简要介绍了中国减重与代谢手术的现状和医保支付情况。

研究进展

随着中国经济的快速增长,肥胖和糖尿病的患病率迅速增加。由于中国人体脂肪百分比高,腹部肥胖为主,与 BMI 相同的白种人相比,中国人更容易出现代谢紊乱。由于对肥胖缺乏社会认识,这些治疗方法不被视为医学治疗。此外,肥胖在中国尚未被视为一种疾病,因此未被纳入医保支付体系。因此,减肥药物不在医保范围内。在中国,减重与代谢手术已经开展了近 20 年,已经制定了相应的指南。然而,医保是否覆盖减重手术在地区和认知上存在差异。最近关于医保覆盖减重手术的财务优势的研究表明,它可以节省医疗保健系统资源。未来提高公众对肥胖的认识,提供更多手术临床疗效的证据,并努力提高肥胖治疗和减重手术的医保报销比例将非常重要。

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