Diagnose in early days: Reduce a good recipe of the medical burden

Diagnose in early days: Reduce a good recipe of the medical burden
Diagnose in early days: Reduce a good recipe of the medical burden
By 2020, the death proportion of chronic disease will rise to 85% New medical reform scheme " Solve and see the doctor expensively " List in the overall goal, therefore initiate people's concern of this new developing field to health economics. Not long ago, there are experts that proposed: In 1~2 months before a person is approaching one's end, will use up 60%~80% of the hospitalization cost in all one's life of his possibly. , realize and protect the self- healthy goal with higher speed. Disease of Ministry of Public Health accuses of Deputy Bureau Director of the office Kong LingZhi's explaining the high growth born in medical treatment at the meeting with a group of lifelike data: "In 1994, once there was growth that experts predicted the acceleration rate of the disease burden would exceed GDP, a lot of people did not believe, but already become real now at that time. In 2005, the resident of our country bore 2,400 billion yuan of Damien, it was equivalent to 12.9% of the economic expenditure; Compared with 1993, GDP has increased by 3.2 times, medical treatment is born but increased 5.4 times. " Talk about the biggest threat that Chinese face healthily, glossy ganoderma Deputy Bureau Director introduces the hole, chronic disease has already become the greatest threat of people life and health of our country. 80% of the diseases are chronic disease at present, the mortality of chronic disease accounts for 75% of total mortality, and predict, by 2020, the death proportion of chronic disease will rise to 85% according to the expert. The fact proves, if much chronic disease gets the prompt, apt treatment, it will not jeopardize the patient's life. Chronic disease the include hypertension, diabetes, include cancer too, it's a pity, hypertension of our country is therapeutic to lead very low, the investigation result in 2003 reveals that was still less than 30%. If a hypertension patient does not find and control the condition early, he will spend ten times of money curing the disease in the future. Deputy Director of Chinese Center for Disease Prevention and Control Yang GongHuan summarizes the development of chronic disease of our country as two points: First, the proportion that chronic disease of our country is born and taken in the cause of the death of disease is larger and larger; Second, the mark mortalities of several kinds of main chronic disease are rising. Mark mortality of taking, mean mortality independent of factors such as aging population,etc. that cause by life style and environmental factor,etc.. For example, have already defined tumour relates to the fact that the tobacco uses, especially lung cancer at present, and mortality is still rising now. A lot of the intersection of initiation and too in increase constantly, lead to the fact high mortality future dangerous factor of chronic disease. In July of 2008 of life when chronic disease prevents from running through people, Ministry of Public Health will begin to start " 2020 strategical planning of China of health " ,Among them has proposed the tactics of prevention and control based on high-risk group clearly, it has contained 6 main points: Bring preventing chronic disease into national economy and social development plan; Make national chronic disease and prevent policy and planning; Adopt various intervening measures to reduce the main variable dangerous factor; Chronic disease prevents from running through people's life; Promote many department's cooperation and the whole communal participation of prevention and control of chronic disease; Monitor chronic disease and decisive factor; Appraise the progress of prevention and control. Yang GongHuan has introduced on the forum " 2020 strategical planning of China of health " China and chronic disease defend accusing of the relevant plan. "Key chronic disease and action plan of prevention and control of senile disease also of this action plan, its focal point of work is to improve the early discovery rate of high-risk group and patient of chronic disease, improve the therapeutic effect, it is therapeutic to offer the clinical preventative service, standardization of chronic disease. Meanwhile, chronic disease will make sure the pass has been moved ago while preventing and controlling very much key a little, regard family and community as the platform, from controlling blood pressure, accusing of the cigarette, diet and sport to intervene and start with, do the work of propagating and educating and preventing and controlling well, improve the chronic disease patient's therapeutic quality. " She points out too at the same time, if you want to realize the planning, project and practice are indispensable, also need more persons and participate in creation of environment of knowledge and building of contingent, can make chronic disease and dangerous factor of China get effective control. How great on earth does chronic disease bring Chinese financial burden to look for the most suitable one early to examine the method in terms of hygiene economics? 1998~2003, the medical technical and economic evaluation research room Deputy Director Liu KeJun of institute for economic research of the hygiene of Ministry of Public Health has made and included malignant tumour, the disease financial burden of brain blood vessel, heart disease inclusive is calculated. In 2003, there were nearly 7,200,000 people because of these three kinds of diseases in hospital in the whole country, per person afforded the hospitalization cost of about 6000 yuan; That year, the urban residents family was per capita the disposable income was more than 8400 yuan, per capita net income of rural resident's family was only more than 2600 yuan. According to the level in 2003, if a peasant suffered from disease in this respect unfortunately, will bring the heavy burden to his family. Find early, diagnose early, treat early it is the important means to reduce financial burden. Liu KeJun says: "The country has sifted ' the second cancer ' and looked into to list in doing something concrete for the people recently, this measure will contribute to advancing the reducing of the hospitalization cost too. Such as cervical cancer, if can be sifted to find before pathological change out, that basically can be cured; But if developing into cancer, the cure rate will drop greatly. By the look of a certain angle, such an early diagnosis can reduce ill rate and going to a doctor rate of a kind of disease at least, in fact just lighten the financial burden. " Before this, Luo diagnose Luo Randy doses of graceful Mr., managing director of the Asian-Pacific area, say while visiting China, the global medical total expenditure is about 2,500 billion dollars at present, but only 1% are used for diagnosing that measure among them, but nearly 2/3 depend on diagnosing the result while making policy in medical treatment. In the following 5 years, the medical treatment of China is consumed and expected to soar at 11% of the speeds of every year, the maximum saves the hospitalization cost for the whole world to increase and can diagnose the application measuring. In the economic field of the hygiene, should not merely calculate the financial burden of disease, also sift checking to different diseases the method is appraised synthetically. The so-called most suitable scheme means that chooses cost and the most appropriate scheme of income according to the patient's ability, but it does not often have a scheme of economic benefits most. Disease of Ministry of Public Health accuses of the straight dragon of Ray, division chief of of office slow disease to point out: "It is in very close relations to diagnose and reduce economic expenses early. As to individual, diagnose early that sure to reduce the financial burden; But to colony, on the issue to must consider the method, invest, produce we, optimize the scheme from economics, should give consideration to technology, sifts and checks the sensitiveness and cost at the same time. Because while sifting and looking into crowds, it is not everybody that has a question, but need input to everybody, and that really benefited is to check the problematic person out on later stage. So, in diagnosing early, we want the note even more And some suitable and simple and easy technology of in weight research popularizes, disease to that the specific morbidity is very low, in fact it is unnecessary to invest much manpower, financial resources to sift and check. " Sift checking it is a clinical expert's prevention and control in early days " The good recipe " On the forum, the clinical expert from first line in China to chronic disease has deeper experience to spread rapidly, and they are perfectly in harmony or agreement without previous consultation in order to solve the prescription that this persistent ailment opens - -That is " Diagnose in early days " . They are making an effort constantly for the prevention and control of diseases such as diabetes, heart brain vascular disease, malignant tumour,etc. too. In heart failure to it treats expenses to be whether index increase in heart failure to become the first killer global with severity, the heart function fails to lead to the fact the situation of dying suddenly obviously increases. Foreign statistical data reveal chronic in heart failure incidence about crowd can so as to up to 6%~10% over the 1.5% to 2%, 65, especially in the past 40 years, the death toll that caused in heart failure increased by 6 times than before. Our country has similar ill rate too. The morbidity in heart failure is 0.9%, among them women's morbidity is 1%, men are 0.7%, the patient exceeds 11 million, but mainly it causes the organ to pour into insufficiently that a pump is depleted for the death reason, the blood supply which produces all internal organs is insufficient and cause the death. In addition the malignant rhythm of the heart is not normal, the danger of dying suddenly obviously increases too. Two cardiovascular head of the department leaves of old age of PLA general hospital are flat for professor to prove the early hygiene economics meaning that examine from one's own ambit again. "People all say the mortality of malignant tumour is very high, so once can make a definite diagnosis of malignant tumour, people all feel very terrible. But we can be seen from the result of study of one of 110,000 people's investigations, the mortality in heart failure should be higher than breast cancer and intestinal cancer, more terrible than malignant tumour. It is the intersection of medical treatment and with very high costs chronic disease to be at the same time in heart failure, account for, treat 67%~75% of expense from great amount of expenses that cause in hospital, the expenses increase with the severity in the form of index, the medical burden is heavy. So seem particularly important to the early diagnosis and intervening in heart failure. " Clinical expert try technology dissolve the intersection of heart and the intersection of brain and vascular disease, examine difficult early effectively with various diagnosis, may adopt elastic index of the artery and monitor arteriosclerosis, find blood sour level,etc. in middle period. On the forum, an advanced diagnosis technology while diagnosing that the flat professor of leaf has also introduced Luo - -Sodium peptide (NT-proBNP) of B -type diuresis before utilizing N end Detection. She says, NT-proBNP is the best heart function mark at present, can be regarded as a useful screening tool, used for the heart which high-risk group such as hypertension, diabetes and coronary heart disease,etc. have unusually measuring, can also be used for finding correctly in the emergency ward the heart declines. Control NT-proBNP index regularly, can help the doctor to be early and diagnosing correctly the heart declines, get involved and treat and change the life style, so as to prevent from or slow down the heart and decline the deterioration of disease in time, and reduce the risk of suffering from the other serious heart diseases that may be fatal, the patient will enjoy better life quality and longer life-span too. She still proves vividly this advanced person diagnoses the economic worth of technology with a group of figures: "After using NT-proBNP, can reduce 58% of the use that pursues aroused in interest of supersound, prevent the is admitted to hospitalled, reduces for 12% of the days, the direct hospitalization cost which reduce 14% in hospital for the first timing of 13%. " Accurate, early diagnosis confirms for the patient the rational healing solution of the easy medical personnel, and can monitor and manage and treat the process accurately, thus save clinic and direct medical cost and expenses produced in hospital greatly. Luo diagnoses the general manager in Greater China district revitalizes gentlemen and says yellow-corktree bark: "NT-proBNP and Kang Luo widely used in cardiovascular disease and diabetes, make a diagnosis products as two of us all, have already been introduced into the Chinese market. They will help the doctor to carry on early and more accurate diagnosis, thus save the long-term great amount of medical expenses greatly for the patient. " " no disease needs self- management even more than diabetes " The endocrine professional professor Professor Pan ChangYu of PLA general hospital introduces: "In 2007, under the leadership of the diabetic summit, we did an investigation in the whole country, found finally the ill rate of diabetes was up to 11%, diabetes previous IGT was up to 15%. If convert into the total ill number of people, our country nearly has 70 million diabetics, have exceeded 26 million that World Health Organization required greatly. " She points out, in 2003, the direct hospitalization cost that diabetes caused was up to 20,800 million yuan, accounting for 4.38% of the total hospitalization cost that year, among them the complication patient accounted for 81.1%, complication patient did not accounted for 18.9%. At present, the whole world is seeking the simple method to sift and check to the unusual and diabetic high-risk group of blood glucose. WHO recommends the method of Finland, namely record indexes such as age, weight, waistline, movement intensity, family's history, medical history of hyperglycemia previously,etc., receive a result through calculating, when the number value is smaller than 7 o'clock, the morbidity is 1%, as the number value is in 7~11, the morbidity is 25%, then and so on and so forth, the number value is greater than 26 o'clock, the ill rate will be up to 50%. Then statistics through a plurality of factors, doctors will recommend doing blood glucose to check that confirm whether there is diabetes. "Prevent and cure the new main point that complication has already become diabetic management of our country, diabetes high endangers the cardiovascular disease state, blood glucose must be controlled well, blood pressure should be controlled below 130/80mmHg. It is to prevent the serious complication to sift checking in early days ahead of time, reduce the important tactics of the personal and national hygiene expenditure. " Pan ChangYu says. "No disease needs oneself to manage even more than diabetes! Our country proposed self- blood glucose to monitor in 5 therapeutic great key elements of diabetes in the 1990s of last century, include medical insurance in yet so far, monitor expense, produce by patient at all oneself, this actually very unreasonable one. I know Beijing a lot of hospital play edge ball, turn on, check behind the fee, the patient can go to check, this can solve some problems, it is not the basic method. " PLA general hospital endocrine head of the department Lu JuMing says, " hope the country issues some policies, how many inspections for example can be offered to insulinogenic patient of the hypoglycemia every month; Controlled through oral medicine or diet, should make different policies, take expenses into consideration, must be regarded as the essential expenditure, and essential. " Professor Lu JuMing has also compared the blood glucose appearance products type of the mainstream at present in detail, point out the developing direction of the whole blood glucose appearance should grow from oxidase to desaturase, grow from photochemistry to the bio-electricity. According to Introduce, Luo various health Luo a most short one take, can reveal and find the result in 5 seconds only in the the whole product, offer the statistical information of up to 15 groups of data for control of diabetic's blood glucose, support oneself to monitor the data analysis. It is overweight fat direct financial burden that bring that regard as, " take, go on chronic disease prevent and control by first account, then what kind of information should we transmit to ordinary people? What should be said in the face of government official? What topic should be proposed in the face of professional personnel? If we learn with way that do accounts, come, cause people to chronic? >>The cherry �Ӧ� does not have Gou �� still humorous �� to take on the third constellations and make a noise and faint! We let out on � on arm �Ԥ� take on Zhyuan Pu �� s solemns competent competent to it is angry that if you can't last curtain �� core, last shellfish to last my darling � coal to last official �� Pu to admire to inlay to if you can't last Ke � s terrifieds of outstanding talent, last three-bristle cudrania Ge? Society and economic development have brought the increase of chronic disease, the trends of overweight, fat and hypertension are serious day by day. The Chinese adult that carried on in 2002 is overweight and fat to investigate it should be the largest one up until now. Investigate that covers 31 provinces and cities in the whole country, the investigation result reveals more than 22% of person of the national adult is overweight, over 7.1% of the people are fat; City have 28.1% people overweight among them, 9.8% people fat, and countryside have 20.6% people overweight even, 6% of the people are fat. It is not only independent disease to be overweight and fat, cause the most important dangerous factor of the relevant chronic disease especially. Compared with person normal in weight, overweight the chance that and the overweight person suffers from hypertension and diabetes should be a lot of times higher, the highest one can reach 4 times; Likewise, lead to the fact probability of coronary heart disease and brain apoplexy will be even more than 30% higher of normal people overweightly and fatly. In other words, if people are not overweight and fat, then 19% of the hypertension and 14% of the diabetics can avoid. Overweight, fat and hypertension are one of the important reasons for financial burden of disease. Developed countries such as U.S.A.,etc. have conducted research on the overweight and fat disease that caused has been born, it accounts for 2%~7% of the expenditure of the national hospitalization cost to due to all fat and cost. So, it is very meaningful to study the relevant chronic disease that leads to the fact overweightly and fatly etc. and bear and make to the policy and distribute the limited hygiene resources in our country effectively. Zhao WenHua says: "Control overweightly, fat and hypertension are the key to lowering chronic disease and danger. In 2002, the ratio of overweight rate of our country to fat rate was 3.21, and the ratio of U.S.A. was 1.11. Though in view of number value only, we are lower than U.S.A., that is because the population base of our country is very great. So we must see the situation is severe, if does not take measures, we be up to 11. In fact, the proportion that the overweight and fat hospitalization cost that leads to the fact takes the medical all-inclusive cost of our country is not low, the same as severity of the developed country. If overweight person does not take measures, it is very low to get back to the possibility of the normal weight, and very difficult. " "Though our every aspect is calling upon and paying attention to the prevention and control of chronic disease, but we also need the country to issue the policy to support chronic disease to prevent at present. Can say so, return none, guide from the intersection of policy and aspect how do the intersection of chronic disease and planning of prevention work well the present stage. In addition, the country proposes giving each person the public health expenses of 15 yuan now, but 15 these on earth can give slow the intersection of disease and odd, everyone can not say clearly; Even if this 15 yuan has been all given chronic disease, for reducing the chronic critically ill hurting and financial burden, also very limited. " Zhao WenHua says. Poverty and in one the intersection of disease and now to to diagnose, yet is enough to understand in early days chronic disease much hospital rich distance, how much used to while putting all a large sum of expenses into treating, but we need to put into on earth, could meet unprecedentedly surging medical demands of ordinary people, this is probably a astronomical figure. " healthy economic forum " Hope for the question that can bear China's medical treatment of pulse with more medical experts, hygiene economics experts and enterprises with sense of duty together, seek the feasible solution, how on the basis of cheaper, reasonabler, scientificcer expense to consider together, diagnose many kinds of chronic diseases in early days, thus obtain the good therapeutic effect. In fact poor and rich just on the distance between a disease. Hope our forum can call upon government and medical organization to put more attention into the discovery in early days of disease and diagnose in early days, wake the public's health consciousness up, promote China's medical reform, thus realize the goal that it is healthy that everybody enjoys. On-the-spot question and answer The expert understands for you " Self- blood glucose is monitored " American diabetic association and endocrine association has pointed out the important meaning that diabetic's self- blood glucose monitors clearly, of our country 2 type diabetes prevent and cure guide, get out of self- blood glucose monitor, accommodate all diabetics clearly even. Research indicates, 31% of the persons who lowers candy medicine treatment of oral administration monitor self- blood glucose in U.S.A., Canada is 22%, and only 14% of China. Oral administration lowered candy medicine and added insulin and treated and monitored self- blood glucose in a patient, U.S.A. and Canada can exceed 80%, and only 50% of our country, it is obvious the number of people that the self- blood glucose of our country monitors is obviously lower than other developed countries. PLA general hospital endocrine head of the department Professor Lu JuMing says: " the diabetic's self- blood glucose is monitored (SMBG) It is a internationally acknowledged effective means to control blood glucose, the diabetic of the developed country nearly holds a blood glucose appearance now. " Germany's famous ROSSO research has proved the hygiene economics meaning that self- blood glucose monitors too. An inferior group of research observes through 8 years, oral administration lowered candy medicine and treated in a patient the persons who monitor oneself reduced the expenditure of more than 1700 euro than the persons who do not monitor, after the patient that and insulin adds oral administration and lowers sugar medicine treatment monitors self- blood glucose, its hospitalization cost has been reduced by more than 13,000 euro, and the life of patient monitoring oneself has all lengthened. It is obvious the diabetic's self- blood glucose is monitored, brought high-efficient output input, this's the most important purpose of medical treatment. On the forum, Lu JuMing has also answered representatives and monitored some questions put forward to oneself's blood glucose. Q: Self- blood glucose monitors and saccharified the data of hemoglobin, how to combine together and see? A: In fact these two data have the same value. Saccharified hemoglobin reflects the average blood glucose in 3 months. The diabetic especially diagnoses or adjusts and lowers candy medicine stage newly in treating, and patient that insulin treat must monitor blood glucose often, observe the intersection of blood glucose and level, improve progressively, and can adjust the healing solution in time horizontally according to blood glucose. Only in this way, saccharified hemoglobin may be improved 3 months later. Instead Came to say, if you did not monitor self- blood glucose, did not change the healing solution in time, saccharified hemoglobin can not usually obviously get improvement 3 months later. Q: If the high-risk group do self- blood glucose to monitor, where are its meaning and necessity? A: Been already making great efforts to list saccharified hemoglobin in the diagnostic standard of diabetes in the world now, but the diabetic's saccharified hemoglobin value overlaps with the normal value many. It is that the blood glucose is a bit high to fix saccharified hemoglobin 6%~6.5% at the beginning now, more than 6.5% will probably suffer from diabetes, a plurality of international diabetic authoritative organizations propose the conditional country can try this standard. But saccharified hemoglobin can't be used for diagnosing yet at present in diabetes earlier stage, because of it? 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It is applying to the self- management of diabetes that self- blood glucose monitors the most important purpose, each patient uses one's own blood glucose appearance fixedly, the result monitored makes a variation smaller, can reflect the blood glucose level and change the law truly. Q: How could improve the rate of accuracy that patient's self- blood glucose monitors? A: The patient needs to pay attention to the following aspects in monitoring oneself: First of all, will choose the advanced detecting instrument. With the progress of science and technology, blood glucose detecting instrument is updated and very fast too, complete such as Luo Kang can raise the accurate rate diagnosed. Secondly, it don't pinch with hands while collecting blood to grasp the complexion blood volume each time, so as not to influence the test result. Third, should keep the test paper and take the test paper correctly. Fourth, should examine and carry on the record regularly. Can already record and examine information automatically with some advanced detecting instruments at present, help the doctor find out about patient's condition, contribute to choosing rational treatment way and whole medical treatment that reduces the patient effectively to bear for the patient. The intersection of staff reporter and Wei Xiao it puts Zhao in order to be auspicious to photograph while being clear


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