【健保局】健保局說明：何以健保支付1成用於洗腎及呼吸器

[MK]

http://www.doh.gov.tw/CHT2006/DM/DM2_p0 ... c_no=77071

建檔時間：2010/09/03 17:30:02
更新日期：2010/09/03 17:30:20


監察委員黃煌雄於全民健康保險總體檢所提健保在洗腎及呼吸器治療費用支付佔1成乙節，健保局說明如下：
洗腎及呼吸器治療之病人，主要係因腎衰竭或呼吸衰竭造成需要接受血液或腹膜透析及呼吸器治療，而腎衰竭及呼吸衰竭是許多重大傷病之末期變化，並非單一疾病造成，而重大傷病正是健保最需要優先照顧之對象，且洗腎及呼吸器治療係救命的治療，病人一旦停止治療，會危及生命，因此需持續治療。

目前我國洗腎大多採用之血液透析為例，透析每次支付4017點，每月約需洗腎13次，每年約需57萬元；另呼吸器依賴患者係採論日支付，平均每人每年支付130萬元，經統計自90-98年符合呼吸器依賴之住院病患計有16萬7千餘人，其中住院少於6個月之人數有12萬人，佔所有病患77％，而超過1年以上之病患累計18,118人，佔所有此類病人10.82％，表示89％之病患會於1年後脫離呼吸器治療，可能是往生或是疾病好轉。以上洗腎與呼吸器治療因醫療費用昂貴，若健保不給付，則民眾可能會因經濟關係而無法持續治療。

以98年健保申報資料分析，洗腎一年花費302.6億元，佔健保全年醫療費用6.33％，呼吸器依賴患者所有費用一年花費242.92億元，佔健保全年醫療費用4.76％，合計佔健保總額醫療費用11.09％，確實為總額之一大負擔。

為能減少洗腎病人之發生，健保局自95年起開始針對慢性腎臟病（CKD）病患及家屬進行衛教及健康管理，以期在病情早期積極治療，進而有效減少腎衰竭病患之發生率或延緩病患進入洗腎階段，故洗腎發生率於96年為每百萬人415人，比95年每百萬人420人已有下降趨勢（92年至96年發生率分別為每百萬人391人、405人、435人、420人及415人，成長率分別為3.58％、7.41％、-3.45％、-1.19％）。本局將於100年擴大CKD計畫收案對象，加強提升照護品質，並希望透過提高腎臟移植率以減少未來洗腎支出不斷擴大。

另為能減緩呼吸器住院病患之醫療負擔，本局亦支付居家呼吸器租賃及訪視費等費用，鼓勵病患回歸家庭，並於98年9月將八大末期疾患（含腎衰竭及呼吸衰竭）納入安寧住院及居家安寧療護支付範圍，以期減少健保支出，爾後健保局亦會積極與國健局等相關單位共同努力推動疾病之預防措施，以期有效減少此類疾病之發生率。

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腰子科學會＆相關立委真有力...

竟然有辦法讓健保局出面說明...

[mmc02]

腰子科學會＆相關立委真有力...

竟然有辦法讓健保局出面說明...

他們是高級人種，薪水比一般賤醫高已是不爭的事實。

[brian1968]

腰子科學會＆相關立委真有力...

竟然有辦法讓健保局出面說明...

他們是高級人種，薪水比一般賤醫高已是不爭的事實。

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