What is the difference between chronic disease and chronic disease?

The core difference can actually be explained in one sentence - Chronic special diseases are special diseases that are selected by local medical insurance departments and enjoy special outpatient insurance policies in the general category of chronic diseases. They are essentially a part of chronic diseases with the attributes of medical insurance policies, and are not a new classification independent of chronic diseases.

It may sound a bit abstract. When I helped the medical insurance department organize application materials at a community health service center, I encountered several patients who confused the two. For example, there is an aunt suffering from rheumatoid arthritis. At first, she only had dull joint pain, which could be controlled by taking some conventional anti-inflammatory drugs. At that time, she only received outpatient services for common chronic diseases, and the annual reimbursement amount was only 2,000 yuan. Later, the disease progressed to joint deformation, requiring long-term use of biological agents. A month's medication costs several thousand. After submitting nearly half a year's examination reports and medical records to apply for chronic disease recognition, not only the reimbursement rate was increased by 20 percentage points, but the annual quota was directly increased to 40,000. Calculated, it can save more than 30,000 a year. This is the most real value of the chronic disease policy.

If we put aside the attributes of medical insurance, in fact, chronic diseases themselves fully meet the definition of chronic diseases - they are diseases that last for more than 3 months, cannot be completely cured, and require long-term medication or intervention. However, the cost of treatment is generally higher and the risk of disability and teratology is high. If reimbursed as a general outpatient service, the patient's out-of-pocket burden will be too heavy, so they are specially selected for policy preference.

By the way, the catalog of chronic special diseases has not yet been unified across the country. The country only provides a reference range. Each locality will adjust it according to the local medical insurance fund carrying capacity and the incidence of common diseases. For example, some places include mild psoriasis as chronic special diseases, and some places have to be severe such as arthritis type and erythroderma type. Even the catalogs of different prefecture-level cities in the same province are different. This is the main reason why many patients who seek medical treatment in other places are confused "Why can I enjoy the treatment of chronic special diseases in my hometown, but not in other places?"

There are a lot of related discussions in the industry. Some people think that the national chronic disease catalog should be unified as soon as possible, and the benefits recognition in different places should be opened to facilitate the floating population to seek medical treatment. Some people think that the situation of medical insurance funds in various places is quite different. Forced unification will put pressure on the funds in some underdeveloped areas, and ultimately affect the benefits of all insured persons. At present, relevant policies are still in the process of gradual adjustment. If you have a chronic disease patient in your family and feel that the annual medical treatment burden is heavy, you might as well go to the local medical insurance bureau or community health service center and ask. Maybe your disease just meets the local chronic disease declaration standards and you can save a lot of money.