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新技术引发「异地就医潮」:相隔百公里 差价几十万
Di Yi Cai Jing·2025-05-09 00:08

Core Insights - The article discusses the phenomenon of patients migrating to major cities for medical treatment due to disparities in insurance reimbursement policies for advanced medical technologies and high-value consumables [1][5][15] - The "siphoning effect" is highlighted, where patients from smaller cities are drawn to larger cities like Shanghai and Beijing for better reimbursement options, leading to a drain of local healthcare resources and funds [2][6][15] Group 1: Medical Technology and Reimbursement Disparities - Advanced medical technologies like the Da Vinci surgical robot and artificial hearts are only covered by insurance in select cities, creating significant cost differences for patients [1][9][13] - In Shanghai, the Da Vinci robot is reimbursed at 80% for certain surgeries, while in surrounding regions like Jiangsu and Zhejiang, patients must pay out-of-pocket, leading to a migration of patients seeking affordable care [3][4][6] - The article notes that as of 2024, only Shanghai and Beijing have included the Da Vinci robot in their insurance coverage, resulting in a concentration of patients in these cities [6][10] Group 2: Impact on Local Healthcare Systems - Smaller cities face challenges such as patient loss and outflow of insurance funds, which restricts their medical development [2][15] - The article cites that in Zhejiang, only 20 cases of artificial heart surgeries were performed in the previous year due to restrictive reimbursement policies, while the demand remains high [2][10] - Local hospitals in regions like Zhejiang report significant patient outflow to cities with better reimbursement policies, impacting their financial sustainability [7][14] Group 3: Economic Implications and Future Considerations - The article emphasizes the financial strain on local insurance funds as patients seek treatment in cities with more favorable reimbursement policies, leading to a potential imbalance in healthcare funding [15][16] - The disparity in reimbursement policies is attributed to the varying financial capabilities of local insurance funds, with wealthier regions able to offer better coverage [15][16] - The ongoing increase in healthcare costs due to aging populations and technological advancements poses challenges for maintaining balanced insurance fund operations [16][17]