《重庆市基本医疗保险门诊特殊疾病保障指南（2025年版）》内分泌代谢专业相关疾病专家共识

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【中图分类号】R58 【文献标志码】A

【Abstract】Withtheaging populationandtheinereasingprevalenceofchronicnon-communicablediseases，theburdenofendocrine and metabolicdiseasshasbecomesubstantialandrepresentsasignfcantportionofmedicalinsurancemanagemetandfundexpenditures.SincetheintroductionoftebasicmedicalinsuraneoutpatintspecialdiseaseprotetionolicyinhongqinginOo，ars havepassed.Duringthisperiod，theevidencebaseforelevantdiseaseshasgraduallyexpanded，ndteconceptsofiagosisad treatment，asellasterapetictchologies，aveundergoecosiderableupdatesandtranformatios.Teeistingmedicalinsu ancepolicyurgentlyneeds tobeupdated to keeppace with modern medicaladvancementsandtoprovidepatientswith more adanced andefectivemedicalsecurityservices.ThereforestartingfromJune1，O25，theMedicalInsuranceBureauofChongqing Muicipalitywillimplementanwmedicalisurancepolicyfo.TosuetesmoothimplemenatioandoperatiooftisoliythEndo crinologyandDiabetesBranchesofthe MedicalAssociationofChongqing Municipalityhaveorganizedexpertsinendocrinemetabolismandpublichealth.Undertheguidanceof the MedicalInsuranceBureau，theseexpertshaveinterpretedthenewpoliciesrelated to thediagnosticcriteriaandreimbursementscopeforoutpatientspecialdiseasesinefieldofendocrinemetabolism.Byintegatingthe latestguidelinesforendocrine and metabolicdiseaseswiththe actual medical practice in Chongqing，and through multiple rounds of expert discussions thatcombineclinical experiencewithmedical insurance management insights，a consensus has been reached on keyaspects such as the reimbursement directory for outpatient special diseases，optimization of disease diagnostic pathways，and the implementation of standardizeddiagnosisand treatmentprotocols. This consensus aims to promote the establishment of a standardized management system.The goalistoenhance the efficiencyof medical insurancefundutilizationandtherateofdiseasemanagementachevement，tostandardizediagnosticandtreatmentpractices，tocurb unreasonablemedicalexpenditures，andtoensure thatmedicalinsurancefundsarepreciselyalocatedtoimprovepatients‘qualityof life.This inititivewillelpevefullifecyclemanagementofoniciseases，supporttheompreensiveimplemenatioofthe "HealthyChina2O3o"actionplaninChongqing，andprovidearegionalpracticereferenceforthenationalmedicalinsurancerefor. 【Key wordsChongqing;medicalinsurancepolicy;endocrineand metabolicdiseases;specialoutpatientServicesfordiseases;xpert consensus

基本医疗保险门诊特殊疾病（简称"门诊特病"），是指需要长期在门诊治疗、纳入基本医疗保险基金支付范围的疾病病种。（剩余25546字）