小钱,大变化:差异化医生诊所费用对医疗保健利用率的分配影响
Tianyu Wang1, Ke Wen1, Qiuming Gao2
1School of Labor and Human Resources, Renmin University of China, 59 Zhongguancun Avenue, Beijing, 100872, China.
Social science & medicine (1982)
|November 20, 2023
概括
中国的差异化医生访问费用成功将患者重定向到初级保健设施,减少了高级医院的过度拥挤. 这一政策特别有利于老年人和患有慢性疾病的人.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 公共卫生 公共卫生
背景情况:
- 高级医院的过度拥挤和初级保健设施的不足利用是中国医疗保健系统面临的重大挑战.
- 患者分配效率低下导致资源分配不足,医疗保健质量下降.
研究的目的:
- 调查差异化医生的诊所费用和共同费用对医疗保健提供者各级患者分配的影响.
- 评估定价政策对影响患者寻求健康行为的有效性.
主要方法:
- 利用参数不连续性回归模型来分析2017年在中国一个大城市实施的政策变化.
- 采用大规模的保险索赔数据库来检查对门诊访问分配的因果影响.
- 利用政策变化的异质性进行强有力的因果推断.
主要成果:
- 差异化医生访问费表的改革显著增加了门诊患者访问初级保健设施的比例.
- 这一转变是由于对高级医院的访问减少,而对社区医疗保健中心的访问增加.
- 该政策在老年患者和患有慢性疾病的人群中表现出更明显的效果.
结论:
- 差异化的定价策略,特别是专注于共同支付,可以有效地引导患者流向适当的医疗保健水平.
- 提高初级保健能力与定价政策调整一起,对于成功的医疗保健分组至关重要.
- 这些发现提供了一种可行的策略,可以减轻医院过度拥挤,提高医疗保健系统的效率,而不会引起道德风险.
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