签约家庭医生是否会促进老年人使用初级医疗保健? - 差异分析的差异分析的证据
Peipei Fu1, Yi Wang2, Dan Zhao1
1Center for Health Management and Policy Research, School of Public Health, NHC Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012, Shandong, China.
BMC geriatrics
|September 10, 2024
概括
中国的家庭医生合同服务 (FDCS) 计划成功引导农村居民到初级保健设施. 签订FDCS合同使得第一接触医疗保健设施的平均水平降低了24.5%,改善了寻求医疗保健的行为.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 医疗保健政策 医疗保健政策
背景情况:
- 中国2016年全国范围扩大家庭医生合同服务 (FDCS) 的目标是将患者从三级医院转移到初级保健.
- 这一倡议旨在优化人口中寻求医疗保健的行为.
研究的目的:
- 评估FDCS计划对农村居民医疗保健利用的门有效性.
- 评估FDCS对选择第一接触医疗保健设施的影响.
主要方法:
- 使用来自山东农村老年人健康队列 (2019-2020) 的数据,采用差异差异 (DiD) 设计.
- 这项研究包括了310名利用医疗护理的受访者,将那些刚刚获得FDCS (治疗组) 和那些没有 (控制组) 的受访者进行了比较.
主要成果:
- 签订FDCS合同的参与者显示,第一接触设施的平均水平显著下降 (从2.204降至1.981).
- 相反,对照组显示出第一接触设施水平的上升趋势 (从2.128到2.445).
- 签订FDCS合同与初接触设施的平均水平降低了0.54%,约减少了24.5% (P=0.03).
结论:
- 农村医疗保健计划在指导农村居民向初级医疗保健方面表现出有效性.
- 建议加强初级医疗保健的质量,并实施限制性第一接触政策,以进一步优化寻求医疗保健的行为.
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