阶层医疗制度是否提高了中国的医疗保健利用率和公平性? 一个纵向研究2012-2018年
Yaxin Zhao1, Xiaojing Fan2, Fukun Zhu1
1College of Humanities & Social Development, Northwest A&F University, No.22 Xinong Road, Xianyang, Shaanxi, 712100, China.
BMC public health
|August 12, 2025
概括
中国的等级医疗体系 (HMS) 减少了医疗保健利用率,但提高了门诊患者的公平性. 政策制定者应该关注初级保健,保险和教育,以提高低收入和中等收入国家的整体医疗保健公平.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医疗保健不平等是普及医疗覆盖的主要障碍,特别是在低收入和中等收入国家 (LMICs).
- 中国的等级医疗体系 (HMS) 是为了改善医疗保健的准入和资源分配而实施的.
- 本研究评估了HMS对医疗保健利用率和公平性的影响.
研究的目的:
- 评估中国的等级医疗体系 (HMS) 对医疗保健利用的影响.
- 分析HMS对跨社会经济维度的医疗保健不平等的影响.
- 根据HMS,确定导致医疗保健利用不平等的因素.
主要方法:
- 利用来自中国家庭小组研究 (CFPS) (2012-2018) 的纵向数据.
- 采用多期差异差异方法进行利用分析.
- 使用度和水平不平等指数 (HI) 来衡量不平等,并进行分解分析.
主要成果:
- HMS对门诊和住院患者的利用产生了负面影响,短期门诊下降和持续的住院患者减少.
- 在门诊利用中观察到有利于穷人的不平等,在住院利用中观察到有利于富人的不平等.
- 医疗保健系统减少了整体的不平等和不平等,特别是门诊服务;经济状况和健康状况是关键因素,而保险和教育减轻了不平等.
结论:
- HMS减少了医疗保健利用率,但改善了门诊公平,面对住院公平的挑战.
- 加强农村/中部地区的初级保健,确保负担得起的护理,并扩大保险/教育对于公平至关重要.
- 调查结果为在LMICs的公平医疗改革和实现可持续发展目标的进展提供了洞察力.
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