中国国家集中体积化药物采购政策对卫生成本和利用的影响:使用小组数据 (2009-2022) 进行中断时间序列分析
Yishi Jiang1, Guangsheng Wan2, Yufeng Shi2
1NHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, China.
PloS one
|December 26, 2025
概括
中国以量为基础的药品采购政策最初提高了非药品成本,但导致了长期的节省. 该政策显示出显著的区域差异,并影响了医疗保健的利用率,需要为未来的优化制定量身定制的战略.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 医疗保健管理的管理
背景情况:
- 中国的基于数量的采购 (VBP) 政策旨在通过集中采购降低药品价格.
- 虽然VBP在降低药物成本方面的成功是已知的,但其对医疗保健支出和服务利用的系统性影响却不太清楚.
- 本研究评估了VBP对门诊和住院服务成本和服务量的影响.
研究的目的:
- 评估中国国家基于数量的药物采购政策对医疗保健支出和服务利用的影响.
- 分析每次门诊和住院费用,住院率和住院时间的变化.
- 调查政策效应的区域异质性.
主要方法:
- 使用2009-2022年面板数据进行中断时间序列分析.
- 用消费者价格指数 (CPI) 调整的门诊/住院费用,住院率和住院时间是主要结果.
- 用细分回归模型和两阶段元分析来评估即时和长期影响以及区域差异.
主要成果:
- 在VBP实施后,观察到每次访问门诊和住院费用的立即增加.
- 长期趋势显示,每次访问成本每年下降.
- 医院门诊和住院率最初下降,而住院时间长度增加,区域异质性显著.
结论:
- 该政策最初增加了非药物成本,但长期实现了成本降低.
- 区域差异,人口结构和补充改革影响了结果.
- 未来的政策优化需要将支付改革与特定区域的战略和增强的评估方法相结合.
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