[目的] 评估筹资政策调整对宁夏城乡医保居民卫生服务利用的影响。[方法] 利用2013年和2016年宁夏未参与城乡医保的居民为对照组,已参加城乡医保的居民为干预组,采用倍差法对两组居民的医疗服务利用率、次均医疗费用变化情况进行评估。[结果] 随着筹资政策调整,参保组居民的医疗、门诊及住院服务利用率分别增加2.29、1.84和0.45个百分点;医疗、门诊及住院次均医疗费用分别增长531.62元、17.67元和2075.41元。[结论] 筹资政策的调整对门诊服务利用的促进作用较为明显,但住院次均费用增长较快。应扩大医保覆盖面,加大对低收入家庭补助;加大对基层医疗机构投入,医改政策落实,控制医疗费用增长。
Abstract
Objective To assess the impact of financing policy adjustment on health care services utilization for urban and rural residents in Ningxia. Methods It used data in 2013 and 2016 of Ningxia,it took the residents who had neither part nor lot in urban and rural medical insuranced as the control group,and had participated in urban and rural medical insurance as the intervention group. The difference-in-difference method was used to evaluate the utilization rate of medical services and the change in the average medical frequency cost. Results With the adjustment of the financing policy,the utilization rates of medical services,outpatient services and inpatient services increased by 2.29,1.84 and 0.45 percentage points respectively. The promotion of outpatient service utilization was more obvious. Medical,outpatient and hospitalization costs increased by 531.62,17.67 and 2075.41 yuan respectively,the average frequency cost of hospitalization grew faster. Conclusions Expand medical insurance coverage,increase subsidies for low-income families. Increase investment to primary medical institutions,implement medical reform policies,and control the growth of medical expenses.
关键词
筹资政策 /
卫生服务利用 /
医保居民 /
倍差法
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Key words
financing policy /
utilization of health services /
medical insuranced residents /
difference-in-difference method
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参考文献
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脚注
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基金
教育部人文社科青年基金项目:城乡基本医疗保障一体化背景下的卫生保健公平性及其分解研究(15XJCZH007);研究生教育创新计划项目:医学院校公共管理专业硕士研究生科研能力提升的探索和实践(YXW2017018);宁夏医科大学特殊人才启动项目:宁夏医疗卫生支出的受益归属研究(XT2017004)
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