摘要
目的:研究门诊服务对住院服务的影响,据此提出管理高血压患者医疗卫生服务的政策建议。方法:通过对北京市新型农村合作医疗高血压患者2008—2013年的报销数据进行描述性统计分析和面板固定效应回归分析,统计分析采用两部模型(Two-Part model)。结果:两部模型第一部研究高血压患者总体人群,发现门诊次数、门诊总费用、门诊自付费用和门诊报销费用每增加1.0%分别降低住院率为3.9%,2.8%,1.4%和1.5%,门诊与住院率存在替代效应;第二部研究高血压患者住院人群,门诊服务对住院服务各项指标的边际效应非常小。结论:卫生决策者应该重视门诊服务对住院率的替代作用,加大门诊服务的范围和补充,以降低总体人群的住院率、住院次数和住院费用。对于已经住院的高血压人群,门诊服务对住院服务的影响并不存在经济学上显著性。
Objective：To study the impacts of outpatient services on inpatient services and provide policy recommendations formanaging patients with hypertension.Methods：Two-Part model was employed to conduct descriptive statistical analyses and panelfixed effectiveness regression analysis on the reimbursement data of patients with hypertension under New Rural Cooperative MedicalSystem（NCMS） in Beijing from 2008 to 2013.Results：While researching group of hypertensive patients in the first part, it found thatthe hospitalization ratio decreased by 3.90%, 2.80%, 1.40% and 1.50% when the outpatient time, total outpatient expenditure, outpa-tient out-of-pocket and outpatient reimbursement increased by 1.00%. There was substitution effect of outpatient services on inpatientlikelihoods. In the second part of research, among hypertensive inpatients, the outpatient services had low marginal effect on indica-tors of hospitalization services.Conclusion：Health policymakers should recognize the substitution effects of outpatient services on im-patient likelihoods, expand coverage and supplement of outpatient services to reduce inpatient likelihoods, times, and hospitalizationexpenditures. For patients with hypertension who already used inpatient services, the impacts of outpatient services on inpatient servic-es were not economically significant.
出处
《中国卫生经济》
北大核心
2016年第6期27-32,共6页
Chinese Health Economics
基金
国家自然科学基金项目(71373013)
关键词
新型农村合作医疗
高血压
门诊
住院
北京
new rural cooperative medical system
hypertension
outpatient
inpatient
Beijing
