新型农村合作医疗按人头支付改革对村医处方行为影响评价  

Analyzing Effects of Capitation Payment Reform on Prescribing Behavior of Village Doctors under New Rural Cooperative Medical System

作　　者：卢颖[1] 孟庆跃[2] 孙强[1] 王颖[1] 王欣[1] 张楠[1] 

机构地区：[1]山东大学卫生管理与政策研究中心卫生部卫生经济与政策研究重点实验室,济南250012 [2]北京大学中国卫生发展研究中心,北京100191

出　　处：《中国卫生经济》2014年第3期45-47,共3页Chinese Health Economics

基　　金：欧盟"亚洲健康和公平疾病风险研究"(HEALTH-F2-2009-223166)

摘　　要：目的:通过设计和实施新型农村合作医疗新的支付体系,评价按人头支付改革对村医处方行为的干预效果。方法:非随机对照实验设计,以平阴县作为空白对照组,对山东省莒南县和梁山县村卫生室进行政策干预,利用DID模型评价干预效果。结果:试验组村医开大处方、联用抗菌药物、处方激素、输液的行为概率降低,单张处方费用下降2.32元。结论:新型农村合作医疗门诊统筹基金按人头支付并和质量考核挂钩显著促进了村医的合理用药行为。Objective： Through designing and implementing the new payment system of New Rural Cooperative Medical System （NCMS）, to evaluate the effect of capitation payment reform on village doctors prescribing behavior under NCMS. Methods： Non- randomized control trial was applied. Pingyin County was used as the blank control group while policy intervenes were processed in clinics from Ju＇nan County and Liangshan County of Shandong. The difference-in difference model was used to evaluate the intervene effect. Results： The probability of village doctors prescribing more than 5 kinds of drugs, jointly using of antibiotics, prescribing hormones and intravenous decreased in the treatment group, as well as 2.32 yuan dropped in average prescription cost. Conclusion： Capitation payments and quality assessment in NCMS medical clinics significantly led to rational drug use behavior of village doctors.

关 键 词：新型农村合作医疗 支付方式改革 处方行为 

分 类 号：R197.1[医药卫生—卫生事业管理]