成都市单病种定额付费实施效果分析:基于双重差分模型  

Empirical analysis on the effects of single-disease quota payment in Chengdu based on difference-in-difference model

作　　者：曹乔 谭婧[2] 王雯[2] 刘艳梅[2] 张桂婷 赵绍阳[3] CAO Qiao;TAN Jing;WANG Wen;LIU Yanmei;ZHANG Guiting;ZHAO Shaoyangs(School of Humanities,Southwest Jiaotong University,Chengdu,611756,P.R.China;Chinese Evidence-based Medicine Center,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;School of Economics,Sichuan University,Chengdu,610031,P.R.China)

机构地区：[1]西南交通大学人文学院,成都611756 [2]四川大学华西医院中国循证医学中心,成都610041 [3]四川大学经济学院,成都610031

出　　处：《中国循证医学杂志》2018年第8期807-811,共5页Chinese Journal of Evidence-based Medicine

基　　金：国家自然科学基金项目(编号:71303167;71773080和71704122)

摘　　要：目的分析成都市医保单病种定额付费的实施效果。方法采用成都市2009~2013年的医保患者数据,通过建立双重差分模型比较实行单病种定额付费与未实行单病种定额付费患者的次均住院费用、住院日、再入院率等指标的变化情况。结果定额付费政策有效控制了总体医疗费用并对药费、检查费的影响显著(P<0.01),但再入院率也有明显上升(P<0.10)。结论四川省成都市单病种定额付费的实施有效控制了费用增长,但需要积极防范其副作用。Objective To investigate the effects of single-disease quota payment in Chengdu. Methods The data of medical insurance in Chengdu from 2009 to 2013 were used to compare changes of average hospitalization expenses, hospitalization days, re-admission rate and so on by establishing a difference-in-difference （DID） model. Results The quota payment policy effectively controlled the overall medical expenses. Drug fee and examination fee were significantly affected （P〈0.01）. However, the re-admission rate was significantly improved （P〈0.10）. Conclusion The implementation of single-disease quota payment in Chengdu controlled the medical expanses growth effectively, but it is necessary to prevent its side effects.

关 键 词：单病种定额付费 医疗费用 双重差分 成都市 

分 类 号：R197.1[医药卫生—卫生事业管理]