综合医改是否缓解了“看病贵”——以中老年群体医疗费用影响因素分析为例  

Has Comprehensive Medical Reform Eased the Affordability of Health Care——Taking the Analysis of Influencing Factors of Medical Expenses in Middle-aged and Aged Groups as an Example

作　　者：杨华磊 廖佩凡 

机构地区：[1]中南财经政法大学公共管理学院,武汉430073

出　　处：《中国医疗保险》2023年第3期84-92,共9页China Health Insurance

摘　　要：目的:探究综合医改是否切实缓解了中老年人“看病贵”问题。方法:以省级综合医改作为准自然实验,采用渐进双重差分的方法探究综合医改对门诊医疗费用的影响。结果:其一,综合医改能够显著降低门诊总费用、自费费用和报销费用,但是对住院费用没有显著的影响;其二,异质性分析发现,综合医改能够显著降低男性、老年人、农村居民、慢性病患者的门诊总费用及报销费用,体现了综合医改对高患病风险人群的有效保护,减轻了其经济负担。结论:持续推进综合医改,尤其是加快构建分级诊疗体系能够在有效缓解“看病贵”难题的同时,促进医疗资源的合理利用。本文的边际贡献在于,在现有文献基础上梳理了各地综合医改实施方案,为后续进一步探讨综合医改作用机制提供思路。Objective:The paper investigates whether comprehensive medical reform can effectively alleviate the problem of"expensive medical care"for the middle-aged and the elderly.Method:With provincial comprehensive medical reform as a quasi-natural experiment,we used the progressive DID method to investigate the impact of comprehensive medical reform on outpatient medical expenses.Results:First,comprehensive medical reform can significantly reduce total outpatient medical expenses,out-of-pocket expenses and reimbursement.Second,in the heterogeneity analysis,we found that the comprehensive medical reform can significantly reduce the total outpatient medical expenses and reimbursement expenses of men,elderly people,rural residents,and patients with chronic diseases,which reflects the effective protection of the comprehensive medical reform policy for people with high risk of diseases and reduces their financial burden caused by medical treatment.Conclusion:Continuing to promote comprehensive medical reform,especially accelerating the construction of a hierarchical diagnosis and treatment system,can effectively alleviate the problem of"expensive medical care"while promoting the rational use of medical resources.The marginal contribution of this paper is to summarize the implementation plans of comprehensive medical reform in different regions based on the existing literature and provide ideas for further exploring the mechanism of comprehensive medical reform.

关 键 词：综合医改 渐进DID 门诊医疗费用 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]