广东省医共体改革对县域内住院率的影响研究  

Estimation of the Impact of Medical Community Reform on Intra-County Hospitalization Rate in Guangdong Province Based on Differences-in-Differences

作　　者：郑芸[1] 郭彦虹 朱良英 黄二丹 农圣[1] ZHENG Yun;GUO Yan-hong;ZHU Liang-ying;HUANG Er-dan;NONG Sheng(Youjiang Medical University for Nationalities,Baise,Guangxi,533000,China;不详)

机构地区：[1]右江民族医学院,广西百色533000 [2]国家卫生健康委卫生发展研究中心,北京100029

出　　处：《中国卫生经济》2023年第5期26-28,49,共4页Chinese Health Economics

基　　金：国家自然科学基金项目(72164036)。

摘　　要：目的:评估2017—2018年广东省医共体改革对试点县县域内住院率的政策干预效应,为其他地区的医共体改革提供参考。方法:以2015—2017年广东省医共体试点县和非试点县的数据做平行趋势检验;以2017—2018年的数据做政策实施后的比较分析;以各县县域内住院率为因变量,纳入人口数、人均县域生产总值和虹吸程度等作为控制变量,使用双重差分法实施“实验对照一前后”比较,探索医共体改革对试点县县域内住院率的影响。结果:医共体改革政策于2017年颁布,在2018年时对县域内住院率产生2.47%的净影响,具有统计学意义(P<0.05)。结论:广东省各试点县患者外流住院的形势仍比较严峻,但医共体政策的实施能够缓解试点县患者外流的现象;医共体政策的实施效果并不是立竿见影的,要给政策发挥作用留出足够的时间和空间,并提供协同性的配套支持。Objective:To estimate the policy intervention effect of medical community reform on intra-county hospitalization rates in pilot counties from 2017 to 2018 in Guangdong Province,and to provide references for medical community and hierarchical diagnosis reform in other regions.Methods:Using the in-county hospitalization rate of each county in Guangdong from 2015 to 2018 as the dependent variable and including population size,GDP per capita and siphoning degree as control variables,it explored the effect of medical community reform on the in-county hospitalization rate of the pilot counties based on the difference-in-difference method.Results:The medical community reform policy was enacted in 2017 and had a positive net effect of 2.47%on the inpatient hospitalization rate in the county by 2018,which was statistically significant(P<0.05).Conclusion:The temporal trend of inpatient outflow in Guangdong counties is still severe,but the medical community policy can alleviate the phenomenon of patient outflow to a certain extent;the effect of the medical community policy is not immediate,and it is important to give the policy time and space to work and provide synergistic supporting support.

关 键 词：医疗共同体改革 县域内就诊率 广东 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R197