农村医疗服务供给结构对慢性病治疗的影响  

The Effect of Rural Medical Service Supply Structure on Chronic Disease Treatment

作　　者：陈佩奇 靳卫东 CHEN Peiqi;JIN Weidong(School of Economics,Qingdao University,Qingdao 266071,Shandong)

机构地区：[1]青岛大学经济学院,山东青岛266071

出　　处：《河北农业大学学报（社会科学版）》2023年第6期57-70,共14页Journal of Hebei Agricultural University (SOCIAL SCIENCES)

基　　金：国家社会科学基金项目:“信息技术促进乡村医疗卫生资源有效供给研究”(编号:21BJY101)。

摘　　要：慢性病已成为我国农民健康的主要威胁,而及早发现和规范管理是慢性病治疗的2个阶段,这为农村医疗服务供给提出了结构性要求。为此,基于中国家庭追踪调查数据,采用双向固定效应模型、工具变量法和Hausman-Taylor模型等方法,考察农村医疗服务供给结构对慢性病治疗的影响。结果发现:农村县级医院和基层医疗机构服务供给都能明显改善慢性病治疗状况,其中县级医院服务供给更适合于慢性病诊断,农村基层医疗机构服务供给更加符合慢性病后期管理需要。进一步机制分析表明:在农村医疗服务供给中,慢性病诊断对医疗服务供给质量要求较高,必须依靠县级医院;而确诊慢性病的后期管理注重医疗服务可及性,对此农村基层医疗机构更具优势。Chronic diseases have become the main threat to the health of Chinese farmers,and early detection and standardized management are two stages of chronic disease treatment,which put forward requirements for rural medical service supply structure.Therefore,based on China Family Panel Studies,this paper used two-way fixed effect model,instrumental variable method and Hausman-Taylor model to investigate the influence of rural medical service supply structure on the treatment of chronic diseases.The results show that:The service supply of county hospitals and primary medical institutions in rural areas can significantly improve the treatment of chronic diseases.The service supply of county hospitals is more suitable for diagnosis of chronic diseases,and the service supply of rural primary medical institutions is more in line with the needs of late management of chronic diseases.Further mechanism analysis shows that in rural medical service supply,the diagnosis of chronic diseases has a higher requirement on quality of medical service supply,and must rely on county-level hospitals.The late management of diagnosed chronic diseases pays attention to the accessibility of medical services,which gives rural grass-roots medical institutions more advantages.

关 键 词：农村医疗机构 医疗服务 慢性病 分级诊疗 

分 类 号：C913.6[经济管理] R197.1[社会学]