健康体检对慢性病患者住院服务利用的影响分析  

Impacts of health checkups on the utilization of inpatient services for patients with chronic diseases

作　　者：李东旭 张苇乐 李汇波 刘泽霖 苏敏[1] LI Dong-xu;ZHANG Wei-le;LI Hui-bo;LIU Ze-lin;SU Min(School of Public Management,Inner Mongolia University,Hohhot,Inner Mongolia 010070,China)

机构地区：[1]内蒙古大学公共管理学院,内蒙古呼和浩特010070

出　　处：《现代预防医学》2024年第6期1036-1043,1111,共9页Modern Preventive Medicine

基　　金：国家自然科学基金项目(72164031);国家自然科学基金项目(72204128)。

摘　　要：目的探究健康体检对慢性病患者住院服务利用的影响,为促进健康体检利用和缓解住院负担提供参考。方法本研究使用了2011年、2013年、2015年和2018年四期的中国健康与养老追踪调查数据,采用粗糙化精确匹配、双重差分框架和BK法分析健康体检对慢性病患者住院服务利用的影响及其影响机制。结果健康体检使慢性病患者的住院概率提高了34.4%(β=0.344,95%CI:0.132~0.556),住院费用降低了约3145元(β=-3145.470,95%CI:-6074.532~-216.407)。运动在健康体检与住院之间起到中介作用(β=-0.184,95%CI:-0.323~-0.045)。年龄负向调节了健康体检与住院的关系(β=-0.531,95%CI:-0.804~-0.258)。多重慢性病患者和有医疗保险群体受健康体检的影响更大。结论健康体检能够提高慢性病患者的住院概率,并降低住院费用。应促进慢性病患者养成健康的生活方式,关注易受健康风险冲击的群体。Objective To explore the impact of health checkups on the utilization of inpatient services for patients with chronic diseases to promote the utilization of health checkups and alleviate the burden of hospitalization.Methods Utilizing data from four waves of the China Health and Retirement Longitudinal Study conducted in 2011,2013,2015,and 2018,this study employed coarsened exact matching(CEM)and the difference-in-difference(DID)and BK method to analyze the impact of health checkups on the utilization of inpatient services for patients with chronic diseases,along with examining its influencing mechanisms.Results Health checkups were found to increase the probability of hospitalization by 34.4%(β=0.344,95%CI:0.132-0.556)and reduce hospitalization costs by 3145 yuan(β=-3145.470,95%CI:-6074.532--216.407)for patients with chronic diseases.Exercise was identified as mediating the association between health checkups and hospitalization(β=-0.184,95%CI:-0.323--0.045).Age was observed to negatively moderate the relationship between health checkups and hospitalization(β=-0.531,95%CI:-0.804--0.258).Patients with multiple chronic diseases and groups with health insurance were more significantly affected by health checkups.Conclusion Health checkups increase the likelihood of hospitalization and reduce hospitalization costs for individuals with chronic diseases.Promoting healthy lifestyles among those with chronic conditions is essential,with a specific focus on groups susceptible to health risk shocks.

关 键 词：健康体检 慢性病 住院 住院费用 

分 类 号：R197.1[医药卫生—卫生事业管理]