机构养老模式的医疗费用和健康结果评估研究——基于价值医疗视角  

Assessment of Healthcare Costs and Health Outcomes in Institutional Elderly Care Model:A Perspective of Value-Based Health Care

作　　者：解垩[1] 王溪 XIE E;WANG Xi(School of Economics,Shandong University,Jinan 250199,China)

机构地区：[1]山东大学经济学院,山东济南250199

出　　处：《财经问题研究》2024年第7期102-112,共11页Research On Financial and Economic Issues

基　　金：国家社会科学基金重大项目“共同富裕视角下培育内生动力解决相对贫困的长效机制研究”(23VRC035);国家自然科学基金面上项目“相对贫困的财税治理研究”(72073081);山东大学人文社会科学研究重大项目“防止返贫的政策研究”(23RWZD14)。

摘　　要：随着老龄化程度的加深和家庭养老能力的降低,机构养老的需求量不断攀升。本文基于价值医疗视角,采用中国老年健康影响因素跟踪调查(CLHLS)数据,运用固定效应模型对机构养老模式的医疗费用和健康结果进行评估。研究发现:机构养老模式有利于降低医疗费用;机构养老模式通过减少问诊就医和住院治疗进而降低老年人的医疗费用,通过规范老年人生活方式、提高医疗效率进而提升老年人健康水平,但机构养老模式缺乏对心理健康的关注,不利于提升老年人健康水平。机构养老模式的医疗控费效果在轻度失能和中度失能老年人中更为明显,且机构养老模式明显降低了失智老年人的健康水平。本文的研究对于实现价值医疗目标的同时提升机构养老服务质量具有一定的参考价值。With the demographic shift and deepening aging,the ability to care for the elderly within families is weakening,and the demand for institutional care is rising.As a countermeasure to population aging,the concept of the combination of medical treatment and endowment is changing the medical model of elderly care institutions,and the medical behaviors of the elderly cared for by institutions differ from those of conventional home care in terms of consultation,medical treatment,convalescence,and rehabilitation.The institutional elderly care model has the mission of providing better and more professional services based on the combination of medical treatment and endowment.At the current stage,there is a lack of quality and effectiveness assessment of the medical services of the institutional care model,and it is difficult to accurately and objectively grasp its characteristics.This paper uses the data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)to assess the healthcare costs and health outcomes of institutional elderly care and discusses the advantages and challenges of institutional elderly care mode.This paper finds that while the institutional elderly care model is conducive to lowering healthcare cost expenditures for the elderly,it does not serve to safeguard and enhance health outcomes.The conclusion still holds after mitigating endogeneity problems and other robustness tests.To explore group differences in the impact of the institutional elderly care model on healthcare costs and health outcomes,this paper conducts a heterogeneity analysis for elderly people with varying degrees of somatic impairments,and the results show that the institutional elderly care model significantly reduces the healthcare costs of mildly and moderately disabled elderly people,and is not conducive to the health of the mentally retarded elderly people.The mechanism test shows that the institutional elderly care model can improve the convenience of diagnosis and treatment of common diseases and home care,and thus reduce

关 键 词：机构养老模式 医疗费用 健康结果 价值医疗 

分 类 号：F061.4[经济管理—政治经济学]