医疗服务价格改革下劳务价值提升对医疗费用的控费效应——基于全国省际面板数据的实证研究  

Empirical Analysis of the Effect of The Improvement of Labor Value of Medicine Staff on Controlling the Growth of Health Expenditure after Medical Service Price Reform Based on Inter-Provincial Panel Data

作　　者：李乐乐 邓天健 Li Lele(School of Labor and Human Resources,Renmin University of China,Beijing,P.R.China)

机构地区：[1]中国人民大学劳动人事学院,北京100872

出　　处：《中国卫生事业管理》2024年第12期1381-1386,共6页Chinese Health Service Management

基　　金：国家自然科学基金项目“标尺竞争机制、DRG/DIP支付方式与医疗服务定价”(72204251);河南省中原医学科技创新发展基金会重点项目“DRG/DIP支付方式对医疗服务定价的影响机制”(24YCG2002)。

摘　　要：目的:实证检验劳务价值对医疗费用的影响,并尝试解释其影响机制。方法:基于2012~2021年全国31个省级行政区的面板数据,采用双向固定效应模型,检验劳务价值对医疗费用的影响,并通过逐步回归验证医务人员薪酬水平的中介效应。结果:门诊劳务价值占比每提高1%,医疗费用降低0.36%,住院劳务价值占比每提高1%,医疗费用降低0.27%。医务人员薪酬水平的中介效应不显著,药检费的中介效应显著。结论:劳务价值的提升有助于控制医疗费用的增长,但其作用机制是通过药品费和检查费,而非通过医务人员薪酬,说明劳务价值提高没有反映在医务人员薪酬中,人力价值回归路径尚有待夯实。应继续完善医疗服务定价调价机制,凸显劳务价值,并探索更为合理的薪酬和绩效机制,将改革红利传导到医务人员群体。Objective To empirically test the effect of labor value on health expenditure,and explain the mechanism of its in-fluence.Methods Based on the panel data of 31 provincial-level administrative regions from 2012 to 2021,the impact of labor value on health expenditure was explored by two-way fixed effect model,and the mediating effect of the salary level of medical staff was verified by step-by-step regression.Results When the proportion of the outpatient labor value increased by 1%,the health expenditure decreased by 0.36%.And when the proportion of inpatient labor value increased by 1%,the health expendi-ture decreased by 0.27%.The mediating effect of medical staff salary was not significant,but the mediating effect of drug and ex-amination fee was significant.Conclusion The increase of labor value is helpful to contain the growth of health expenditure,but its action mechanism is through the cost of drugs and examination fees,rather than through the salary of medical staff,indicating that the increase of labor value is not reflected in the salary of medical staff.It is necessary to continue improving the pricing mecha-nism of medical services,highlight the value of labor services,and explore more reasonable compensation and performance mecha-nisms,transmitting the reform dividend to the medical staff group.

关 键 词：医疗服务价格改革 劳务价值 医务人员薪酬 医疗费用 双向固定效应模型 

分 类 号：R197.1[医药卫生—卫生事业管理]