摘要
目的:研究紧密型县域医共体对城乡居民和城镇职工医保患者住院成本分担的政策效应。方法:采用双重差分法,探究紧密型县域医共体试点县与非试点县在改革前后医保患者住院成本分担的因果处置效应及异质效应。结果:紧密型县域医共体提升了医保患者次均住院费用,住院成本分担的作用机制存在异质效应,对城乡居民医保患者住院成本分担有显著的促进效应,对城镇职工医保患者住院成本分担有显著的阻滞效应。结论:探索建立市域统筹尺度下符合城乡居民和城镇职工医保筹资特征、服务利用、资源配置的差异化医保支付机制。
Objective To study the policy effects of compact county-level medical community reform on the hospitalization cost-sharing for the patients participating in urban and rural resident basic medical insurance and urban employee basic medical insurance.Methods The double difference method was used to investigate the causal disposition and heterogeneous effects of the hospitalization cost-sharing for medical insurance patients between pilot counties and non-pilot counties of compact county-level medical community before and after the reform.Results The compact county-level medical community reform has increased the average hospitalization cost for medical insurance patients.There was a heterogeneity effect in the mechanism of the hospitalization cost-sharing.This was manifested as a significant promoting effect on the hospitalization cost-sharing for the patients with urban and rural resident basic medical insurance,and a significant blocking effect on the hospitalization cost-sharing for the patients with urban employee basic medical insurance.Conclusion It is necessary to explore the establishment of a differentiated medical insurance payment mechanism that conforms to the financing characteristics,service utilization,and resource allocation of urban and rural resident basic medical insurance and urban employee basic medical insurance under municipal coordination.
作者
谭华伟
陈迎春
TAN Huawei;CHEN Yingchun(School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei 430030,China;不详)
基金
国家自然科学基金面上项目“价值导向的县域医共体按人头总额预付中‘结余’形成机制与测量模型研究”(NO.71974066)。
关键词
紧密型县域医共体
城乡居民医保
城镇职工医保
住院成本分担
异质效应
compact county-level medical community
urban and rural resident basic medical insurance
urban employee basic medical insurance
hospitalization cost-sharing
heterogeneous effects
作者简介
通讯作者:陈迎春,E-mail:chenyingchun@hust.edu.cn。
