医疗消费者视角下双向转诊制运行效果的实证分析

李桑桑; 时松和; 陈华楠; 刘德臣; 王鸟

引用本文：李桑桑, 时松和, 陈华楠, 刘德臣, 王鸟.医疗消费者视角下双向转诊制运行效果的实证分析[J].中国卫生政策研究,2017,10(7):22-27

医疗消费者视角下双向转诊制运行效果的实证分析

投稿时间：2017-05-05 修订日期：2017-06-20 PDF全文浏览 HTML全文浏览

李桑桑, 时松和, 陈华楠, 刘德臣, 王鸟

郑州大学公共卫生学院河南郑州 450001

摘要:目的：基于医疗消费者视角探讨双向转诊制的运行效果。方法：利用倾向得分匹配建立2013年和2015年的平衡面板数据，并使用双重差分法评估双向转诊制对实际补偿比、年次均住院自付费用、高费用支出的可能性、年次均住院天数和年住院次数的影响。结果：双向转诊制使住院患者的实际补偿比增加11.3%（P<0.001），年住院次数增加0.710次（P<0.001）。但政策并未显著降低高费用医疗支出的可能性和减少年次均住院天数、年次均住院自付费用。结论：双向转诊制在减轻患者住院成本和优化资源利用方面有一定程度的积极影响。

关键词:双向转诊住院双重差分实证分析

基金项目:河南省医学科技攻关计划（201503015）

An empirical study on the effects of two-way referral system: A perspective of medical service consumers

LI Sang-sang, SHI Song-he, CHEN Hua-nan, LIU De-chen, WANG Niao

School of Public Health, Zhengzhou University, Zhengzhou Henan 450001, China

Abstract:Objective: To explore the effects of the bi-directional referral system from the perspective of the medical service consumer. Methods: A balanced panel data which was adjusted by Propensity Score Matching was employed to evaluate the effects of two-way referral system using difference-in-difference (DID) for the 2013 and 2015 data. The evaluation indicators including actual cost sharing ration, out-of-pocket cost per unit, the possibility of high cost, annual inpatient visits and length of hospital stay per unit were used. Results: Compared with the control group, the two-way referral system resulted in an 11.3% (P<0.001) increase in actual cost sharing ratio and an increase of 0.710 (P<0.001) annual inpatient visits in the intervention group. However, the policy did not significantly reduce the possibility of high-cost medical expenses and reduce the length of hospitalization and the annual cost hospitalization. Conclusion: Based on the key findings of the analysis of this study, the two-way referral system has beneficial effects on reducing inpatient financial burden and optimizing resource allocation.

Key words:Two-way referral Inpatients Difference-in-differences Empirical analysis

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