| 引用本文：何丽月, 潘文利, 林颖, 季海英, 赵锋, 杨莉.收支两条线背景下海南基层医疗卫生机构“限费医疗”政策实施效果研究[J].中国卫生政策研究,2017,10(12):73-78 |
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| 收支两条线背景下海南基层医疗卫生机构“限费医疗”政策实施效果研究 |
| 投稿时间：2017-03-30 修订日期：2017-09-22 PDF全文浏览 HTML全文浏览 |
| 何丽月1, 潘文利2, 林颖2, 季海英2, 赵锋1, 杨莉1 |
1. 北京大学公共卫生学院(北京大学医学部卫生政策与技术评估中心) 北京 100191;
2. 海南省卫生和计划生育委员会 海南海口 570203 |
| 摘要:目的：评价不同政策背景下，新农合参合农民乡镇住院“限费医疗”政策对住院服务利用、住院费用和患者经济负担的影响，为政策在不同背景下的落实提供实证依据。方法：数据主要来源于2010—2014年新农合住院病历资料，评价指标主要选取住院人次、次均住院费用、次均自付费用等。分析方法主要采用描述性分析和倍差法模型，并结合访谈资料对定量研究结果进行补充和解释。结果：海南省万宁市和乐东县、琼海市和文昌市高血压、肺炎的住院人次随时间变化差异无统计学意义；万宁市高血压、肺炎的次均自付费用分别上升了11%和28%，而琼海市无明显变化；琼海市高血压、肺炎次均住院费用分别降低了66%和67%，而万宁市无明显变化。结论：收支两条线使“限费医疗”在促进控费效果上有积极作用。 |
| 关键词:限费医疗 收支两条线 政策效果 |
| 基金项目:国家自然科学基金项目（71273016；71673004） |
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| Study on the outcome differences of the payment policy “fix out of pocket” under the background of separation between revenue and expenditure |
| HE Li-yue1, PAN Wen-li2, LIN Ying2, JI Hai-ying2, ZHAO Feng1, YANG Li1 |
1. School of Public Health, Peking University, Beijing 100191, China;
2. Hainan Provincial Commission of Health and Family Planning, Haikou Hainan 570203, China |
| Abstract:Objective:This study aimed to evaluate the impacts of the separation between revenue and expenditure on the outcome of the payment policy "fix out of pocket". Methods:Using descriptive analysis, difference in difference(DID) model based on data from Wanning county where the new policy has been carried out, Ledong county where has not, including claim data and hospital utilization data from Nov 2010 to Oct 2014. We also supplemented and interpreted the results of quantitative analysis combined with qualitative data from the interview recording material; Results:As for the two most common hospitalized diseases(hypertension and pneumonia), the number of inpatient visits in primary medical institutions didn't change respectively. From DID model, the policy only increased out of pocket(OOP) in Wanning by 11% and 28% and decreased average medical expense in Qionghai by 66% and 67% respectively. Conclusion:The separation between revenue and expenditure make the "fix out of pocket" payment policy have better performance on the control of medical expense. |
| Key words:Fix out of pocket Separation between revenue and expenditure Policy effect |
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