| 引用本文：王婵, 李鑫武, 吴如意, 骆娴.分级诊疗对“倒三角”就医秩序的纠正效应评估——基于渐进性试点的准自然实验[J].中国卫生政策研究,2021,14(3):13-20 |
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| 分级诊疗对“倒三角”就医秩序的纠正效应评估——基于渐进性试点的准自然实验 |
| 投稿时间：2020-11-30 修订日期：2021-03-22 PDF全文浏览 HTML全文浏览 |
| 王婵1, 李鑫武2, 吴如意2, 骆娴2 |
1. 广东财经大学 广东经济与社会发展研究院 广东广州 510320;
2. 广东财经大学金融学院 广东广州 510320 |
| 摘要:目的：评估开展分级诊疗政策试点对“倒三角”就医秩序的纠正效果。方法：基于准自然实验方法，构建渐进性双重差分模型，评估我国2004—2018年分级诊疗政策试点对“倒三角”就医秩序的纠正效果。结果与结论：总体上，分级诊疗政策对“倒三角”就医秩序的纠正存在短暂的效果，随着时间推移，政策效果消失。进一步探讨区域异质性时发现，当社区医疗服务能力较高时，公立医院就诊率显著降低了3.1%。研究为分级诊疗制度实施效果提供了一种直观的评价依据，也为当前分级诊疗制度陷入困境提供了一种解释，有助于把握进一步完善分级诊疗制度的着力点。 |
| 关键词:分级诊疗 渐进性双重差分 就医秩序 政策评估 |
| 基金项目:国家自然科学基金（72003045，72074055，72003044）；国家社科后期资助基金（20FGLB072）；广东省教育厅项目（2020KZDZX1095）；广东省哲学社科规划项目（GD2018CYJ01）;广东省高校珠江学者岗位计划项目（GDUPS2019）；广州市社会科学规划项目（2020GZQN39） |
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| Evaluation of the corrective effect of hierarchical on “Inverted Triangle”order of medical visits: A Quasi-natural experimental research on progressive pilots |
| WANG Chan1, LI Xin-wu2, WU Ru-yi2, LUO Xian2 |
1. Guangdong Institute of Economic and Social Development, Guangdong University of Finance & Economics, Guangzhou Guangdong 510320, China;
2. School of Finance, Guangdong University of Finance & Economics, Guangzhou Guangdong 510320, China |
| Abstract:Objective: To evaluate the effect of carrying out a pilot hierarchical medical policy on the "inverted triangle" order of medical visits. Methods: Based on the quasi-natural experimental research method, this paper established a progressive difference-in-difference model to evaluate the corrective effect of hierarchical medical policy on the "Inverted Triangle" medical order during the period from 2004 to 2018. Results and conclusions: The results of this research showed that hierarchical medical policy has a short-term effect on the correction of the "Inverted Triangle" in the process of medical treatment, which means thatthe effect of the policy disappears over time and is not greatly significant. When the study further explored the regional heterogeneity, it found that the public hospital visit rate was significantly reduced by 3.1% when the community healthcareservice capacity was high. The above results provide an intuitive evaluation basis for the implementation of hierarchical medical policy, and an explanation ofthe current difficulties in the system, as well as tohelp grasp the focus for its improvement in the future. |
| Key words:Hierarchical medical system Progressive DID Order of medical visits Policy evaluation |
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