个人医疗保险账户家庭互助制度对儿科患者门诊使用模式和费用的影响:差异分析。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Xinyi Liu, Chunhui Gao, Mingyue Wei, Guohong Li, Xianqun Fan
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引用次数: 0

摘要

本研究探讨了在一家儿童医院(中国上海 A 医院)的儿科患者中实施个人医疗保险账户家庭互助制度(FMAS)对儿科医疗改革的影响。我们于 2021 年 8 月至 2023 年 7 月在 A 医院内分泌科开展了一项队列研究,以评估加入家庭医疗互助制度对患者年门诊量、年门诊支出以及这些费用在基本医疗保险统筹基金和患者自付费用中的分配的影响,并进一步细分为线上和线下就诊。分析采用了倾向得分匹配后的固定效应模型中的加权差分法。研究涵盖了 10975 名儿科患者,分为加入 FMAS 的患者(观察组)和未加入 FMAS 的患者(对照组)。参加 FMAS 的患者每年门诊量平均增加了 1.107 人次,这在统计学上有显著相关性,主要归因于离线咨询的增加。此外,年度门诊费用也大幅增加了 38.9%。详细分析显示,医疗保险统筹基金支付的费用增加了 52.5%,而患者的自付费用平均减少了 69.2%。这些研究结果凸显了加入《联邦医疗保险计划》对医疗服务利用率和医疗保险风险分担机制的有利影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of Family Mutual Aid System for Personal Medical Insurance Accounts on Paediatric Patients' Outpatient Utilisation Patterns and Costs: a difference-in-differences analysis.

This study explores the effect of the transformation of paediatric healthcare through the implementation of the Family Mutual Aid System (FMAS) for personal medical insurance accounts, among paediatric patients at a children's hospital (Hospital A in Shanghai, China). We conducted a cohort study in the endocrinology department of Hospital A from August 2021 to July 2023 to assess the impact of the FMAS enrolment on patients' annual outpatient visits, annual outpatient expenditures, and the allocation of these costs among the Basic Medical Insurance Pooling Fund and patients' out-of-pocket (OOP) expenses, with a further subdivision into online and offline consultations. Analysis employed a weighted Difference-in-Differences approach within a fixed-effects model following Propensity Score Matching. The study encompassed 10,975 paediatric patients, divided into those enrolled in the FMAS (observation group) and those not (control group). Enrolment in FMAS was associated with a statistically significant increase in annual outpatient visits by an average of 1.107, predominantly attributed to an uptick in offline consultations. Additionally, there was a substantial 38.9% rise in annual outpatient costs. Detailed analysis revealed a 52.5% increase in costs covered by the medical insurance pooling fund, while patients' OOP expenses decreased by an average of 69.2%. These findings highlight the beneficial effects of FMAS enrolment on healthcare service utilization and risk-sharing mechanisms of medical insurance.

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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
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