摘要
分级诊疗是解决我国"看病贵,看病难"问题的重要举措。研究以医疗服务利用模型为基础,运用CFPS (2014)数据,实证检验了分级诊疗制度对家庭医疗经济负担的影响。结果显示:基层首诊可显著降低居民家庭医疗经济负担,对慢性病和有住院经历居民更加明显。医疗费用报销比例对降低居民医疗经济负担至关重要,但基层医疗机构建设效果则不显著。对策建议:培育和充实家庭医生队伍,引导居民基层首诊。提高基层就医报销比例,按人头支付家庭医生服务;提升基层医疗卫生服务机构诊疗水平,吸引居民签约和就医。
Hierarchical medical system is an important measure to solve the problem of ＂ high cost for getting medical treatment, difficult to receive medical treatment＂. Based on the medical service utilization model, this paper makes use of the data of CFPS 2014 to empirically test the effect of the hierarchical medical system on household medical financial burden. The findings show that the household medical financial burden can be significantly reduced by residents choosing the first treatment at the grass roots, and the effect is more obvious on the patients with chronic diseases or having the experience of hospitalization. The proportion of reimbursement for medical expenses is critical to reducing household medical financial burden. But the effect of the construction of grass root medical institutions is not significant. This paper puts forward the following countermeasures： to cultivate family doctors and enrich their services, and guide the residents to treat their diseases firstly at the grass root clinics; to raise the proportion of reimbursements for medical expenses at the community level, and to pay for the services of family doctors in capita; to improve the level of medical treatment of primary health care institutions, so as to attract the residents to sign contracts for medical treatments.
作者
李华
徐英奇
高健
LI Hua;XU Ying-qi;GAO Jian(Shanghai University of Finance and Economics,Shanghai 200433,China)
出处
《江西财经大学学报》
CSSCI
北大核心
2018年第5期49-61,共13页
Journal of Jiangxi University of Finance and Economics
基金
国家社会科学基金项目"城乡居民大病保险精准治理健康贫困的效果研究"(18BGL240)
国家自然科学基金项目"我国公立医院医生薪酬水平与激励机制研究"(71473158)
上海财经大学2017年研究生创新基金项目"分级诊疗制度对降低家庭医疗费用负担效果研究"(2017110346)
关键词
分级诊疗
家庭医疗经济负担
基层首诊
hierarchical medical system
household medical financial burden
first treatment atthe grass roots
