摘要
家庭医生制度通过签约的形式促使居民与家庭医生形成良好互动,提供医疗服务,改善居民健康状况。本文运用微观调查数据,探寻签约家庭医生对自评健康水平的影响。研究发现:由于家庭医生制度实施时间短,描述性分析与普通最小二乘法均无法证明家庭医生与居民自评健康水平存在因果关系,后通过倾向得分匹配法和两阶段最小二乘法,验证了签约家庭医生对居民自评健康水平影响的显著性,同时发现良好的信任关系与医患关系也可以改善居民自评健康感受,揭示了有效的制度设计对居民健康的促进效应。并就如何进一步扩大签约率,对"为签而签"等现象进行了讨论,为促进家庭医生制度进一步发展提供建议。
Family doctor system encourages residents to form good interactions with family doctors through contractual formsand provides medical services to improve the health of residents.This paper uses micro-survey data to explore the impact of contracted family doctors on self-evaluation health level.The study has found that,due to the short implementation time of the family doctor system,the descriptive analysis and ordinary least squares method can t prove the causal relationship between family doctor services and residents self-evaluation health level,and thus it verifies the contract by using the propensity score matching method and two-stage least squares method.The results show that family doctor signing services have a significant impact on the health level of residents self-assessment,and the discovery of good trust relationship and doctor-patient relationship can also improve residents self-evaluation health feelings,which reveals the effective system design to promote residents health.Moreover,in this paper,the ways to further expand the signing rate,and the phenomenon of“signing for signing”,“signing inconsistency”and other issues arediscussed,and suggestions are provided to further promote the development of family doctor system in China.
作者
张琪
王德永
ZHANG Qi;WANG De-yong(School of Labor Economics,Capital University of Economics and Business,Beijing 100070,China)
出处
《中国卫生政策研究》
CSCD
北大核心
2019年第1期60-67,共8页
Chinese Journal of Health Policy
基金
国家社科基金一般项目(13BGL138)
首都经济贸易大学研究生2018年科技创新学术型项目"社区医生签约制度的分级诊疗效果研究--基于倾向得分匹配模型"
关键词
家庭医生
自评健康水平
倾向得分匹配
工具变量
Family doctor
Self-evaluation health level
Propensity score matching
Instrumental variable
