摘要
目的 评估健康扶贫政策对贫困家庭疾病经济负担的影响,为完善健康扶贫政策提供参考。方法 采用倾向性匹配双重差分法对四川省48个县进行分析。先利用四川省贫困人口就医信息系统数据和新农合数据进行倾向性匹配,找出与贫困人口最接近的非贫困人口,再进行双重差分明确政策效果。结果 健康扶贫政策使得贫困家庭年度医疗自付费用平均下降13.1%,门诊医疗自付费用平均下降2.4%,住院医疗自付费用平均下降19.5%,发生灾难性医疗卫生支出的概率平均下降3.9%。政策效果在贫困县相较于非贫困县更显著。尽管政策效果明显,但在政策实施后贫困组中仍然有12.1%家庭发生灾难性医疗卫生支出。结论 健康扶贫政策可以降低贫困家庭疾病经济负担,且对贫困县贫困家庭经济负担的减轻效果更好,但仍有部分家庭发生灾难性医疗卫生支出。在巩固和拓展健康扶贫成果进行医疗费用支出防贫监测中,应重点关注这些灾难性医疗卫生支出家庭,防止其返贫。
Objective To evaluate the effect of Health Poverty Alleviation Project on the economic burden of disease among poor families and to provide references for further improvement of the Health Poverty Alleviation Project.Methods The difference-in-differences with propensity score matching method was used to analyze 48 counties in Sichuan Province. Propensity score matching was first carried out with data from the Sichuan Provincial Information System for Medical Care for Low-Income Population and the New Rural Cooperative Medical Insurance data to identify the non-poor population closest to the poor population. Then, difference-in-difference method was used to determine the effect of the Health Poverty Alleviation Project. Results Health Poverty Alleviation Project reduced the total annual outof-pocket(OOP) payments by 13.1% on average, the outpatient OOP payments by an average 2.4%, inpatient OOP payments by an average 19.5%, and the probability of incurring catastrophic health care expenditures by an average of3.9% for low-income households. In addition, the program had a more significant effect in poverty-stricken counties than it did in non-poverty-stricken counties. Despite the significant effectiveness of the project, 12.1% of the low-income families still incurred catastrophic health expenditures after the program was implemented. Conclusion Health Poverty Alleviation Project reduces the economic burden of disease for poor households, and it has a better effect on reducing the economic burden of poor households in poverty-stricken counties. However, a certain number of households still incurred catastrophic health expenditures. When consolidating and expanding the effects of Health Poverty Alleviation Project and monitoring medical expenses for poverty prevention, policymakers should focus on the households with catastrophic medical expenditures to prevent them from sinking back into poverty.
作者
陈楚
陈婷
潘杰
CHEN Chu;CHEN Ting;PAN Jie(School of Health Management,Fujian Medical University,Fuzhou 350000,China;Healthcare Evaluation and Organizational Analysis Group,West China School of Public Health and West China Fourth Hospital,Chengdu 610041,China;Institute for Healthy Cities and West China Research Center for Rural Health Development,Sichuan University,Chengdu 610041,China)
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2023年第2期393-399,共7页
Journal of Sichuan University(Medical Sciences)
基金
中国博士后科学基金(No.2020M683298)
泰康溢彩公共卫生及流行病防治专项基金资助。
关键词
健康扶贫
疾病经济负担
倾向性匹配双重差分法
Health Poverty Alleviation Project
Economic burden of disease
The difference-in-differences with propensity score matching method
