体检改变了人们的就医行为吗?——基于新农合健康体检数据的分析

Does Health Check-up Change People's Health Seeking Behaviors?——Based on the Analysis of New Rural Cooperative Medical System Data

为了有助于疾病的早诊早治,中国部分地区开展了新农合体检工作。健康体检结果给予居民健康信号,促使居民权衡未来健康风险,引起就医行为发生变化。高血压是对健康具有长期影响的基础性疾病,是身体健康的重要信号,本文选取新农合体检中进行血压测量的人群为研究对象,运用事件研究法对中国西部某县新农合报销数据库和体检数据库分析,采用倾向性评分-双重差分的框架研究了体检高血压知晓对医疗费用和医疗服务利用的影响。结果显示,高血压的知晓使得患者体检后的门诊和住院年均医疗费用及年均就诊次数增加,并且具有年龄阶段和受教育程度的异质性。表明体检健康信号对人群的就医行为发生了显著性影响,并且短时期内表现为医疗费用和医疗服务利用的显著性增加。研究结果提示新农合体检促进人们早期干预治疗相关疾病,并为新农合体检政策的完善和实施提供了依据。

In order to facilitate early diagnosis and treatment of disease, rural residents in certain areas of China have joined in the health check-up program aided by New Rural Cooperative Medical System （NCMS）. The check- up result sends health signals to the residents, which alters their health seeking behaviors. Hypertension is a fundamental disease having long-standing effects on physical health, and therefore is an important health signal. To work out the impact of awareness of hypertension on the medical expenditure and medical care utilization ,we analyzed the NCMS claim data and check-up data with the methodology of Difference in Differences （DID）. The results showed that awareness of hypertension made outpatient and inpatient expenditure increase significantly as well as hospital visits. Further analyses found that the amount of the increase varied with different age groups or education levels. The above results suggested that health check-up actually changed health seeking behaviors, and led to a significant increase in medical expenditure and medical service utilization in a short period. The research indicated that NCMS health check-up urged people to interfere with treatment of a disease at an early stage,and provided evidences for improving the check-up program.