基于平衡面板数据模型分析新农合政策对农村居民门诊服务利用的影响

Analyzing the Impact of the NRCMS Polices on the Utilization of Outpatient Services in Rural Resident Based on the Balanced Panel Data

目的分析新农合政策历史演变对农村居民门诊服务利用的影响。方法基于济南市三县区两年相同个体平衡面板数据资料,构建面板数据模型,采用随机效应二元选择面板数据模型、随机效应泊松(Poisson)回归模型以及倍差法模型等进行研究。结果与2008年相比,2011年的四周就诊率增加了4. 1个百分点;年龄、健康自评、是否得慢病、到最近医疗机构的距离等对居民门诊服务利用有显著影响;新农合门诊补偿政策对中收入组和高收入组居民门诊服务利用有显著影响,新农合补偿受益主要向中、高收入人群转移。结论应该适当提高低收入人群新农合门诊补偿水平。

Objective To analyze the influence of NRCMS polices evolution on residents＇＇＇＇＇＇＇＇ utilization of outpatient services. Methods Based on the same individual balance panel data in two years of three counties in Ji＇＇＇＇＇＇＇＇nan city, we build panel data model and conduct random effects of binary choice panel data model, random effects Poisson regression model, difference in differences （DID） model to analyze the influence. Results Our study shows that the four-week consultation rate in 2011 increased by 4.1% compared to 2008. Age, self-rated health status, suffering from chronic diseases or not, the distance to the nearest medical institution have an influence on outpatient service utilization. The new rural cooperative medical outpatient reimbursement policy has an effect on the four-week consultation rate of middle-income residents and high-income residents. The NCMS policy tends to benefit middle- and high-income groups. Conclusion we should increase NCMS outpatient compensation level appropriately.