分级诊疗制度对农村居民就医行为与社会福利的影响研究——基于河南省241份问卷调查的实证分析

Study on Influence of Hierarchical Diagnosis System on Rural Residents' Health Seeking Behavior and Social Welfare——Based on Empirical Analysis of 241 Questionnaires in Henan Province

分级诊疗制度为我国农村居民提供良好就医条件与就医机会。运用消费者行为理论与市场供需理论,分析分级诊疗制度对我国农村居民效用水平与农村地区社会福利水平的影响。并基于河南省中牟县241份问卷调查,运用Ordered Probit模型与倾向匹配得分方法,实证分析分级诊疗对农村居民就医行为与社会福利的影响。结果表明,分级诊疗制度促进农村居民积极就医行为,有效改善其健康状况,促进农村社会福利提升,显著积极影响农村低收入家庭。基于此,为进一步完善分级诊疗制度,促进其作用发挥,提出完善新农合分级诊疗制度设计,以提升农户参合体验、提高大病补偿额度,同时加大乡镇与县级以上医院报销比例差距,引导"患者分流"。

Hierarchical diagnosis and treatment system has been providing good medical conditions and opportunities for rural residents in China.The impacts on improvement of the utility level of rural residents and social welfare in rural areas were analyzed,using the theory of consumer behavior and the theory of market supply and demand.Based on 241 questionnaires in Zhongmu County in Henan Province and"ordered probit"model and tendency matching score method,the impacts of graded diagnosis and treatment on medical behavior and social welfare of rural residents were discussed in this paper.Recent study showed that the hierarchical diagnosis and treatment system had effectively stimulated the medical consumption in rural areas,improved their physical and mental health,promoted the social welfare and made a more significant impact on rural low-income families.Aiming at improving the hierarchical diagnosis and treatment system to play a positive role,designs about the new rural cooperative medical system were presented in order to increase the proportion of farmers'participation in the system and intensely encourage local administrative officers to compensate for serious diseases,besides,"patient diversion"will be perfectly guided by increasing the rational gap on reimbursement between towns and hospitals above the township level.