城镇职工医保个人账户制度对门诊服务的影响分析

Impact of Medical Insurance for Urban Workers Personal Accounts System on Outpatient Service Utilization

目的评估城镇职工医疗保险个人帐户制度对居民门诊医疗服务利用的影响。方法采用中国健康和营养调查专项数据,以政策实施年度1998年为界,采集1997年和2006年的公费医疗和城镇职工医保个体门诊卫生服务利用数据,应用倍差法评价实行城镇职工医疗保险个人账户制度对于门诊服务利用的影响,在消除处理组和对照组不可比问题时使用了倾向评分匹配法。结果控制其他因素不变的前提下,2006年较1997年门诊服务利用率提高,城镇职工医保群体较公费医疗群体门诊服务利用率低。结论实施城镇职工医疗保险个人账户制度确实降低了门诊服务利用。

Ojbective To evaluate the influence of the personal account system of medical insurance for urban workers on the utilization of outpatient medical services.Methods The Chinese health and nutrition survey data provided by the North Carolina Population Center was used to collect data on the use of public health care and medical insurance individual outpatient service in 1997 and 2006,the policy implementation of the year 1998 used as the division time.Difference-in-Difference matching approach was used to evaluate the effect of personal account system of medical insurance for urban workers on the utilization of outpatient medical services and the propensity score matching method was use to eliminate the problem in non-comparability between the treatment and control groups.Results All other factors were well controlled,in 2006 the utilization of outpatient services was higher than that in 1997.The utilization rate of outpatient service of medical insurance group of urban workers was lower than that of public health care group.Conclusion The implementation of the personal account system of medical insurance for urban workers is effective in reducing the use of out-patient services.