基本医疗保险制度下农村患者住院就医流向研究

Research on Rural Inpatients Flow under the Basic Medical Insurance

目的:分析基本医疗保险制度对农村住院患者就医流向的影响,找出影响居民选择住院医院的主要因素,为引导参保患者有序就医、完善分级诊疗制度提供政策性依据。方法:应用嵌套Logit模型对农村住院患者就医流向影响进行研究。结果:新农合实际住院补偿比对农村居民的住院选择产生显著的正向影响,说明人们更倾向于报销比较高的医疗机构。农村居民选择住院机构还受年龄、收入等多种因素的影响。结论:不同级别医疗机构差异化的住院补偿比能够发挥引导住院患者流向的作用。

Objective: To analyze the influence of the basic medical insurance system on the flow of hospitalized patients in rural areas, find out the main factors influencing the residents choose hospital, so as to provide the policy support for guiding the orderly medical process and improving the system of grading diagnosis and treatment. Methods: Nested Logit model was applied to study the influence on the choice of medical institutions for rural inpatients. Results: The actual compensation rate of the NCMS had a significant positive effect on the treatment choice for rural residents. It indicated that people were more inclined to the medical institutions with higher reimbursement. The choice of medical institutions for rural inpatients was also affected by age, income, etc. Conclusion: The differentiated inpatient compensation ratio could play a positive role in guiding orderly medical process.