不同医疗保险制度的医疗服务利用差异性分析

Analysis of The Differences in Medical Service Utilization in Different Medical Insurance System

目的:探索不同医疗保险制度参保者的医疗服务利用差异性,为医疗资源的合理利用提出相关政策建议。方法:研究对2012-2016年中国家庭追踪调查(China Family Panel Studies,CFPS)所有调查对象(共计102907人)的基本情况进行描述,进而聚焦不同医疗保险居民的医疗服务利用情况(2周内患病就诊情况、患者医疗机构选择情况和患者去年住院情况三个维度)。结果:新农合参保者2周内患病就诊率显著高于其它类型参保者,且患者在医疗机构的选择上倾向于综合医院而非社区首诊。结论:利用医保杠杆引导患者基层首诊,充分合理利用有限医疗资源。

Objective To explore the differences in medical service utilization of insured persons in different medical insurance system,and put forward relevant policy recommendations for the rational use of medical resources. Methods The basic information of all the102,907 cases respondents of China Family Panel Studies( CFPS) from 2012 to 2016 was analyzed. The utilization of medical services of residents in different medical insurances was further studied from three dimensions of medical treatment within two weeks,patients’ choice of medical institutions,and the patients’ hospitalization last year. Results The outpatient rate in 2 weeks of insured of the new rural cooperative medical system was significantly higher than that of insured of other insurance system. For the first medical visiting,The patients preferred to general hospitals,not to the community health centers. Conclusion It is suggested to take medical insurance to guide patients’ seeking medical treatment in primary health institutions and make full and reasonable use of limited medical resources.