县域医共体改革对患者住院服务利用的影响研究——以安徽省芜湖市为例

Impacts of County Medical Community Reform on Inpatient Hospitalization Service Utilization:Through Taking Wuhu City,Anhui Province as an Example

目的评价芜湖试点县医共体改革对患者住院服务利用的影响。方法采用倍差法分析改革对住院服务利用的影响,数据来源于新农合数据库。结果与非试点县相比,试点县人均住院次数、住院日、自付费用分别下降2%(P<0.01)、5.9%(P<0.01)、29.5%(P<0.01),人均县外住院次数、住院费用、自付费用分别下降0.03天(P<0.01)、309.59元(P<0.05)、252.61元(P<0.01)。结论改革控制了患者外流,患者自付费用降低;未来仍需加强各机构间合作、信息化建设、基层能力建设和控制大医院的变相扩张。

Objective To evaluate the effects of the county medical alliance reform on inpatient hospitalization ser⁃vice utilization in Wuhu City.Methods DID model was used to analyze the policy reform on the hospitalization service utilization.The data was obtained from NCMS.Results The inpatient visits per capita,inpatient days per capita and OOP cost per capita in the pilot county decreased significantly,compared with 2%(P<0.01),5.9%(P<0.01)and 29.5%(P<0.01)in non-pilot counties.The inpatient visits per capita,inpatient cost per capita and OOP cost per capita outside the county in the intervention group decreased by 0.03 days(P<0.01),309.59 yuan(P<0.05)and 252.61 yuan(P<0.01).Conclusion The reform has controlled the flow of patients outside the county,reduced the OOP cost.It is necessary to strengthen cooperation among institutions,information construction and basic level con⁃struction,and control the covert expansion of large hospitals.