家庭医生签约服务:经济绩效还是健康绩效

Contracted family doctor services: Economic performance or health performance

本研究在对既有研究进行回顾与梳理的基础上,利用CHARLS2018年微观调查数据实证检验了家庭医生签约服务的经济绩效和健康绩效。研究发现,家庭医生签约服务能使居民的健康水平显著提升,但对于医疗总费用支出和个人医疗负担的影响不显著。这一结论通过替换核心解释变量、考虑内生性问题等稳健性检验后依然成立。进一步研究表明,家庭医生签约对于不同年龄、户籍、慢性病人群和残疾人的健康促进存在差异,对于医疗经济负担的影响仍不明显。该结论对于我们重新审视和优化家庭医生签约制度具有借鉴意义。

On the basis of reviewing and sorting up the existing studies,this Study empirically tested the economic performance and health performance of contracted family doctor services by using the micro survey data of CHARLS 2018.This study finds that contracted family doctor services can significantly improve the health level of residents,but it has no significant impact on total medical expenses and personal medical burden.This conclusion is still valid after robustness tests such as replacing core explanatory variables and considering endogenous problems.Further research shows that family doctor contracting has different effects on health promotion of residents with different age and different registered residence,patients with chronic diseases and disabled people,and the impact from family doctor contracting on medical economic burden is still not apparent.This conclusion provides a reference significance for helping us re-examine and optimize the family doctor contracting system.