某省县域医共体建设试点目标完成情况评价——基于双重差分方法的实证研究

Evaluation on the Completion of the Goals for the Pilot Construction of the County-level Medical Community in a Certain Province——Empirical Research based on DID

目的:对某省县域医共体建设试点目标完成情况进行评价。方法:基于双重差分方法,对某省54家县域医共体建设情况进行评价,重点关注县域医疗卫生服务能力提升、医保基金有效利用、居民医药费用负担合理控制、有序就医格局四个建设目标。结果:与非试点医共体相比,试点医共体牵头医院出院患者三四级手术比例提升23.3%、向基层下转住院患者人次增加75.8%,试点医共体医疗卫生机构医保基金支出提升8.0%、县域门诊次均费用增长15.4%。结论:试点医共体建设对牵头医院服务能力提升及有序就医格局形成有很好的推动作用,但同时容易导致医保基金支出增加、医疗费用增长。这一结果为推进县域医共体高效建设提供了一定的政策启示。

Objective To evaluate the completion of the goals for the pilot construction of a county-level medical community in a certain province.Methods The DID model was used to evaluate the construction of 54 county-level medical communities in a certain province,and focused on four construction goals.Results Compared with non-pilot medical communities,the proportion of discharged patients undergoing level III and IV surgeries in hospitals led by pilot medical communities has increased by 23.3%,the number of patients transferred to the grass-roots institutions has increased by 75.8%,the expenditure of medical insurance funds in pilot medical community healthcare institutions has increased by 8.0%,and the average cost of outpatient at the county level has increased by 15.4%.Conclusion The pilot construction of medical communities has a good promoting effect on improving the service capacity of leading hospitals and forming an orderly medical treatment pattern.But at the same time,it can easily lead to an increase in medical insurance fund expenditure and medical expenses.