药品集中带量采购政策对我国慢性病患者生活满意度的影响

Influence of Centralized Drug Volume-based Purchasing Policy on Life Satisfaction of Chronic Disease Patients in China

目的:分析药品集中带量采购政策对我国慢性病患者生活满意度的影响,为药品集中带量采购政策的进一步推进提供参考依据。方法:利用2018年和2020年中国健康与养老追踪调查数据,运用双重差分倾向得分匹配模型和Bootstrap中介检验,分析药品集中带量采购政策是否显著影响慢性病患者的生活满意度以及该政策对生活满意度的作用路径。结果:药品集中带量采购政策对慢性病患者生活满意度有显著的提高作用(β=-0.124,P<0.05),该政策降低了慢性病患者医疗支出(β=-689.762,P<0.01),并提高了其自评健康水平(β=-0.309,P<0.01),医疗支出和自评健康水平在药品集中带量采购政策影响慢性病患者生活满意度的过程中起到链式中介作用。结论:药品集中带量采购政策提高了慢性病患者生活满意度,可以通过降低慢性病患者医疗支出来提高患者自评健康水平并反映在生活满意度上这一路径来施加影响。提高慢性病患者生活满意度可从药品负担和健康信心角度介入,同时应重视药品集中带量采购的政策反馈和优化。

Objective:To analyze the potential influence mechanism of centralized drug volume-based purchasing policy on chronic disease patients'life satisfaction in China,and to provide reference basis for the further promotion of centralized drug volume-based purchasing policy.Methods:Using the data of China health and retirement longitudinal study in 2018 and 2020,the differential propensity score matching model and Bootstrap mediation test were used to analyze whether centralized drug volume-based purchasing policy significantly improved the life satisfaction of patients with chronic diseases and the effect path of centralized drug volume-based purchasing policy.Results:Centralized drug volume-based purchasing policy significantly improved the life satisfaction of patients with chronic diseases(β=-0.124,P<0.05),reduced the medical expenditure of patients with chronic diseases(β=-689.762,P<0.01),and improved their self-rated health level(β=-0.309,P<0.01).Medical expenditure and self-rated health level played a chain mediating role in the process of the influence of centralized drug volume-based purchasing policy on the life satisfaction of patients with chronic diseases.Conclusion:Centralized drug volume-based purchasing policy can improve the life satisfaction of patients with chronic diseases,and can exert influence on the path of improving the self-rated health level of patients with chronic diseases and reflecting the life satisfaction by reducing the medical expenditure of patients with chronic diseases.To improve the life satisfaction of patients with chronic diseases,we should intervene from the perspective of drug burden and health confidence,and pay attention to the policy feedback and optimization of collection.