门诊统筹制度与大病风险防范的关系分析

目的：验证门诊统筹制度与大病风险的关系。方法：从第四次卫生服务调查公布的公开数据资料库中获取2008年全国94个县区门诊报销情况、住院需要及服务利用情况和社会经济状况的指标数据。以住院需要、住院医疗费用、住院间接费用和住院时间分别作为因变量,获得报销的门诊患者比例作为自变量,控制其他社会经济人口学变量,进行回归分析。结果：获得报销的门诊患者比例每提高1个百分点,将导致住院需要下降0.03个百分点,间接费用占家庭年消费支出比例下降0.02个百分点,例均住院时间减少0.04天;但例均医疗费用占家庭年消费支出的比例没有显著的变化。结论：有一定证据支持门诊统筹的开展有助于降低大病风险的出现,但有必要进一步开展严格意义上的影响评价分析,获取更可靠的证据。

Analysis on the relationship between pooling outpatients and preventing catastrophic risks

Objective: To test the linkage between pooling outpatients and the catastrophic risk prevention. Method: Data were drawn from the open access database of National Health Household Survey (NHSS) in 2008. The information about outpatient reimbursement, needs and utilizaiton of inpatient services and social-economic status in 94 sample regions were collected. Using inpatient need, medical expenditure, indirect expenditure and length of stay (LOS) as dependent variables, respectively, and the proportion of outpatients reimbursed as independent variable, regression analysis were carried out. Results: When proportion of outpatients reimbursed increased one percent, inpatient need decreased 0.03 percent, average indirect inpatient expenditure reduced 0.02 percent and average LOS shortened 0.04 days; while medical expenditure had not any statistically significant changes. Conclusion: Some evidences had been received to support that pooling outpatient benefits the prevention of catastrophic risks. However, further robust impact evaluations need to do for providing more reliable evidences.