首页|药品集中带量采购政策改善城乡老年人群健康状况和健康不平等研究

药品集中带量采购政策改善城乡老年人群健康状况和健康不平等研究

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目的:明确药品集中带量采购政策与老年人群健康状况和健康不平等之间的关联,探索该关联在城乡之间是否存在差异,进而厘定医疗总费用在其中发挥的作用.方法:基于CFPS 2018与CFPS 2020的两期面板数据,使用双重差分法和PSM-DID探索药品集中带量采购政策试点对我国城乡老年人群健康状况和健康不平等的影响,并运用逐步法和Sobel检验验证医疗总费用的中介作用.结果:药品集中带量采购政策效应首先在城镇老年人群中体现,通过降低医疗总费用促进其身心健康,但暂未对该群体内部的健康不平等展现出明显关联.而在农村老年人群中,政策效应在3个因变量中均无相关性(P>0.1).结论:药品集中带量采购政策底层逻辑值得肯定,但其今后改革重点应向农村老年群体倾斜,并考虑群体内部及城乡之间的效应公平性,从而提升全民健康水平.
Research on Improvement of Health Status and Health Inequalities among Older Adults in Urban and Rural China by Centralized Drug Volume-based Purchasing Policy
Objective:Clarify the correlation between the Centralized Drug Volume-based Purchasing Policy,changes in physical&mental health status,and health inequalities among the older adults,as well as exploring whether this correlation differs between urban and rural areas so as to determine the role played by the total cost of healthcare.Methods:Based on CFPS 2018 and 2020,DID and PSM-DID were used to verify the impact of the Centralized Drug Volume-based Purchasing Policy on physical&mental health status and health inequalities of the elderly in urban and rural China.Three-step method and Sobel test were used to verify the mediating effect of total medical costs.Results:The pilot effect of the Centralized Drug Volume-based Purchasing Policy was first realized among the urban elderly population,promoting their physical and mental health through the intermediary mechanism of reducing the total medical costs,but for the time being did not show a significant correlation with health inequalities within this group.Among the rural elderly population,none of the three dependent variables was significant(P>0.1).Conclusion:The underlying logic of the Centralized Drug Volume-based Purchasing Policy is right,but its future reform should focus on the rural elderly group,and consider the fairness of the effect within the group and between urban and rural areas,so as to improve the health level of the whole society in the longer term.

Centralized Drug Volume-based Purchasing Policygeriatric healthhealth inequalitiesurban-rural disparities

汤少梁、钱雨昕、陈蕾、董慧秋、冯雨莉、贡悦、孙文婷

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南京中医药大学卫生经济管理学院 南京 210023

药品集中带量采购政策 老年健康 健康不平等 城乡差异

国家自然科学基金项目

72074125

2024

中国卫生经济
中国卫生经济学会,卫生部卫生经济研究所

中国卫生经济

CSTPCDCHSSCD北大核心
影响因子:1.524
ISSN:1003-0743
年,卷(期):2024.43(6)