Analysis of Policy Effects on the Overall Planning of Medical Insurance Outpatient Services for Employees'Medical Insurance
Objective:The paper analyzes the impact of outpatient overall planning of employees'medical insurance on the health level,medical treatment behavior choice and out-of-pocket medical expenses of insured employees,in order to provide policy suggestions for improving the outpatient overall planning system of employees'medical insurance.Methods:Based on the China Health and Retirement Longitudinal Study and the outpatient reimbursement policy documents of employees'medical insurance in sample cities,OLS regression,probit regression,propensity score matching,instrumental variable method and other methods were used to explore the policy effect of outpatient overall planning system.Results:The outpatient overall planning system could significantly improve the health status of insured employees,reduce the medical burden of insured employees,and improve their overuse of inpatient services.There is significant heterogeneity in the policy effects of the reform among different insured groups,which is affected by the employment and retirement status,income level and health status.On the whole,the outpatient insurance model of"no cap line or high cap line"has the most significant effect on improving the health level,optimizing medical treatment behavior and reducing personal medical burden of insured employees.Conclusion:The outpatient overall planning system has shown significant policy effects.It is recommended that places with favorable conditions gradually improve the level of outpatient coordination and guarantee.It is possible to refer to and explore the implementation of"no cap line or high cap line"outpatient coordination and guarantee methods,in order to maximize the policy effect of employees'medical insurance outpatient overall planning.It is suggested that when adjusting the payment ratio for outpatient overall planning,regions can consider giving appropriate policy preferences to retirees and vulnerable groups with poor physical health conditions and facing greater health risks.At the same time,we should strengthen the long-term tracking and evaluation of the implementation effect of the outpatient coordination system,timely summarize experience and improve shortcomings.
employees'medical insurance outpatient coordinationhealth levelmedical behavior selectionout-of-pocket medical expenses
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