Institute for Global Health and Development, Peking University, Beijing 100871, China.
Public Administration School, Guangzhou University, Guangzhou 510006, China.
Health Policy Plan. 2021 Nov 11;36(10):1633-1643. doi: 10.1093/heapol/czab018.
This study examines the impacts of high-speed railway (HSR) transportation on the healthcare-seeking behaviour of patients along newly integrated areas of Sichuan province, China. The opening of the Cheng-Mian-Le intercity HSR is considered as quasi-experimental evidence from China, and we make a propensity score matching the difference in differences research design, using data from the monthly report database of the Sichuan Province health statistical data collection and Decision Support System from 2014 to 2015. We find that, first, the opening of the HSR resulted in significant healthcare-seeking behaviour with great heterogeneity. Second, patients are more likely to go to areas with high-density healthcare resources, in which case HSR may mitigate the diagnostic inaccuracies that patients face locally. Third, the 'distance enhancement effect' was present, and its marginal effect is more significant for long-distance patients. Fourth, the tiered-network healthcare policy has no significant restrictive impact on patients seeking high-level medical services. Our results show that HSR establishment has a substantial impact on the behaviour of people seeking medical treatment and medicine. Furthermore, we discuss the results' policy implications for the allocation and integration of China's healthcare market, and the accessibility of medical and health services.
本研究考察了高速铁路(HSR)运输对中国四川省新整合地区患者就医行为的影响。成绵乐城际 HSR 的开通被视为来自中国的准实验证据,我们采用 2014 年至 2015 年四川省卫生统计数据收集和决策支持系统的月度报告数据库,采用倾向评分匹配差分法设计进行研究。我们发现,首先,HSR 的开通导致了就医行为的显著变化,具有很大的异质性。其次,患者更有可能前往医疗资源密度高的地区,在这种情况下,HSR 可能减轻患者在当地面临的诊断不准确问题。第三,存在“距离增强效应”,其边际效应对于远距离患者更为显著。第四,分层网络医疗政策对患者寻求高级医疗服务没有明显的限制作用。我们的研究结果表明,HSR 的建立对人们就医和用药行为有重大影响。此外,我们讨论了这些结果对中国医疗市场的分配和整合以及医疗保健服务的可及性的政策含义。