School of Public Administration, Central China Normal University, Wuhan, Hubei, 430079, China.
Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100020, China.
Int Health. 2021 Dec 1;13(6):640-647. doi: 10.1093/inthealth/ihab041.
In 2009, China began to implement new health system reform aimed at reducing the financial burden of patients. This study aimed to compare changes in the utilization of medical services and expenditures in different groups from 2004 to 2015.
Pooled cross-sectional data from 2004 to 2015 from the China Health and Nutrition Survey Database were used to conduct a segmental linear regression to estimate changes in the medical expenditures of different groups before and after implementation of the reform.
During the reform process, the utilization rate of outpatient healthcare, primary health services and hospital health services showed a trend of increasing first and then decreasing slightly. The frequency of residents using inpatient services increased after the reform. The average medical expenditures increased significantly, especially for uninsured and primary health services users.
China's new round of health reform increased the coverage rate of basic medical insurance. Medical insurance has controlled the growth of the average medical expenditures; nevertheless, the average medical expenditures per patient has shown a continuous upward trend. Consequently, both basic medical insurance funds and residents face greater economic burdens and financial risks. Effective methods of controlling the growth of medical expenditures are therefore required.
2009 年，中国开始实施新的医疗卫生体制改革，旨在减轻患者的经济负担。本研究旨在比较 2004 年至 2015 年不同人群医疗服务利用和支出的变化。
本研究使用 2004 年至 2015 年中国健康与营养调查数据库的汇总横断面数据，采用分段线性回归估计改革前后不同人群医疗支出的变化。
在改革过程中，门诊医疗服务、基层卫生服务和医院卫生服务的利用率呈现先增加后略有减少的趋势。改革后，居民住院服务的利用频次增加。平均医疗支出显著增加，尤其是未参保和基层卫生服务使用者。
中国新一轮医改提高了基本医疗保险的覆盖率。医疗保险控制了平均医疗支出的增长；然而，每位患者的平均医疗支出呈持续上升趋势。因此，基本医疗保险基金和居民都面临更大的经济负担和财务风险。因此，需要采取有效的医疗支出控制方法。
