Department of Health Policy and Management, School of Public Health, Peking University Health Science Center, Beijing, China.
Front Public Health. 2023 Feb 14;11:964789. doi: 10.3389/fpubh.2023.964789. eCollection 2023.
To evaluate the policy effect of replacing hospitalization service with outpatient service and reducing diabetes-related avoidable hospitalizations by improving outpatient benefits package.
A database of hospital discharge from 2015 to 2017 in City Z was used. All diabetic inpatient cases enrolled in Urban Employee Basic Medical Insurance were selected as the intervention group, and diabetic inpatient cases enrolled in Urban and Rural Resident Basic Medical Insurance were selected as the control group. The Difference-in-Difference model was used to analyze the effect of improving outpatient benefits package level of diabetes from 1800 yuan (about $252.82) to 2400 yuan (about $337.09) per capita per year on avoidable hospitalization rate, average hospitalization cost and average length of stay.
The avoidable hospitalization rate of diabetes mellitus decreased by 0.21 percentage points ( < 0.01), the average total cost of hospitalization increased by 7.89% ( < 0.01), and the average length of stay per hospitalization increased by 5.63% ( < 0.01).
Improving the outpatient benefits package of diabetes can play a role in replacing hospitalization service with outpatient service, reducing diabetes-related avoidable hospitalizations, and reducing the disease burden and financial burden.
通过提高门诊待遇包，评估用门诊服务替代住院服务、减少糖尿病相关可避免住院的政策效果。
利用 Z 市 2015 年至 2017 年的医院出院数据库，选取参加城镇职工基本医疗保险的所有糖尿病住院病例作为干预组，选取参加城乡居民基本医疗保险的糖尿病住院病例作为对照组。采用双重差分模型分析糖尿病患者人均每年门诊待遇包水平从 1800 元（约 252.82 美元）提高到 2400 元（约 337.09 美元）对可避免住院率、住院总费用和平均住院天数的影响。
糖尿病的可避免住院率降低了 0.21 个百分点（<0.01），住院总费用增加了 7.89%（<0.01），每次住院的平均住院天数增加了 5.63%（<0.01）。
提高糖尿病的门诊待遇包可以在一定程度上替代住院服务，减少糖尿病相关可避免住院，减轻疾病负担和经济负担。
