Department of Health Economics, School of Public Health, Fudan University, 130 Dong'an Road, Shanghai, 200032, China.
Key Laboratory of Health Technology Assessment (Fudan University), National Health Commission, 130 Dong'an Road, Shanghai, 200032, China.
BMC Public Health. 2024 Aug 29;24(1):2353. doi: 10.1186/s12889-024-19719-9.
Price levels of medical services may vary across regions with different income levels, which would raise concerns about the equal access to medical services. This study aimed to estimate the spatial price index of medical services to measure price levels across 31 provincial regions in China.
Price data were collected from medical service price schedule in each region. Two methods based on the Purchasing Power Parities were used to estimate the spatial price index and measure price differences across regions. The two-way fixed effects models were used to examine the association between medical service price levels and income levels, and further investigate the impacts of price differences on utilization of medical services and medical expenditure.
The consistent estimation results were given by two methods. Medical service price level in the highest-price region was found to be 74% higher than the lowest. There was a significant negative correlation between price levels and income levels, as well as price levels and the utilization of outpatient services. Moreover, we also found a 1% increase in medical service price level was significantly associated with a 0.34% and 0.24% increase in the medical service expense per outpatient visit and per inpatient respectively.
Regions in China had significant gaps in medical service price levels. Policymakers should pay more attention to regional price differences and take great measures such as enhancing financial protection to ensure the equal access to medical services and better achieve the universal health coverage.
医疗服务的价格水平可能因收入水平不同的地区而异，这引发了对医疗服务公平可及性的担忧。本研究旨在估算医疗服务的空间价格指数，以衡量中国 31 个省级地区的价格水平。
从各地区的医疗服务价格表中收集价格数据。使用两种基于购买力平价的方法来估算空间价格指数并衡量地区间的价格差异。采用双向固定效应模型来检验医疗服务价格水平与收入水平之间的关联，并进一步探讨价格差异对医疗服务利用和医疗支出的影响。
两种方法给出了一致的估计结果。发现最高价格地区的医疗服务价格水平比最低价格地区高 74%。价格水平与收入水平呈显著负相关，与门诊服务利用也呈显著负相关。此外，我们还发现，医疗服务价格水平每上涨 1%，门诊和住院医疗服务费用分别显著增加 0.34%和 0.24%。
中国各地区的医疗服务价格水平存在显著差距。政策制定者应更加关注地区间的价格差异，并采取重大措施，如加强财政保障，以确保医疗服务的公平可及，并更好地实现全民健康覆盖。
