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了解2019冠状病毒病对社区卫生服务利用的影响:来自中国北京的证据。

Understanding the Impact of COVID-19 on the Utilization of Community Health Services: Evidence from Beijing in China.

作者信息

Zhang Yuqing, Li Lele, Yu Qiao, Li Qi

机构信息

School of Public Policy and Management, Tsinghua University, Beijing 100084, China.

Asia Competitiveness Institute, Lee Kuan Yew School of Public Policy, National University of Singapore, 469C Bukit Timah Road, Singapore 259772, Singapore.

出版信息

Healthcare (Basel). 2025 Mar 23;13(7):707. doi: 10.3390/healthcare13070707.

Abstract

Primary healthcare (PHC) at the community level is essential to improving access to health services and reducing healthcare costs. However, compared to developed countries where PHC is well developed, PHC in developing countries is not as well developed. The worldwide prevalence of COVID-19 has put a tremendous strain on the healthcare systems of all countries. Interestingly, we found that the impact of COVID-19 on the global healthcare system has brought about a new opportunity for PHC in developing countries. Based on community-scale panel data from Beijing, China, in the period from 1 January 2018 to 30 June 2021, this paper employed the Anderson model to reveal the impact of COVID-19 on community health service utilization. Two-way fixed effects models and double-difference models were used to analyze the data for robustness. The results show that COVID-19 significantly reduced visits to the Community Health Center, but meanwhile, it raised the cost of single visits. While the costs of treatment, together with medical materials, were significantly lower during the pandemic, COVID-19 has affected the cost control of family physicians, resulting in the cost of contracted patients being significantly lower than that of non-contracted patients. While the COVID-19 pandemic significantly reduced routine visits to established medical centers, it served as a catalyst for the increased utilization of community health services. If appropriate measures to contain COVID-19 were taken, it would be possible to extend the scope of community health services and strengthen the PHC system.

摘要

社区层面的初级卫生保健对于改善卫生服务可及性和降低医疗成本至关重要。然而,与初级卫生保健发展良好的发达国家相比,发展中国家的初级卫生保健发展程度较低。新型冠状病毒肺炎(COVID-19)在全球范围内的流行给各国医疗系统带来了巨大压力。有趣的是,我们发现COVID-19对全球医疗系统的影响为发展中国家的初级卫生保健带来了新机遇。基于中国北京2018年1月1日至2021年6月30日期间的社区规模面板数据,本文采用安德森模型揭示COVID-19对社区卫生服务利用的影响。使用双向固定效应模型和双重差分模型对数据进行稳健性分析。结果表明,COVID-19显著减少了社区卫生服务中心的就诊次数,但同时单次就诊费用有所增加。虽然疫情期间治疗费用和医疗物资费用显著降低,但COVID-19影响了家庭医生的成本控制,导致签约患者的费用显著低于未签约患者。虽然COVID-19大流行显著减少了对既定医疗中心的常规就诊,但它成为了社区卫生服务利用增加的催化剂。如果采取适当的COVID-19防控措施,就有可能扩大社区卫生服务范围并加强初级卫生保健系统。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c60/11989127/ea9e35009a84/healthcare-13-00707-g001.jpg

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