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按人头付费对中国糖尿病患者血管并发症的影响。

Impact of capitation payment on vascular complications among treated diabetic patients in China.

作者信息

Wang Ennan, Lin Yisha, You Yanan, Xi Xiaoyu, Zhu Minglai

机构信息

School of Health Policy and Management, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, Jiangsu, China.

The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, No. 639 Longmian Avenue, Nanjing, 211198, Jiangsu Province, China.

出版信息

Sci Rep. 2025 Sep 26;15(1):32970. doi: 10.1038/s41598-025-17273-x.

Abstract

Diabetes imposes a substantial economic burden on patients worldwide, and various national healthcare insurance systems adopt different payment methods to mitigate medical costs. However, the impact of insurance payment methods on patient health remains unclear. This study uses the reform of per capita payment for diabetes in Tianjin, China, as a quasi-experiment to investigate the effects of insurance payment methods on diabetes complications. The results indicate that the experimental group exhibited a significant reduction in vascular complications compared to the control group. The incidence of peripheral neuropathy, peripheral vascular disease, diabetic nephropathy, retinopathy, cardiovascular disease, and diabetic foot decreased significantly, with these effects becoming more pronounced over time. Moreover, compared to the control group, the incidence rates of complications in retired individuals were lower than those in employees within the experimental group.

摘要

糖尿病给全球患者带来了沉重的经济负担,各国的医疗保险系统采用不同的支付方式来减轻医疗费用。然而,保险支付方式对患者健康的影响仍不明确。本研究以中国天津的糖尿病按人头付费改革作为一项准实验,来探究保险支付方式对糖尿病并发症的影响。结果表明,与对照组相比,实验组的血管并发症显著减少。周围神经病变、周围血管疾病、糖尿病肾病、视网膜病变、心血管疾病和糖尿病足的发病率显著降低,且这些影响随着时间的推移愈发明显。此外,与对照组相比,实验组中退休人员并发症的发病率低于在职人员。

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