A Study On The Impact Of Basic Medical Insurance On Patients' Medical Behavior

For a long time,under the administrative hierarchy of medical system,China presents the phenomenon that medical resources and patients are gathered in large hospitals.The allocation and use of medical institutions and resources is not reasonable.The problem of “difficult to see a doctor and expensive to see a doctor” is becoming more and more serious.To this end,the state focuses on building a hierarchical medical system centered on the “First Treatment in Community”,guiding patients to actively select grassroots medical institutions for medical treatment,and achieving rational diversion among medical institutions at all levels.Some scholars have suggested that in the new medical reforms with emphasis on hierarchical medical system,the guiding role of medical insurance should be emphasized,and in the practice of hierarchical medical system,most regions have guided residents to the grassroots level by setting differential reimbursement policies for medical insurance.Does the differential reimbursement policy play a guiding role in grading diagnosis and treatment? Is there a difference in the impact of different medical insurance on patients' medical treatment behavior? Not yet answered.This article takes the medical behavior of patients as the entry point,divides the medical treatment behavior into two stages: the manner of disease treatment and the selection of medical institution.According to the Andersen medical service utilization model,this article divides the independent variable into medical insurance,demand factors,ability factors,propensity factors and other factors.And using the Probit model to study whether there are differences in the impact of different types of medical insurance on patients' medical behavior and how medical insurance plays a role in guiding residents to seek medical care at the grassroots level.And then provide advice and suggestions to promote medical resources flow to grassroots,perfect the system of hierarchical medical system.The findings are as follows:(1)Different medical insurance has obvious differences in the impact of patients' medical behavior.Compared with Urban employee medical insurance,the participation rate of patients participating in the new rural cooperative medical care is lower,and there is no significant difference in urban insurance.(2)The Medicare differentiated reimbursement policy has not played a role in guiding patients to seek medical care at the grassroots level.In other word,The primary medical institutions with high reimbursement ratio can not effectively attract patients to actively choose primary medical institutions.(3)Providing health care services can significantly affect patient behavior.Based on this,this article proposes five recommendations:integrate the basic medical insurance system to promote institutional fairness;Actively introduce excellent physicians into the grassroots to enhance the service capacity of grassroots medical institutions;Give full play to the interest adjustment role of medical insurance;Fulfil the policy of “First Treatment in Community”;Encourage grassroots to provide medical care services.In this way,the role of medical insurance is effectively played and the patient's medical behavior is changed.The innovation of this article is to try to expand the research field that refines the medical behavior of patients affected by medical insurance:(1)Under the background of the full coverage of basic medical insurance in China,this article mainly analyzes the differences in the impact of new rural cooperative medical insurance,employee medical insurance and urban residential insurance on patients' medical behavior,and provides targeted advice for promoting the fairness and perfection of China's medical insurance system.(2)Based on the national survey data for the first time,this paper evaluates the role of medical insurance from the perspective of the differentiated reimbursement policy of medical insurance.Through empirical analysis,it is clear whether the differentiated reimbursement policy of medical insurance will have a positive impact on the choice of patients in outpatient clinics,thus grading diagnosis and treatment.Provide further scientific basis for further implementation and improvement.The shortcoming of this article is that it is limited by data.This article cannot confirm that the medical institution selected by the patient is the first consultation or referral,and can only show the approximate medical flow.In addition,due to this article focuses on patients who have been ill for nearly four weeks and who choose to see an outpatient visit,the sample size is small.Therefore,it is not divided into urban and rural samples.Whether there is a difference in the impact of medical insurance on urban and rural patients remains to be further studied.