Study On The Differences In Drug Welfare Effects Of Chronic Disease Patients Based On Shapley Value Decomposition Model

Objective To explore the issues related to the differences in drug welfare among patients with chronic diseases in the sample areas,then study the differences in drug welfare of patients with chronic diseases from three dimensions:overall,urban,rural,and region.By Comparing the levels of drug welfare effects between regions and between urban and rural areas to analyze the differences in drug welfare among patients with chronic diseases.By constructing a regression model to study the influencing factors of drug welfare of patients with chronic diseases in different dimensions,and on the basis of this regression model,the relevant variables that affect the drug welfare effects of patients with chronic diseases were decomposed into Shapley values,and the contribution of different variables to the differences in drug welfare effects was analyzed.In this way,targeted strategies for improving drug welfare were proposed,with a view to providing scientifically feasible and reasonable proposals for the healthy development of China's "2030" strategy and promoting the balanced development of drug welfare for patients with chronic diseases in different regions.Methods Based on the drug welfare evaluation index system constructed by the previous research the actual value of drug welfare for patients with chronic diseases in different dimensions was calculated and compared.Multivariate linear regression models were constructed using STATA.14.0 software to identify the key factors that affect the drug welfare of patients with chronic diseases in different dimensions,and a Shapley value decomposition model was constructed to further decompose the significant variables in regression,to research the contributions to drug welfare differences,thereby deepening the understanding of drug welfare differences of patients with chronic diseases in China.Results There are obvious differences in drug welfare between patients with chronic diseases in the urban and rural dimensions and regional dimensions.From the perspective of the urban and rural dimensions,the overall drug welfare effect of patients with chronic diseases in rural areas is slightly higher than those with chronic diseases in urban areas.The level of effect in three aspects of equity is higher than that of patients with chronic diseases in rural areas.Only patients with chronic diseases in rural areas have a higher level of effect in terms of drug health than in urban areas.From the perspective of regional dimensions,the overall drug welfare effect in the eastern region is higher than that in the western region.In terms of dimensions,the level of drug accessibility and the drug price for patients with chronic diseases in the eastern region is higher than that for patients with chronic diseases in the western region,while the level of drug fairness and drug health are slightly lower than those for patients with chronic diseases in the western region.The results of the Shapley value decomposition show that,as a whole,the contribution rate of the influencing factors of the drug welfare differences in patients with chronic diseases from high to low are:age(27.82%),income level(22.34%),and medical insurance(17.78%),Health checkup(12.02%),multiple chronic diseases(9.47%),marital status(7.40%),financial source(3.18%)From the perspective of the urban dimension,the contribution rates of the factors that have an impact on the differences in drug welfare of urban chronic disease patients are as follows:age(27.11%),income level(25.59%),health checkup(13.07%),medical insurance(12.91%),Multiple chronic diseases(11.11%),marital status(7.19%),financial source(2.58%),gender(0.23%),education level(0.22%);factors contributing to the differences in drug welfare of rural chronic disease patients The rates are from high to low:age(44.05%),medical insurance(24%),multiple chronic diseases(14.35%),marital status(13.19%),financial resources(3.11%),and income level(1.30%)From a regional perspective,the contribution rates of the factors that have an impact on the differences in drug welfare among patients with chronic diseases in the eastern region are as follows:income level(26.52%),age(25.84%),medical insurance(14.52%),and health checkups(12.72%),multiple chronic diseases(10.15%),marital status(6.69%),financial source(2.50%),education level(0.79%),BMI(0.26%);those that have an impact on the differences in drug welfare among patients with chronic diseases in the western region Factor contribution rates from high to low are:age(31.02%),medical insurance(21.27%),income level(16.15%),health checkup(11.93%),multiple chronic diseases(9.32%),marital status(8.53%),Economic sources(1.77%).Conclusion Based on the analysis results,this paper proposed that we should pay attention to the vulnerable groups,strengthen their disease management capabilities,and reduce the differences in drug welfare;Improving the medical insurance compensation mechanism,reducing the level of differences between various types of medical insurance,and promoting the balanced development of urban-rural and regional drug welfare;Promoting the health education,and improving the level of health management to improve the overall drug welfare;Improving the drug price system and enhencing the drug supply guarantee mechanism,so that to improve access to drugs and protect drug welfare.