Evaluation On The Policy Effect Of Medical Insurance Support For Capitation Package Payment For Family Doctor Contracted Services

An important task in comprehensively promoting the construction of a healthy China and deepening the reform of the medical and health system is to implement family doctor contracting services,further strengthen the function of the primary medical and health service network,and better maintain the health of the people.China has made certain achievements in exploring the reform of medical insurance payment methods in recent years,but the family doctor contracting service still needs to be further developed and improved.Medical insurance support for capitation package payment for family doctor contracted services can play the role of economic leverage of medical insurance funds,the part of family doctor contracted services funded by medical insurance support for capitation package payment will be paid to primary medical and health institutions and family doctor teams,to better encourage family doctors to become the "gatekeeper" of residents’ health.This study selects China Family Panel Studies(CFPS)database,to "whether for family doctor contracted services capitation package payment implementation area" as the core explanatory variables,respectively selected economic effect,health effect and grading effect of diagnosis and treatment three indicators for the explanatory variables,select other factors for control variables,build the difference-in-difference model to evaluate the support of the family doctor contracted services capitation package payment policy effect,and through the parallel trend test and robustness test proved that the model is scientific.Finally,the difference of policy effect of capitation package payment was further explored by heterogeneity analysis.The DID results show:(1)Health self-assessment and policy effect(did)in 1%significance level,health changes and policy effect(did)in 5% significance level,and the interaction coefficient is positive,that medical insurance to support capitation package payment for family doctor contracted services improved the health of residents,improved the health level of residents.(2)The doctor condition satisfaction and the medical level respectively and policy effect(order)in 1% significant level,and the interaction term coefficient is positive,that medical insurance to support capitation package payment for family doctor contracted services implementation area to a certain extent,improve the residents of the doctor condition satisfaction and the medical level.(3)The total hospitalization cost,where to go to the doctor in general and policy effect(did)were not significant.In summary,this study concludes that:(1)The economic effect of capitation package payment for family doctor contracted services is not obvious;(2)The health effects of capitation package payment for family doctor contracted services are significant,but there are differences in health effects for different regions and different groups of people;(3)The graded diagnosis and treatment effect of capitation package payment for family doctor contracted services is more significant,but it is not enough to guide residents to go to the grassroots level for medical treatment.The following effective and feasible policy suggestions for improving family doctor contracted services are proposed:(1)Improve the incentive mechanism and assessment mechanism of family doctor contracted services;(2)Promote the coordination of family doctor contracted services and medical insurance payment reform;(3)Improve the top-level design and supporting mechanism of family doctor contracted services,and promote the high-quality development of family doctor contracted services.