Study On The Effect Of Medical Consortium Policy Implementation

The construction of medical consortium is an important part of deepening the reform of China’s medical and health system,and is the core of building a "hierarchical diagnosis and treatment system".It provides an important solution for the society to solve the problem of "difficult and expensive access to medical care ".However,in the continuous promotion of the medical consortium project,problems such as "formal integration" and "profit grabbing" are still prominent,which hinder the construction of hierarchical diagnosis and treatment system.There are a lot of studies on the effect of medical consortium construction and its influencing factors,but most of the them are qualitative analyses based on experience summary,lacking quantitative evidence of the practical effect of medical consortium policy from the provincial level.Especially for the achievement of the core goal of improving the pattern of citizens’ medical treatment,there is still a lack of in-depth theoretical analysis and empirical test.To this end,this paper focuses on “How effective is the implementation of the medical consortium policy?” “Has the pattern of citizens’ medical treatment and the capacity of primary care services been improved?” “Has the burden of medical care been reduced?” For these problems,firstly,we systematically review the relevant literature on medical consortium.Secondly,the research hypotheses of this paper are formed through the analysis of the health equity theory and the transaction cost theory.Then,the implementation effect of the medical consortium policy is quantitatively analyzed.Specifically,based on the multi-period DID model,this paper explores the impact of the promulgation and implementation of the medical consortium policy on the citizens’ access patterns,citizens’ access burden and primary care capacity at different points in time in 31 provincial-level administrative units across the mainland before and after the enactment of a dedicated medical consortium policy at the national level in 2017.The empirical results of this paper show that,during the relatively short period of implementation,the promulgation of the medical consortium policy has had a significant impact on reducing the medical costs of patients in public hospitals,but has had no obvious effect on optimizing the medical treatment pattern,changing the "inverted triangle" structure of access to medical care and strengthening the capacity of primary medical care,and has even had a negative impact on the construction of hierarchical diagnosis and treatment pattern.This may be due to the fact that the implementation of the medical consortium policy has brought more benefits to the leading hospitals,thus reducing the development space of primary institutions and leading to a more disorderly medical care pattern.Improving the pattern of medical treatment is the core goal of the construction of medical consortium,so this paper further discusses the effect of medical consortium in this regard.Regional heterogeneity analysis shows that after the implementation of the medical consortium policy,the pattern of residents’ medical treatment in the western region was not improved,but was negatively affected,while the pattern of medical treatment in the eastern and central regions did not change significantly.The level of urbanization,the level of financial subsidy and the level of employee medical insurance moderate the effect of the medical consortium policy,which all weaken the negative effect of the medical consortium policy on the pattern of citizens’ medical treatment.The findings of this study provide statistical support for the future adjustment direction of medical consortium construction.