Utilization, cost and risk analysis of outpatient medical services among insured persons of basic medical insurance

Corresponding author: 张, zhangxjzhang@163.com

DOI: 10.12201/bmr.202302.00013

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  Abstract: Objective: To analyze the utilization, cost and risk of outpatient services among people over 45 years old. Methods: Based on CHARLS 2018 data, univariate analysis and multivariate logit regression were performed respectively. Results: The utilization rate of outpatient services was significantly lower than that of self-purchasing medicines. The group with an average monthly average of more than 1,000 yuan for outpatient and self-purchasing medicines accounted for the highest proportion. The level of outpatient security has a statistically significant impact on the utilization of outpatient expenses; outpatient utilization and self-purchasing of medicines are both important factors that lead to catastrophic health expenditures; with the increase in the number of chronic disease patients, the number of catastrophic health expenditures for non-hospitalized patients increases. Risk increases. Recommendations: Improve the basic medical insurance outpatient reimbursement policy, guide patients to rationally use medical services, and improve the efficiency of fund expenditure; re-understand outpatient expenses, and reconstruct the medical insurance treatment and security portfolio; improve the outpatient insurance level of chronic disease patients, and reduce the risk of outpatient expenses for chronic disease patients.

  Key words: outpatient service utilization; outpatient cost; catastrophic health expenditure

  Submit time: 28 February 2023

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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