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疾病专项医疗保障标准化的影响

The impact of standardized disease-specific healthcare coverage
Journal of Public Economics · 2025 · Felipe Menares、Pablo Muñoz

中文摘要

我们研究了一项医疗改革的影响,该改革对一组疾病的诊疗程序和及时保障进行了标准化。利用智利全部死亡记录和双重差分研究设计,我们发现,该改革所覆盖疾病的死亡率平均下降了4.4%。特定疾病冲击或资源从未覆盖疾病向已覆盖疾病的转移均无法解释这一效应。来自多发创伤住院患者的证据表明,该改革通过降低医院间经风险调整的手术率和支出的离散程度,使医疗服务利用率趋于均等。

Abstract

We study the impact of a healthcare reform that standardized procedures and timely coverage of a set of diseases. Using Chile’s universe of death records and a difference-in-differences research design, we show that mortality from the diseases covered by this reform decreased by 4.4% on average. Disease-specific shocks or a resource shift from non-covered to covered diseases do not explain this effect. Evidence from polytraumatized inpatients suggests that the reform equalized utilization rates as it reduced the dispersion of risk-adjusted surgery rates and spending across hospitals.
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