← ireadpaper · 顶刊中的公共政策研究

社区卫生团队与萨尔瓦多的医疗服务利用

Community health teams and health utilization in El Salvador
Journal of Health Economics · 2026 · Antonella Bancalari、Pedro Bernal、Pablo Celhay、Sebastian Martinez、María Deni Sánchez

中文摘要

高成本的住院和急诊服务被过度利用,而初级保健却利用不足,这被视为医疗浪费性支出的一个关键驱动因素。我们研究向以社区为基础的初级保健的转变如何重塑萨尔瓦多卫生系统各层级的诊疗模式。利用254个市镇的门诊诊疗与住院数据,我们采用事件研究设计,利用2010年至2013年间社区卫生团队(CHTs)的交错引入加以识别。我们发现,CHTs提高了预防性医疗的利用,减少了可通过有效初级保健治疗的病症的治疗性诊疗,并降低了可预防住院。我们还记录到,此前未获诊治的慢性病症的初级保健覆盖率有所改善。综合来看,这些结果表明,通过CHTs加强初级保健能够切实改善医疗服务的组织方式,并提升卫生系统绩效。

Abstract

The overutilization of costly hospital and emergency care and the underutilization of primary care is considered a key driver of wasteful health spending. We study how a shift toward community-based primary care reshapes care patterns across levels of the health system in El Salvador. Using data on outpatient consultations and hospitalizations across 254 municipalities, we exploit the staggered introduction of community health teams (CHTs) between 2010 and 2013 using an event-study design. We find that CHTs increased preventive care, reduced curative consultations for conditions amenable to effective primary care, and lowered preventable hospitalizations. We also document improved primary-care coverage for previously unattended chronic conditions. Together, these results suggest that strengthening primary care through CHTs can meaningfully improve the organization of care and bolster health system performance.
在 ireadpaper 查看全部 →