Effect of Outpatient Pooling Scheme on the Medical Costs of Patients with Chronic Diseases -- Based on Multi-period DID Modeling

Abstract

The establishment of a sound mechanism for covering outpatient medical bills under the basic medical insurance for urban employees is one of the major livelihood projects to deepen the reform of China's medical security system. This study utilizes the China Health and Retirement Longitudinal Study (CHARLS), combines the interview data from four periods from 2011 to 2018, empirically analyzes the impact of the outpatient pooling scheme on the total outpatient costs and personal burden of patients with chronic diseases by using a multi-period double-difference model and further validates it by using the double-difference propensity score matching method (PSM-DID). The results show that the implementation of the outpatient pooling scheme is conducive to reducing the healthcare burden of chronically ill patients. Although the outpatient co-ordination did not have a significant impact on the reduction of outpatient costs for patients with chronic diseases, it significantly reduced the self-treatment costs of patients with chronic diseases. Further research found that the policy had a greater impact on chronic disease patients with poorer health. Combined with the results of the study, this paper suggests gradually eliminating the differences in basic policy treatment between regions, guaranteeing the level of outpatient treatment for insured patients in different places, and promoting better utilization of the outpatient co-ordination policy effect.