家庭医生会提升居家养老群体的自评健康水平吗？——基于DID双重差分研究

Will Family Doctors Improve the Self-Rated Health of the Home-Based Care Community?—Based on DID Differential Study

摘要: 目的：了解家庭医生签约服务政策在老年群体中的实施效果。方法：用CHARLS2015和2018两期的数据，通过DID双重差异分析评估家庭签约服务政策的实施效果。结果：研究发现，家庭医生签约服务能够从慢性病的管理、生活自理能力的改善、以及门诊、住院、购药等医疗服务的利用等几个方面来提高居家老人的健康水平，但对居家老人精神健康状况的改善效果不太明显，且家庭医生签约服务对不同年龄阶段和居住区域的老年人的实施效果具有异质性。结论：家庭医生签约服务对居家老人的健康水平有提升作用，应继续推动家庭医生签约服务的政策的执行与落实，提升签约服务质量，扩大签约覆盖范围，加强老人家庭签约家庭医生的积极性。

Abstract: Objective: To understand the effectiveness of the implementation of the family doctor contracted services policy in older age groups and the effect on the health level of older people in practice. Methods: The article assessed the implementation effects of the family contracted services policy through DID double difference analysis using data from both CHARLS 2015 and 2018. Results: The study found that family doctor contracted services could improve the health of homebound older people in several ways, including the management of chronic diseases, improvement of self-care ability, and the use of medical services such as outpatient, inpatient and medication purchase, but the effect on the improvement of mental health status of homebound older people was less obvious, and the implementation effect of family doctor contracted services was heterogeneous for older people of different age groups and living areas. Conclusion: Family doctor contracting service has improved the health of the elderly at home, and we should continue to promote the implementation of the policy of family doctor contracting service, improve the quality of contracting service, expand the coverage of contracting, and strengthen the enthusiasm of the elderly families to contract family doctors.