Research on the diffusion mode and influence mechanism of the outpatient coordination policy of employees'basic medical insurance:Event history analysis based on 228 prefecture-level cities in China
10.3969/j.issn.1674-2982.2025.08.007
- VernacularTitle:职工医保普通门诊统筹政策扩散模式与影响机制研究
- Author:
Dan-ni XIAO
1
;
Wen-bo REN
1
;
Lin-lin HU
1
Author Information
1. 中国医学科学院/北京协和医学院 卫生健康管理政策学院 北京 100730
- Publication Type:Journal Article
- Keywords:
Outpatient pooling;
Outpatient mutual-aid;
Policy diffusion;
Event history analysis;
Influencing factors
- From:
Chinese Journal of Health Policy
2025;18(8):53-62
- CountryChina
- Language:Chinese
-
Abstract:
Implementing the reform of outpatient mutual-aid is a crucial measure to improve China's medical security system.Based on the policy diffusion theory,we took 228 prefecture-level cities across the country as the research objects and used the event history method to analyze the diffusion mode and influencing factors of the general outpatient pooling policy for employees'basic medical insurance,and divided into three types:the type of reducing the stock of Medical Savings Accounts(MSA),the welfare increment type I and type II for separate analysis.We found that the diffusion of the general outpatient pooling policy presented an"S"-shaped curve over time,and was mainly horizontally diffused in space,with a neighboring effect and a regional demonstration effect.The type of reducing the stock of MSA policy diffuses horizontally;the welfare increment type I is mainly horizontal diffusion,supplemented by vertical diffusion;the welfare increment type II is not affected by the pressure from higher-level governments,and mainly adopts the horizontal diffusion mode.In terms of the influencing factors of policy diffusion,the diffusion of the general outpatient pooling policy was affected by multiple factors such as policy issues,legitimacy,and government capacity.The diffusion of the type of reducing the stock of MSA policy was not affected by the pressure from higher-level governments,but was influenced by policy issues and government capacity.The diffusion of the welfare increment type I policy was most affected by policy issues,and the welfare increment type II was most affected by government capacity.
