Does the Appointment Referral Reform Improve the Efficiency of Health Resource Allocation? -----Evidence Based on Beijing Samples

Abstract

Abstract The structural congestion of health resources in China is serious. Under the guidance of "Healthy China 2030" development plan, the hierarchical medical reform has been carried out all over the country, with a view to realizing the pattern of hierarchical medical by guiding patients to make initial diagnosis and appointment for referral, thus improving the allocation efficiency of health resources and realizing the sustainable development of health undertakings. In this paper, county-level data were collected, and 16 counties in Beijing were taken as the treated group samples, and 101 counties in Guangzhou and Henan provinces were taken as the control group samples. The supply index(input index),demand index(output index) and efficiency index (input-output ratio) were calculated by entropy weight method, and the policy impact of the hierarchical medical reform on the allocation efficiency of health resources was explored by using propensity score matching difference-in-differences method(PSM-DID). The results show that the hierarchical medical reform in Beijing with appointment referral as a breakthrough has significantly improved the number of outpatients and the allocation efficiency of health resources, but it has no significant impact on the input index and output index. It can be seen that appointment referral has some effects on the demand side; The main reason is that the appointment referral optimizes the transfer of local residents between low-level hospitals and high-level hospitals, which has a demand conversion effect and a certain resource optimization effect, and has obvious influence on the urban areas and weak influence on the suburbs; Therefore, in order to improve the efficiency of health resource allocation, both demand-side reform and supply-side reform are needed.