Research on the Impact of Special Outpatient Chronic Diseases on the Medical Expenses of Middle-Aged and Elderly Hypertensive Patients

Li Yi; Zhang Siqi; Wang Jiayi; Shan Linghan; Zhang Xin

Abstract：Objective:To evaluate the economic effects of the implementation of Special Outpatient Chronic Diseases(SPOCD)in urban and rural resident basic medical insurance on middle-aged and elderly hypertensive patients in Heilongjiang.Methods:Based on the mixed cross-sectional data of Basic Medical Insurance claims for Outpatient Unified Accounts in Heilongjiang from 2022 to 2023,generalized linear regression was used to measure the impact of SPOCD on the total medical expenses,out-of-pocket expenses,fund expenditures and medical saving account expenditures of hypertensive patients for outpatient and inpatient services.Results:The total outpatient medical expenses,total fund expenditures and individual saving account expenses of the patients who enjoyed the program benefits were 3.03,3.97 and 1.40 times of those who didn't enjoy the benefits,respectively.For inpatient services,program benefits only have a significant impact on the out-of-pocket expenses(P＜0.05).Compared with those who did not enjoy the benefits,the out-of-pocket expenses of patients who enjoyed the benefits decreased by 54%.The robustness checks were consistent with the benchmark regressions.The results of heterogeneity test showed that there were heterogeneities in gender,age,work type and time in the effects of SPOCD on variables in outpatient.Conclusion:The economic effect of SPOCD on middle-aged and elderly patients with hypertension existed,and it induced ex-post moral hazard.In order to achieve the goal of chronic disease prevention and control,it is necessary to further explore the connection with other programs,and accelerate the refined benefit designs.