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To analyze the impact of the outpatient mutual assistance reform of employee medical insurance on outpatient costs in medical and pharmaceutical institutions, offering valuable insights for deepening outpatient medical system reforms and optimizing chronic disease management.
Outpatient cost indicators for hypertensive patients in City L from January 2022 to December 2023 were collected. Univariate analysis and a two-group interrupted time-series model were employed to compare changes in cost indicators before and after the reform.
A total of 688 510 valid cases were included, with 158 474 (23.02%) from pharmacies, and 530 036 (76.98%) from hospitals. The overall outpatient costs in medical and pharmaceutical institutions showed statistically significant differences before and after the reform (Z/t= -3.486/6.972, P<0.05), with post-reform data showing reduced total expenditures. However, the reform also led to a decline in the average reimbursement rate per visit, with a more pronounced effect observed in retail pharmacies than in medical institutions. Furthermore, the reform was associated with increased utilization of Chinese herbal medicines, accompanied by a significant rise in related expenditures (Z/t= -4.229/-4.285, P<0.05).
The outpatient mutual assistance reform of employee medical insurance has alleviated the financial burden of hypertension patients in medical and pharmaceutical institutions, though the payment capacity of health insurance slightly declined in the early stages of reform. It is essential to coordinate the outpatient mutual assistance reform with other policies, establish a comprehensive tripartite linkage system involving medical management, insurance payment, and drug supply, and optimize outpatient management strategies for chronic diseases.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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