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首页> 外文期刊>The European journal of health economics: HEPAC : health economics in prevention and care >The closer the better: does better access to outpatient care prevent hospitalization?
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The closer the better: does better access to outpatient care prevent hospitalization?

机译：更越越好：更好地获得门诊护理防止住院治疗吗？

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摘要

In 2010-2012, new outpatient service locations were established in poor Hungarian micro-regions. We exploit this quasi-experiment to estimate the extent of substitution between outpatient and inpatient care. Fixed-effects Poisson models on individual-level panel data for years 2008-2015 show that the number of outpatient visits increased by 19% and the number of inpatient stays decreased by 1.6% as a result, driven by a marked reduction of potentially avoidable hospitalization (PAH) (5%). In our dynamic specification, PAH effects occur in the year after the treatment, whereas non-PAH only decreases with a multi-year lag. The instrumental variable estimates suggest that a one euro increase in outpatient care expenditures produces a 0.6 euro decrease in inpatient care expenditures. Our results (1) strengthen the claim that bringing outpatient care closer to a previously underserved population yields considerable health benefits, and (2) suggest that there is a strong substitution element between outpatient and inpatient care.
机译：2010 - 2012年，新的门诊服务地点是在匈牙利贫困的微地区建立的。我们利用了这种准实验来估计门诊和住院护理之间的替代程度。 2008 - 2015年多年来个人级别面板数据上的固定效果泊松模型显示，门诊次数增加了19％，住院住院人数减少了1.6％，因潜在可避免住院治疗而导致（PAH）（5％）。在我们的动态规范中，PAH效果在治疗后的一年内发生，而非PAH仅限于多年滞后。仪器变量估计表明，住院护理支出的一欧元增加在住院护理支出减少0.6欧元。我们的成果（1）加强了将门诊护理更接近以前所提供的人口的索赔产生了相当大的健康福利，并建议在门诊和住院护理之间存在强有力的替代因素。

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