高等经济研究院教师论文被国际权威经济学期刊接收发表

2024年11月22日

近日，高等经济研究院副教授杨婉彧与北京大学经济学院副教授石菊、助理教授袁野合作的论文 “Cover More for Less: Targeted Drug Coverage, Chronic Disease Management,and Medical Spending” 被经济学领域权威期刊 Journal of Development Economics 接收并正式线上发表。

扩大公共医疗保险计划的一个关键挑战是如何在有限的预算下进行有效的政策实施。本文研究了一种基于价值的医保设计，该设计为两种慢性疾病——高血压和糖尿病引入了门诊内的处方药覆盖。这种针对性的药物覆盖方案增加了基层医疗资源的使用，并显著减少了住院率，从而在总体医疗支出上实现了显著的净节省。该医保设计主要通过三个运作机制达到了政策效果。首先，该医保设计通过促进基层医疗的常规使用和疾病改善的有效管理，实现了住院率的降低。其次，文章结果显示非目标慢性疾病的住院率降低更为显著，这表明该医保设计有显著的正向的跨疾病溢出效应。第三，患者通过该医保设计的宣传和实施学习了如何管理慢性疾病和养成良好习惯，进而提升了目标和非目标疾病的管理效率。论文的研究结果突显了一种可行的尤其适用于资金有限的发展中国家的基于价值的医保设计。

 

 

Associate Professor Wanyu Yang’s Paper Accepted for Publication in Journal of Development Economics

November 11, 2024

Wanyu Yang, Associate Professor of IAER, had her paper accepted for publication in Journal of Development Economics recently. Entitled "Cover More for Less: Targeted Drug Coverage, Chronic Disease Management, and Medical Spending", the paper was co-authored with Julie Shi, Associate Professor of Economics at Peking University and Ye Yuan, Assistant Professor of Economics at Peking University.

A key challenge in expanding public health insurance programs is how to deliver these programs cost-effectively with limited budget. This paper studies a value-based insurance design that introduced prescription drug coverage for two chronic diseases—hypertension and diabetes. This targeted drug coverage scheme increased the use of primary care and sharply reduced hospitalizations, leading to substantial net savings in total medical expenditure. Three operating channels were in play. First, a hospitalization offset was achieved by stimulating regular use of primary care and improving disease management. Second, the offset occurred more notably for nontargeted chronic diseases, suggesting a strong positive cross-disease spillover effect. Third, learning contributed to more efficient management of both targeted and nontargeted diseases. Our findings highlight a viable value-based insurance design, especially for developing countries with limited funding.