Integrated Care and Medical Expenditure Control: A Research Based on Pilots of “Cognitive-friendly Communities”

Yu Yangyang; Zhai Ying; Zhang Yi

doi:doi:10.16538/j.cnki.jfe.20240218.401

Summary

The traditional medical and health service system with disease and treatment as the core and characteristic of care fragmentation lacks service efficiency and causes waste of medical resources, so it cannot cope with the great challenges brought by the rapid aging process. Integrated care allows patients to receive continuity of care through collaboration among different types of care providers, which not only helps to improve service efficiency, but also becomes an important way to control the rapid growth of medical expenditure. This paper takes the policy of “Cognitive-friendly Communities” as an example to investigate the impact of integrated care for chronic disease prevention and treatment on medical service utilization and carry out welfare analysis. Using the data of disabled elderly assessment and medical insurance accounts in a typical city and the DID method, the study finds that “Cognitive-friendly Communities” can significantly reduce the hospitalization probability of disabled elderly people by 3% below the significance level of 1%. Further combined with the long-term care insurance system and related heterogeneity analysis, it finds that the effect is more significant among male, group who participate in urban employee medical insurance, and moderate and severe disabilities. The possible mechanism is that “Cognitive-friendly Communities” can improve health behavior through information and improve the quality of care through inter-departmental care resource collaboration to improve service efficiency. In addition, the welfare analysis finds that integrated care not only improves the health level of disabled elderly people, but also has a better economic effect. This paper discusses for the first time that the integrated care mode of cognitive disorder prevention and treatment can control the increase of medical expenditure by improving service efficiency from the economic perspective of cause-and-effect identification, which complements the gap in this research field. At the same time, combined with the long-term care insurance system, it explains the impact mechanism from the perspective of inter-departmental cooperation between care resources. The results show that the community-focused integrated care mode for chronic disease prevention and treatment has a promoting and demonstrating role. In the future, it is necessary to vigorously promote the inter-departmental collaboration to improve the health level and reduce medical expenditure, and use the concept of integrated care to deal with the challenge of “fragmented” medical service system in China.