摘要
发展基层医疗机构对完善医疗卫生体系起着至关重要的作用,但是国内现有文献对其市场竞争方面的实证研究还较为缺乏。本文通过计算中国某副省级城市2018—2020年住院患者的全样本数据得到相对外生的竞争测量,以综合分析市场竞争对基层医疗机构住院患者医疗费用的影响及影响渠道。研究发现,基层医疗机构的竞争会导致住院患者总费用的上涨。该结果与支持“医疗设备竞赛”的研究发现一致。分项费用方面,竞争会导致药品费、治疗费和服务费上涨,但诊疗费下降。从影响渠道来看,竞争会直接导致住院天数、床位数及人员设备投入的显著增加。
Primary medical institutions play a very important role in providing healthcare service in China.Compared with hospitals,the medical services provided by primary medical institutions are relatively common and simple,and the patients served are quite stable,thus it provides an appropriate market setting to analyze the effects of competition of medical institutions.However,there are very few studies in China examining this issue.This paper analyzes the effect of market competition on medical expenses of inpatients in primary medical institutions by utilizing a detailed micro-level administrative data set of inpatients and medical institutions from a sub-provincial city in China between 2018 and 2020.The results show that market competition will lead to the rise of medical expenses of inpatients in the current healthcare system.This result is consistent with the research findings that support the “medical arms race”.In terms of itemized fees,competition will lead to an increase in drug,treatment fees and service fees,but a decrease in diagnosis.This paper also analyzes the potential impact mechanism of market competition on medical expenses,and the results shows that market competition is significantly and positively correlated with hospital length of stay,number of beds,number of medical personnel,and equipment investment.
作者
石婷
陈晨
臧文斌
王一如
Shi Ting;Chen Chen;Zang Wenbin;Wang Yiru(School of Finance, Lanzhou University of Finance and Economics;School of Public Finance & Economics,Shanxi University of Finance and Economics;School of Public Administration,Southwestern University of Finance and Economics)
出处
《经济科学》
CSSCI
北大核心
2024年第2期178-198,共21页
Economic Science
基金
国家自然科学基金面上项目“中国医疗市场供给侧竞争效应研究”(项目编号:72273111)
教育部人文社会科学研究青年基金项目“医保支付方式与医疗供方道德风险:表现形式和影响机制研究”(项目编号:22YJC790010)的阶段性成果。
关键词
基层医疗机构
竞争
医疗费用
primary medical institutions
competition
medical expense
