区域内医院间竞争对医疗费用和质量影响之空间测度与实证研究

项目名称： 区域内医院间竞争对医疗费用和质量影响之空间测度与实证研究

项目编号： No.71303165

项目类型： 青年科学基金项目

立项/批准年度： 2014

项目学科： 管理科学

项目作者： 潘杰

作者单位： 四川大学

项目金额： 21万元

中文摘要： 通常竞争能最有效调动全社会生产积极性，提供更多、更好产品和服务。然而，在高度信息不对称、提供"差异化产品"的医疗市场中，竞争是否"有效"，长期以来在理论研究上存在巨大争议。如果"有效"，那么就应该出台更多支持竞争的卫生政策，反之亦然。尽管已有多项研究从所有制角度就社会办医对医疗市场的影响展开实证分析，但是从医院间竞争的角度展开的实证研究仅1项，且采用的是省级宏观数据。在此背景下，本研究集中关注后者，尝试使用更详尽的医院层面数据回答区域内医院间竞争是否有利于降低医疗费用、提高质量这一问题。本研究运用产业组织理论提供的"市场结构-市场行为-市场绩效"分析框架构建计量经济学模型，采用空间数据测度医院间竞争强度，利用时间上、空间上竞争强度变化的"自然实验"就竞争对医疗产出的影响开展实证研究和评价。根据研究结果，阐明区域内医院间竞争在医疗市场中的作用及其机制，为国家制订相关卫生政策提供思路和依据。

中文关键词： 实证研究；竞争；医疗费用；医疗质量；空间测度

英文摘要： Under general economic theory, competition can effectively mobilize production of the whole society, generating higher quantity and quality products or services. However, health care as special goods makes it hard to apply classic economic theory because the premises for perfect competition do not exist. The effectiveness of competition in health market is still questionable. In China's new round of health system reform since 2009, on one hand, the government encourages social participation in health care delivery to promote the competition with the public health facilities, however, on the other hand, emphasizes the regional health planning to limit the competition in a specific area. Because there are already some studies in good quality on the topic of the role of the non-public hospital in China's health care market, this project plans to study the impact of regional competition on health quality and price in China, which has not been fully studied in the literature. Draw on industry organization theory, the structure-conduct-performance analytical framework and econometric approach would be employed to evaluate the impact of competition on health quality and cost. The degree of competition which the specific hospital faces would be measured using the geographic techniques. The variation of competition among

英文关键词： empirical study；competition；health care cost；health care quality；space measure