基于内部市场视角的医疗费用与医疗服务质量的双重控制  

Double Control of Medical Cost and Medical Care Quality Based on the Perspective of Internal Market

作　　者：王苏生[1] 孔昭昆[1] 向静[1] 周明建[1] 

机构地区：[1]哈尔滨工业大学深圳研究生院,深圳518055

出　　处：《管理评论》2010年第10期37-43,共7页Management Review

基　　金：国家自然科学基金青年项目(70702010)

摘　　要：为了提高医疗市场的效率,需要建立医疗内部市场,将市场力量从医疗供给方转移到购买方,从而促进医疗机构之间的竞争。文中通过一个基本空间竞争模型,分析得出在医疗内部市场中,按病种分类的预付机制能够有效控制医疗费用,竞争则有利于提高医疗质量,降低医疗机构的信息租金;而分散的地理布局会为医疗机构获取地域租金提供机会。因此,公共代理机构在确定医疗偿付制度与医疗质量时,应当同时考虑医疗机构的信息租与地域租。Information asymmetry results in the medical market failure. In order to improve the medical market efficiency,internal markets need to be established for shifting the market power from providers to purchasers so that providers will compete drastically with each other for medical purchasers. The paper shows that DRG-related prospective payment scheme can control medical expense; competition between medical providers can lead to higher medical quality and lower information rent; but discrete distribution of medical care providers allows them to enjoy position rent. Therefore,the payment system and the medical quality should be determined by reference to the information rent and position rent.

关 键 词：医疗市场 内部市场 信息租 空间竞争 

分 类 号：R197.1[医药卫生—卫生事业管理]