医保支付方式对医生行为约束的路径分析  

A path annlysis on the constraints of physician behavior by medical insurance payment

作　　者：杨永梅[1,2] 陈翰丹[1] 

机构地区：[1]温州医科大学人文与管理学院,浙江温州325035 [2]西安建筑科技大学管理学院,陕西西安710055

出　　处：《中国卫生政策研究》2015年第12期31-35,共5页Chinese Journal of Health Policy

基　　金：国家博士后基金(2014M562517XB);陕西省教育厅基金(2013JK0110);温州市社会科学重点研究基地项目(15JD29)

摘　　要：中性的医保支付方式既可以实现医保资金的成本效益,又可以使医生在医疗服务中遵循患者健康收益最大化原则。由于医生代理人职能的不完善,完全的预付费用和按费用支付都无法抑制医生的目标收入和诱导需求。以第三方支付为主的基本医疗服务中,采取以诊疗效率相关的预付费用为基础,混合以边际成本小于边际费用及平均费用支付的支付,不仅可以弥补医生服务成本,还可以约束医生诱导需求等行为,完善医生代理人作用,使医保支付趋近中性。As a rational economic man and agent,in the primary care Physicians not only pursue target income,but also pursue the utility of the agent. Different health care payment has different effect on physician,due to imperfect physician agent of the primary health care,the health care payment is difficult to achieve economic neutral.Based on the theory of target income and physician-induced demand,the paper proves that in the primary health care with the third party payment,there should be a prospective component of payment and fees should be lower than marginal cost,which can not only improve the role of agent,but also constraint the physician-induced demand,so as to achieve health care for physician＇s behavior constraints.

关 键 词：医保支付 支付中性 医生行为 

分 类 号：R197[医药卫生—卫生事业管理]