收入分成制度与医生兼差的激励机制:多任务委托代理理论的视角  

Sharecropping and Incentives of Physician's Moonlighting: A Multitask Principal-Agent Perspective

作　　者：顾昕[1,2] 郭科[1] 

机构地区：[1]北京大学政府管理学院,北京100871 [2]北京大学政治发展与政府管理研究所,北京100871

出　　处：《中国卫生经济》2016年第9期5-9,共5页Chinese Health Economics

基　　金：教育部基地重大项目(15JJD810002)

摘　　要：在我国,公立医院大多实施一种强激励型薪酬制度,即固定底薪+分成制,具体表现在医院对科室创收的管理上。基于多任务委托代理模型,若管制者-管理者禁止医生兼差(即走穴),那么医生有可能会在高难度、不确定任务的完成上丧失积极性。相反,若医院管理者适当约束医生将精力投放于边际效用最大化的医疗活动,那么默许兼差也能带来双方效用的提升。因此,对医生采取强政府管制的必要性和可行性都大可怀疑。医院管理者一般远比政府管制者对医疗服务以及相关医生的行止有明显的信息优势,让前者而不是后者对医生兼差实施更适当的激励机制,更为可行。In China, a high-powered incentives salary system, which contained fixed salary and sharecropping, were implemented in public hospitals. It embodied in performance management of revenue generating on departments. Based on multitask princi- pal-agent model, physicians were likely to be inactive in performing difficult and uncertain tasks if regulators/managers impose moon- lighting ban. In contrary, tacit permission on moonlighting would bring about utility improvements for both sides if hospital managers limit physicians＇ moonlighting only on health care with the highest marginal utility. Hence, the desirability and necessity of govern- ment regulations of physician moonlighting were doubtful. As hospital managers generally possessed more information advantage than government regulators, it would be more practicable for the former than for the latter to impose more adequate incentives on physician moonlighting.

关 键 词：多任务委托代理模型 医生兼差 收入分成制 

分 类 号：R192[医药卫生—卫生事业管理]