供方诱导需求视角的就医行为研究——基于CHARLS数据的实证分析  

Medical Attention Seeking Behaviors in China from the Perspective of Supplier-induced Demand: An Empirical Analysis Based on CHARLS

作　　者：李海明[1] LI Hai-ming

机构地区：[1]中央财经大学政府管理学院

出　　处：《中央财经大学学报》2018年第11期117-128,共12页Journal of Central University of Finance & Economics

基　　金：国家自然科学基金"先验信息;社会网络与互动过程:行为视角的医患关系研究"(项目编号:71603298)

摘　　要：在健康中国建设的战略背景下,研究供方诱导需求是否存在及其程度,对于提高医疗资源配置效率、控制不合理的医疗费用增长、避免不合理医疗行为具有重要意义。关于供方诱导需求,国外卫生经济学领域已有丰富的研究成果,而国内鲜见规范的定量分析,本文使用CHARLS调查数据进行量化研究,一定程度上弥补了国内研究的不足。通过建立经典的两阶段计数模型,分别使用Logit模型和负二项截断模型进行回归分析,结果发现:(1)在控制了正常医疗需求的影响之后,供方诱导需求确实仍然存在,但影响程度并不强烈。(2)医疗服务可及性的提高,能够显著提高患者就医的概率。(3)医疗保险能够显著提高居民第一阶段初次就医的概率,同时降低第二阶段的就医次数,这说明参加医疗保险对不合理医疗行为及诱导需求具有一定的抑制作用。Under the background of the Healthy China Strategy,it is of great importance to research the Supplier-induced Demand(SID)issue,in order to optimize the allocation of medical resources,control the increases of unreasonable medical expenditure and avoid unreasonable medical behaviors.There have been lots of literature on the SID topic in other countries,but few in China.This article establishes a two-stage count model,and regresses it by negative binomial hurdle model using CHARLS data.This paper concludes that:(1)After controlling the impact of normal medical needs,SID does exist,but the impact is not strong.(2)The accessibility of medical services can significantly improve the probability of medical treatment.(3)Medical insurance can significantly improve patients access to outpatient treatment in the first stage,while reduce the number of medical treatment in the second stage,indicating that participation in medical insurance has a certain inhibitory effect on the unreasonable medical behavior and SID.

关 键 词：供方诱导需求 就医行为 医疗保险 健康中国 

分 类 号：F062.6[经济管理—政治经济学]