医院声誉、空间距离与患者就医选择——基于病案首页数据的分析  

Hospital Reputation,Spatial Distance and Patient Choice——Evidence from Hospital Discharge Data

作　　者：詹佳佳 傅虹桥 JIAJIA ZHAN;HONGQIAO FU(Peking University)

机构地区：[1]北京大学国家发展研究院 [2]北京大学公共卫生学院卫生政策与管理系

出　　处：《经济学（季刊）》2022年第1期343-364,共22页China Economic Quarterly

摘　　要：利用广州市髋、膝关节置换手术患者的病案首页和复旦医院排行榜等数据,本文使用离散选择模型探究了医院声誉和空间距离对患者就医选择的影响,并估算了患者愿意为医院声誉所付出的距离(WTT)和医院声誉的经济效应。本文发现:第一,患者偏好更高声誉和更短距离的医院。相比综合实力声誉,患者更加看重专科声誉,其WTT分别为5.54千米和6.98千米。第二,医院声誉、距离等因素对就医选择的影响在不同人群中存在异质性。第三,医院声誉提高能够显著增加患者数量,同时会降低竞争对手医院的患者数量,降低幅度随医院间距离增加而降低。以上结果对完善卫生供给侧改革具有启示意义。Using hospital discharge data in Guangzhou City and Fudan hospital ranking list primarily,this study applies discrete choice model to examine the impact of hospital reputation and spatial distance on hospital choice by patients undergoing hip or knee replacements.We also calculate the patient’s willingness to travel(WTT)for hospital reputation as well as the size effect of hospital reputation.Three findings emerge.First,patients prefer higher hospital reputation and shorter distance.Moreover,they place more emphasis on orthopedic specialty reputation than on general hospital reputation;patients are on overage willing to travel additional 5.54 kilometers for general hospital reputation and 6.98 kilometers for orthopedic specialty reputation.Second,preferences over hospital characteristics vary across patients’characteristics.Third,improvement in reputation for a hospital can increase its own demand and concurrently reduce demand for its competitors.The cross-effect declines rapidly as distances between providers increase.These results have implications for health delivery reform in China.

关 键 词：医院声誉 患者就医选择 空间距离 

分 类 号：R197.323[医药卫生—卫生事业管理]