在线付费诊疗服务对线下诊疗服务改善的溢出效应  

Spillover Effects of Online Paid Medical Treatment Services on Improving Offline Medical Treatment Services

作　　者：杨雪[1] 王程珏 童昱 张楠[4] YANG Xue;WANG Chengjue;TONG Yu;ZHANG Nan(School of Business,Nanjing University,Nanjing 210093,China;Jiangsu Sushang Law Firm,Nanjing 210009,China;School of Management,Zhejiang University,Hangzhou 310058,China;School of Management,Harbin Institute of Technology,Harbin 150001,China)

机构地区：[1]南京大学商学院,南京210093 [2]江苏苏商律师事务所,南京210009 [3]浙江大学管理学院,杭州310058 [4]哈尔滨工业大学经济与管理学院,哈尔滨150001

出　　处：《管理科学》2023年第3期66-80,共15页Journal of Management Science

基　　金：国家自然科学基金(72272075,71872086,72022017,71821002,72121001,72131005,92046007);南京大学文科青年跨学科团队专项(14370115);南京大学新时代文科卓越研究计划“中长期研究专项”(14914220)。

摘　　要：由于当前庞大的就医需求,中国线下医院、医生诊疗压力普遍较大,医疗资源在不同地区间的分配也不均衡,由此产生的医患矛盾日益严峻。随着“互联网+”计划的推广,互联网诊疗迅速发展成为线下就诊过程中医患辅助管理的新兴渠道。为了解在线诊疗服务对线下诊疗的影响和机制,整合有关医疗服务质量、医疗信息技术的影响和空间溢出效应等方面的研究和理论,建立在线付费诊疗对线下诊疗服务影响的理论模型,并进行实证研究,同步检验在线付费诊疗资源在区域内的溢出效应及其异质性。基于2010年至2017年长江三角洲地区的上海市、江苏省、浙江省、安徽省及其所属的41个地级市线下医疗服务数据,以及中国国内领先的互联网诊疗平台上长三角地区的互联网诊疗数据,采用描述性统计、相关性检验和多元回归分析等研究方法进行实证分析,并利用变更数据维度和引入滞后期等手段进行稳健性检验。研究结果表明,(1)互联网诊疗平台上提供的付费诊疗服务显著降低当地医院的线下服务压力和医生的人均诊疗负担,在医疗资源能力较充足的地区这种分流缓解效果更为明显;(2)提供在线付费诊疗服务能适度降低患者的医疗负担,在医疗资源能力较为不足的地区这种辐射效应影响更为明显;(3)优质医疗资源借助互联网诊疗平台在区域内具有正向溢出效应,其中,提供给来自同省和同省其他城市患者的付费诊疗服务均能显著降低医生所在城市的线下医院服务压力、医生诊疗压力和当地居民的医疗支出,进而减少患者跨地区求诊的可能性,而区域内医疗资源相对薄弱的地区享受到的平台医疗资源的溢出红利更为明显。研究结果揭示了互联网诊疗的社会价值,并就地域上的溢出效应差异进行详细分析,梳理出具体的作用机制,对区域内医疗健康发展、在线诊疗平台�Currently,the pressure of offline hospitals and doctors in China is generally high due to the huge demand for medical treatment.The distribution of medical resources among different regions is not balanced,resulting in increasingly severe doctor-patient conflicts.With the promotion of the“internet plus”plan,internet diagnosis has taken the advantage of the development and become a new channel for the assistant doctor-patient management after offline diagnosis.In order to understand the impact and mechanism of internet diagnosis on offline medical treatment services,empirical research is conducted by integrating research and theories on the quality of medical treatment services,the impact of medical information technology and spillover effect.We established an empirical model for the impact of internet diagnosis on offline medical treatment services,and simultaneously tested the spillover effect and heterogeneity of online paid medical treatment services on internet diagnosis platforms in the region.Using the offline medical service data from Shanghai,Jiangsu,Zhejiang,Anhui province and 41 prefecture level cities in the Yangtze River Delta region from 2010 to 2017,as well as internet diagnosis data from the leading internet diagnosis platforms in China.Research methods include descriptive statistics,correlation test,multiple regression analysis,and robustness test methods such as changing data dimension and introducing hysteresis period.The study results found that,(1)the provision of online paid medical treatment services on internet diagnosis platforms can significantly reduce the offline medical treatment pressure of local hospitals and the per capita treatment burden of doctors.Moreover,for areas with more sufficient medical resource capacity,the above-mentioned diversion relief effect is more obvious;(2)the provision of online paid medical treatment services on internet diagnosis platforms can moderately reduce the medical burden on patients,and the radiation effects mentioned above are more pronounced in

关 键 词：医疗健康 互联网诊疗 在线付费诊疗服务 溢出效应 诊疗压力 医疗负担 

分 类 号：F713.36[经济管理—产业经济]