杭州地区医疗市场结构与医院效率相关性分析

Correlation between medical market structure and hospital efficiency in the Hangzhou area

目的 了解杭州市所属 7个市 (县、区 )中心城镇医院的效率和医疗市场状况 ,为医疗市场化的推行提供理论依据。方法 对杭州市 37家医院 ,在确定医疗市场范围的基础上 ,计算各地医疗市场的HHI值。采用DEA方法测量各医院的平均效率 ,并进行平均效率与HHI值的相关性分析。结果 杭州市所属各市 (县 )的中心城镇医疗市场 ,HHI值均大于 180 0 ,属于垄断性竞争市场。 37家医院中 ,相对效率达 10 0 %的医院共 11家 ,小于 6 0 %的 11家。医疗市场的垄断性越高 ,其医院的平均效率越低。结论 建立低市场集中度的竞争市场是提高整体医院效率的有效途径。

Objective To assess the efficiency of central urban and rural hospitals in the 7 cities, counties and districts under the jurisdiction of Hangzhou City and the status of the medical markets so as to provide theoretical basis for the promotion of decentralized medical markets. Methods On the basis of defining the scope of a medical market, the HHI values of the medical markets in places where 37 hospitals in Hangzhou were located was calculated, the average efficiency of the various hospitals was measured by means of DEA, and an analysis was made on the correlation between the average efficiency and the HHI values. Results The central urban and rural medical markets in the various places surveyed, whose HHI values were all greater than 1 800, belonged to markets of monopolistic competition. Of the 37 hospitals, there were 11 whose relative efficiency reached 100% and another 11 whose relative efficiency was less than 60%. The greater the monopoly of a medical market, the lower the average efficiency of its hospitals. Conclusion Establishing competitive markets with low market concentration is an effective way of enhancing overall hospital efficiency.