医疗领域所有制和市场竞争效果的研究评述

A review of the role of ownership and competition in health care

医疗领域的所有制和市场竞争问题是卫生经济学研究的热点之一。本文分析了现有的研究成果,主要考察两个问题的研究和所得到的结论,一是医疗服务由政府或私人提供会产生什么差异,二是医疗市场竞争会产生什么结果。总体上看,现有实证研究表明不同所有制医院在成本、质量、效率等方面的差异并没有明确的结论。而竞争在很多情况下可以起到降低医疗费用的作用,但这一作用的前提是医院激励机制的改变。本文对中国医疗改革的政策含义在于,医疗市场的所有制模式需要根据国情而定,但市场机制的作用是不可忽视的。

The ownership and market competition is one of the hottest topics in health economics. This paper reviews the related theoretic and empirical studies and explores the answers for two questions： What are the differences between public and private provision in health care？ What are the outcomes of market competition in health care market？ Generally speaking, there is no conclusive result about the impacts of ownership on cost, quality, and effiency. However, competition does have an impact on the costs conditional on the changing of incentive of hospitals. The implication to China health care reform is that the ownership structure in health care should be in accordance with the specific situation of China, but the role of competition should not be ignored.