医疗费用的供方成本分担及其启示

Provider Cost-sharing of Medical Expenditure and Its Implications

医疗费用的支付方式对于控制医药费用的上升具有重要作用,采用需方成本分担来控制医疗费用会加重患者的财务负担,却未必能控制费用增加。而采用供方成本分担则会促进医院之间的竞争,将遏制医疗费用的过快上升。大多数国家正在使用或努力采用可以同时给医疗服务的消费者和提供者都提供激励的支付方式。我国通常采用按服务项目收费,仅仅强调对需方医疗费用的控制,忽视对供方的成本分担,导致医疗费用快速上升。在医疗体制改革过程中,应当注重对供方成本分担的激励。

The payment system plays a key role to control medical expenditure. Relying on demand- side cost sharing will impose financial risks on consumers, yet it will not necessary to succeed in containing the cost. While the supply-side cost sharing will bring competitions to the providers in keeping cost down. More and more countries have implemented the mixed payment system to provide incentives for both sides. The commonly- used fee-for-service payment in China, which only relies on demand-side cost sharing, neglects the supply-side cost sharing and should be modified in further reform.