医院所有制与效率:以德国为关注重点的研究回顾

Hospital ownership and efficiency:A review of studies with particular focus on Germany

德国医院市场在过去20年里进行了一揽子医疗改革,特别是在2004年引进了疾病诊断相关分组——以期提高医院效率。本文旨在回顾近期就比较德国公立医院、私立非营利医院和私立营利医院效率所开展的研究。尽管研究结果错综复杂,但结合其他国家,特别是美国的研究证据,德国方面的研究结果表明:与公立医院相比,私立医院(私立非营利和私立营利医院)的运营效率并不一定就高。由于私立营利医院通常都会被认为是最有效率的所有制形式,因此本研究结果对很多决策者来说也许有些意外。

The German hospital market has been subject over the past two decades to a variety of healthcare reforms.Particularly the introduction of diagnosis-related groups（DRGs） in 2004 aimed to increase efficiency of hospitals.The objective of the paper is to review recent studies comparing the efficiency of German public,private non-profit and private for-profit hospitals.The results of the studies are quite mixed.However,in line with the evidence found in studies from other countries,especially the US,the evidence from Germany suggests that private ownership（i.e.,private non-profit and private for-profit） is not necessarily associated with higher efficiency compared to public ownership.This may be a surprising result to many policy makers as private for-profit hospitals are often perceived the most efficient ownership type by the public.