医保支付方式影响医疗机构经济运行的机理探讨

Study on the Mechanism of Medical Insurance Payment Influencing the Economic Operation of Medical Institutions

研究从我国医疗服务体系制度设计的演变历程和医疗机构的定位,以及医疗机构的收入来源和支出方向等角度,分析了影响医疗机构经济运行的因素。以此为基础,从支付方式改变医疗机构及其人员的收入可预期性、改变医疗机构及其人员的收入水平和改变医疗机构加强管理的积极性等角度阐明了支付方式影响医疗机构经济运行的机理。最后,得出医疗机构将立足实现自身利益,利用其专业技术优势和作为一个团体的博弈能力,通过改变支付单元的数量,甚至影响其价格拟定来寻求利益最大化的结论。

Factors influencing the economical operation of medical institutions have been studied through the perspectives of medical service system＇s evolution as well as the sources of institutions＇ income and the direction of its expenditure. Based on the study, reveals the mechanism how payment influence economic operation of medical institutions. Finally, it finds out that the medical institutions will use their professional and technical advantages as a group, change the number and price of the payment unit to maximize their benefits.