医改中规避供方诱导需求的补偿方式研究

The Compensation Way in Health Care Reform for Evading Supplier Induced Demand

在现行的医疗保障制度中,供方诱导需求被认为是导致医疗费用上涨的重要诱因,同时也是我国医疗领域最严重的道德风险问题。医疗领域的道德风险根源于供需双方的信息不对称,因此卫生经济学认为合理的补偿方式设计是必要的。我国现行医疗保障制度中的医疗供方的道德风险问题应该引起医改部门的重视,通过效用模型分析,政府对医疗供方的补偿方式的设计应该成为政策制定的重点。结论显示,用按固定人头付费相对于现行的按项目付费制能够更有效的规避道德风险。

In the current medical insurance system, supplier induced demand is regarded as the major inducement for the increase of hos-pitalization costs and is the most serious ethical risk in the medical field. As ethical risks in the medical field are caused by information asymmetry between supply and requisitioning parties, health economics put forward that rational compensation design is necessary. Health care reform departments shall pay close attention on the ethical risks in the current medical insurance system. The design of compensation approach shall be the focus of policy making with the analysis of utility models. In conclusion, payment by capitation is a better way than payment by items in evading the ethical risks.