公立医疗机构比私立医疗机构更利他吗？

Is the Public Medical Sector More Altruistic Than the Non-Public Counterpart?

为了研究不同所有制医疗机构的利他性,本文使用相关调查数据对农村地区新农合受访者门诊费用、药品费用及其各自付比进行回归分析。结果显示:在基层公立医疗机构看门诊所产生的医疗总费用、总费用自付额均显著地高于基层非公立医疗机构,而这一差异可能源自总费用中的非药品费用;相比基层非公立医疗机构,患者在基层公立医疗机构看门诊拥有更高的总费用报销比。以上结论不满足公立医疗机构降低患者医疗费用利他性假设,因此本文建议更加深化医疗改革,促进非公立医疗机构发展、提升患者福利。

This paper studies the altruism of the government-owned medical institutions,by examining the impact of medical institution ownership on outpatient costs,medication costs and their respective out-of-pocket ratio of the new rural cooperative medical insurance（NCMI） beneficiaries.The empirical evidence shows that：（1） public grassroot medical facilities increase outpatient costs and out-of-pocket medical expenses significantly,suggesting that public medical grassroot facilities seek economic profit through non-pharmaceutical methods by taking advantage of NCMI;（2） outpatients have more medical reimbursements in public grassroot medical facilities.These conclusions do not satisfy the altruism hypothesis in public medical sector.So it＇s important to deepen medical reform to develop non-public medical sector and improve patients＇ welfare.