“医药分开”政策对医疗费用的影响机制探索——医生收入、医院收入的中介效应

The Influence Mechanism of Separation of Clinic from Pharmacy on Medical Expense——Mediated Effects of Doctor Income and Hospital Income

论文以医生和医院收入为中介变量,对"医药分开"政策对医疗费用的影响机制进行了实证研究。结果显示:"医药分开"政策通过影响医院和医生收入,间接影响医疗费用及资源配置效率;相较于卫生财政补贴,提升医疗服务价格对收入的激励效果更显著;医院和医生收入的增加,将促使医疗费用进一步上涨;相较于补贴医生收入,补贴医院收入能够延缓医疗费用的上涨趋势。进一步研究表明:应将医院和医生收入作为提升医疗资源配置效率的主要因素;将理顺医疗服务价格作为合理化医院和医生收入的主要举措;为防止医疗费用过快上涨,仍需加大政府卫生投入力度,且应侧重对医疗机构的补偿;通过财政补贴改善医院收入,是现阶段延缓医疗费用,尤其是人均医疗费用过快上涨的最有效的方式。

This paper explores the influence mechanism of ＂Separation of Clinic from Pharmacy＂policy on medical expense using doctor income and hospital income as mediators. The results show that,the policy affects medical costs and resource allocation efficiency indirectly via hospital and doctor income; compared with the health financial subsidies,improving the medical service price is more significant for income; an increase in income of hospitals and doctors will lead to further rise in medical costs; compared to the subsidies to doctors,hospital income subsidies can reduce medical costs rising trend. Further research shows that： we need to regard the hospital and doctor income as the main factors to improve the medical resource allocation efficiency; to rationalize the price of medical services as the main measure of the rationalization of the hospital and doctor income; in order to prevent the medical costs rising too fast,still need to increase government health investment,especially focus on medical institutions compensation; the most effective way of reducing costs rising currently is to improve the hospital income by subsidies.