医师双点/多点执业的政府管制:国际经验比较与理论探索

Government Regulations on Physician Dual Practice/ Multi-site Practice:International Comparison and Theoretical Explorations

医师在两个或多个医疗机构同时执业的现象,即"双点执业"或"多点执业",在各国的医疗系统中普遍存在,影响深远。由于对患者以及整个医疗服务体系的运行有可能存在一定的负面影响,各国政府对医师双点/多点执业推出了多样化的管制措施。这些措施一方面导致医师行为策略的改变,但另一方面也存在着管制失灵的现象。与政府直接管制相比,契约制度的完善会提供一个更好的行为规范环境。

The phenomenon of physicians practicing in two or more medical institutions, referred as dual practice or multi-site practice, widely exists in health care systems around the world and makes profound impacts. Due to its potential negative externalities on patients and the whole system, the governments in many countries impose various regulations on physician dual practice/multiple johholding. These regulations bring about the change of behavioral strategies of physicians on the one hand, and leadto some regulatory failures on the other hand. In comparison with direct government regulations, the perfection o{ contract system would provide a better environment of behavior norms.