多重道德风险下公立医院大型医用设备过度投资形成动因分析

An analytic framework on over-investment of large medical equipment in public hospitals under multiple moral hazards

本文结合我国公立医院的制度安排,基于委托代理理论的分析框架,从医院内部决策环节和外部政府审批环节对其大型医疗设备过度投资的形成动因进行理论分析,得出结论:在当前制度安排下,各代理人都存在严重的道德风险,即患者存在过度消费道德风险,医生存在诱导需求道德风险,医院管理者存在声誉、控制权等道德风险以及政府部门官员代理冲突,各利益相关者都具有强烈的大型医疗设备过度投资冲动。最后文章提出通过完善和创新相关制度安排来预防和治理大型医用设备的过度投资。

This paper analyzed the moral hazard of public hospitals ＇investment stakeholders in the investment process and how to affect the hospital medical equipment over-investment from the perspective of institutional arrange-ments.The result showed that each agent has a severe moral .The impulse of over-investment from patients to doc-tors, managers, government regulators is strong .This paper also put forward the suggestions on the prevention and governance of over-investment from institutional innovation .