地区医院集聚与医疗费用研究——基于某市11区县面板数据的实证分析

Empirical Analysis of the Iinfluence of Agglomeration Economies on Medical Cost Based on Panel Data in 11 Districts

目的:通过对浙江省某市11区(县)医院聚集和人均门诊检查检验费及医药费的增长分析,探讨区域医院聚集规模对医疗费用的影响程度。方法:采用随机截距模型对样本地区2009年~2014年的数据进行REML回归分析,地区医院床位数每增加1张,门诊患者次均检查检验费和医药费显著上涨0.006%和0.011%。结果:地区医院聚集不仅没有产生技术外溢,提高资源聚集的技术效率,反而降低了医院技术效率,促进了医疗费用的上涨。因此,政府区域卫生规划在考虑卫生服务可及性的同时,也应考虑投入绩效,减少地区医疗资源重复建设,鼓励优质医疗资源共享,提高医疗资源使用效率。

Objective To study the influence of agglomeration of hospitals on medical cost. Methods The data of medical cost in 11 cases of sampled districts from 2009 to 2014 was analyzed with random interception model. Results The agglomeration of regional hospitals had decreased the efficiency of utilization of medical resources, and increased the medical costs. Conclusion It is suggested for the government to consider the accessibility of health care and performance of input in regional health planning, encourage the sharing of high quality medical resources and improve the efficiency of utilization of medical resources.