公立医院“三重垄断”与医疗行业效率——基于我国省际面板数据的研究

Public Hospitals Threefold Monopoly and Medical Industry Efficiency——Based on China's Provincial Panel Data

一直以来,处于垄断地位的公立医院主导着我国医疗服务供给市场。随着我国新一轮医药卫生体制改革的深入开展,提升公立医院经营效率、优化医疗资源配置已成为新时代改革的重点。本文揭示了公立医院的"三重垄断"属性及其助长"看病难、看病贵"现象的经济学逻辑,并采用前沿的Bootstrap-DEA方法,实证研究了我国2010至2014年公立医院垄断对医疗机构经营效率的影响。研究发现:公立医院在数量占比上的减少对于医院系统经营效率的提升有促进作用,而公立医院在门诊、住院两大核心业务上的垄断势力与医院系统经营效率的关系不明显。

For a long time,public hospitals have been in a monopolistic position and led the supply market of medical services in China.With the further development of the New Healthcare Reform of China,improving the efficiency of public hospitals and optimizing the allocation of medical resources has become the key of China’s reform.This paper reveals the"threefold monopoly"property of Chinese public hospitals,and the economic logic that how the"threefold monopoly"property promotes the phenomenon that"too difficult and too expensive to see a doctor".This paper also performs an empirical analysis with Bootstrap-DEA approach and China’s provincial panel data.The results find that decreasing in the proportion of public hospital number has a positive effect on the promotion of hospital-system efficiency,but in medical-services aspect there is not obvious relationship between the monopoly power of public hospitals and the hospital-system efficiency.