总额预付制对医疗供给行为的作用效应研究述评

Review on the medical provider behavior under global budget payment

支付方式改革在健康中国国家战略中扮演着重要角色。本文从总额预付制的基本理念、强化机制以及总额预付制对医疗成本、医疗供给数量、服务质量以及供给方行为变化等几个方面系统的梳理了国外相关研究成果,指出总额预付制对医疗供给行为以及除了成本控制之外的医疗系统表现,不论是理论还是实证的认知都非常有限,进一步研究需要关注发展中国家制度背景下总额预付制的市场表现及其差异、总额预付下医疗供给行为的跨期选择等问题,并改进评估总额预付市场表现方法。

The payment reform plays an important role in the Health China strategy.This article makes a review on the global budget payment from the basic concept,strengthening mechanism,as well as the medical costs,medical supply quantity,quality of service and the behavior of the supply side changes.We point out that the knowledge about medical supply behavior and the performance under global budget payment system besides cost control is very limited,neither theoretical nor empirical,further research directions should focus on market performance of global budget payment under developing countries and differences between different institutional backgrounds,and the inter-temporal choice of medical supply behavior under global budget payment,as well as the improvement of assessing method of global budget payment performance.