多任务委托代理分析框架下取消药品加成后对公立医院医生不同行为的激励研究

Incentive Research on Different Behaviors of Doctors in Public Hospitals under the Background of Abolishing Drug Price Addition:A Mutitask Principal-Agent Analytical Framework

目的:分析影响公立医院医生不同行为努力水平和最优激励系数的因素,为完善公立医院激励机制提供合理化建议。方法:多任务委托代理理论的模型化方法。结果:医生不同行为的努力水平与医生努力的成本系数、不同行为给医生带来的边际激励有关,而医生在不同行为上的最优激励系数取决于政府的边际收益、医生努力的成本系数、政府对医生行为的可监督性和医生的绝对风险规避度。此外,医生会对政府激励性高、风险与投入成本较小的行为付出更多努力。结论:完善公立医院医生激励机制应从财政补偿、管理体制、政府监管、医生抗风险能力等方面着手。

Objective:To analyze the factors affecting the different behavior effort level and the optimal incentive coefficient of doctors in public hospitals.so as to provide reasonable suggestions for improving the incentive mechanism of public hospitals.Methods:Modeling method of multi task principal-agent theory.Results:The effort level of doctors’ different behaviors is related to the cost coefficient of doctors’ efforts and the Marginal Incentive brought by different behaviors to doctors,and the optimal incentive coefficient of doctors’ different behaviors depends on the marginal income of the government,the cost coefficient of doctors’ efforts,the supervision of doctors’ behaviors by the government and doctors ’ absolute risk aversion.In addition,doctors will decide the level of effort according to the relative importance of economic behavior and public benefits behavior,and will make more efforts for behaviors with high government incentive and low risk and investment cost.Conclusion:It is proposed that improving the incentive mechanism of doctors in public hospitals should start from the aspects of financial compensation,management system,government supervision,doctors ’ anti risk ability and so on.