紧密型城市医疗集团交易费用测量与评价研究

Study on Measurement and Evaluation of Transaction Costs of Compact Urban Medical Groups

目的对紧密型城市医疗集团的交易费用进行测量,并分析各利益主体对交易费用的评价。方法采用典型抽样法,以河南省郑州市J区总医院紧密型城市医疗集团为研究范例,于2024年1月19—24日,对建设方(卫生健康行政部门、牵头医院和成员单位)及相关工作人员进行问卷调查。调查内容包括机构报表、受访者基本信息、各参与主体的相关费用或成本、各参与主体工作人员对交易费用的评价等。结果2023年郑州市J区紧密型城市医疗集团的总交易费用为75811014.49元;牵头医院承担了绝大部分交易费用(98.1%);各方均认为交易费用普遍存在,但对交易费用的存在形式和分布环节的认知有显著差异(P<0.05)。结论紧密型城市医疗集团的交易费用高昂,绝大部分由牵头医院承担;各方尚未清晰认知交易费用的存在形式和分布环节;应从“正视交易费用普遍存在”“健全补偿激励机制”和“建立节约性制度供给路径”3个层面入手应对紧密型城市医疗集团的交易费用。

Objective To measure the transaction costs of compact urban medical groups and analyze the evaluation of transaction costs by various stakeholders.Methods Using the typical sampling method,it took the Compact Urban Medical Group of J District General Hospital in Zhengzhou City,Henan Province as an example.A questionnaire survey was conducted on the construction party(health administration department,leading hospital and member units)and related staff from January 19 to 24,2024.The contents of the survey included institutional statements,basic information of the respondents,relevant fees or costs of each participant,and the evaluation of transaction costs by the staff of each institutional participant.Results In 2023,the total transaction cost of District J Medical Group in Zhengzhou City was 75811014.49 yuan;the majority of transaction costs were borne by the leading hospital(98.1%);all stakeholders confirmed the existence of transaction costs in the medical group,but there were differences in the perception of the manifestations and distribution of transaction costs(P<0.05).Conclusion The transaction costs of compact urban medical group are high,most of which are borne by the leading hospital;The stakeholders have not yet clearly understood the form and distribution of transaction costs.The measures to deal with transaction costs include“facing up to the widespread existence of transaction costs”,“improving the compensation incentive mechanism”and“establishing a saving system supply path”.