市场结构、医疗保险与医疗费用的关系研究 本期目录 >>
Title: Relations on Market Structure,Health Insurance and Medical Expenses
作者 张平;徐兵;甘筱青
Author(s): ZHANG Ping; XU Bing; GAN Xiaoqing
摘要: 本文构建了全民医保环境下由一家基层医院和一家综合医院组成的两级医疗服务系统。应用两层决策模型研究不同医疗市场结构下医疗保险对医疗服务价格和医疗总费用的影响,最后进行了数值模拟,对医保报销比例和患者选择偏好进行敏感性分析。研究发现:医疗总费用比率报销模式要优于医疗服务量补贴模式;当医疗供给方具备定价能力时,医疗保险的引入会导致医疗服务价格的上升和社会医疗总费用的增加;而医疗竞争市场能在一定程度上遏制医保带来的医疗价格膨胀效应,但受到患者选择偏好的影响。因此,要重视建立分级医疗体系,提高基层医院医疗服务能力和服务水平,对于不同层级医院的医保报销病例进行严格规定,并实施严格的审查监督制度,才能真正提高医保资金的使用效率,切实帮助患者减轻医疗负担。
Abstract: Though universal medical insurance system had been preliminary established in China, individual self-paying medical expense ratio has moved steadily downwards, the total health expenses of the whole society and the amount of the patients’ average self-paying were in substantial increase. So in this paper the effect of medical insurance on medical health price and medical expenses is studied in the different market structure by using two-phase game model. By analyzing the interaction between medical service systems composed of general hospital and primary hospital, it is compared to the medical group in which all decision are made to maximize the whole revenue. It is found that health insurance would cause health care price inflation and offset the effect of health insurance if the hospital has market power, and the effect will be weakened in a competitive market but influenced by the patients’ preferences on primary hospital.
关键词: 市场结构 ; 医疗保险 ;医疗费用;博弈论
Keywords: market structure;; medical insurance; medical expense; game theory
基金项目: 国家自然科学基金;江西省社会科学规划重点资助项目
发表期数: 2018年 第2期
中图分类号: 文献标识码: 文章编号:
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