市場競爭程度對醫院行為的影響 -- 以昂貴醫療處置 採用為例
醫療服務市場的特殊性，包括資訊不對稱、保險的介入、不確定性等
等，長期以來讓經濟學家認為可能造成醫療服務市場將會脫離一般市 場法則，這也是衛生主管機關強力介力醫療服務市場最重要的原因之 一。然而若是醫療服務市場雖然具備一些異於一般市場的特性，但卻 仍然沒有脫離一般經濟學的法則，也許政府仍可透過自由競爭的結果
，讓醫療服務市場的效率提高，進而降低總體的醫療成本。
本研究旨在檢視臺灣醫院服務市場昂貴醫療處置的採用是否與市場競 爭程度有關，也就是醫院競相採用醫療儀器及設備，造成無效率的醫 療品質（ inefficient quality ）及總體醫療費用的上漲。初步研究結果 發現，競爭程度愈高的地區，醫院採用昂貴醫療儀器或手術的可能性 愈高，而平均醫療費用亦越高。
本研究建議未來衛生政策制定時應考量此一因素，在醫院服務產業高 度競爭的情況下加強儀器設備的共同使用，並透過制度的改變，以降 低無效率的昂貴醫療處置採用。
The Impact of Competition on Hospital Behavior--E vidences from the Adoption of Expensive Procedur
es
For a long time, economists think that the health services market won’t acc ord with the general rules because of the information asymmetry, insurance , and the uncertainty. Also, it’s the main reason of the government interven tion. However, if the health services market accords with the general rules, we can promote the efficiency even reduce the total health expenditure thro ugh competition without government intervention.
This study examines if the adoption of expensive medical procedures relate d with the degree of competition in Taiwan, which results in the inefficient quality and the rising health expenditure possibly. The results show that ho spitals in more competitive environment tend to adopt the expensive proce dure, which also have higher health expenditure.
We suggest that the phenomenon must be considered when the health polic y formed in the future. To reduce the inefficiency, the government should promote the share of the medical procedure between hospitals and change t he payment system.
