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
The Impact of Competition on Hospital Behavior--Evidences from the Adoption of Expensive Procedures
中文摘要
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。
英文摘要
For a long time, economists think that the health services market won’t accord with the general rules because of the information asymmetry, insurance, and the uncertainty.
Also, it’s the main reason of the government intervention. However, if the health services market accords with the general rules, we can promote the efficiency even reduce the total health expenditure through competition without government intervention.
This study examines if the adoption of expensive medical procedures related with the degree of competition in Taiwan, which results in the inefficient quality and the rising health expenditure possibly. The results show that hospitals in more competitive environment tend to adopt the expensive procedure, which also have higher health expenditure.
We suggest that the phenomenon must be considered when the health policy formed in the future. To reduce the inefficiency, the government should promote the share of the medical procedure between hospitals and change the payment system.
