竞争,质量和综合医疗保健
Kurt R Brekke1, Luigi Siciliani2, Odd Rune Straume3
1Department of Economics, Norwegian School of Economics (NHH), Helleveien 30, N-5045 Bergen, Norway.
Journal of health economics
|April 4, 2024
概括
医疗保健服务整合可以改善护理协调,但可能会减少竞争,影响服务质量. 对患者结果的净影响取决于竞争力和服务质量的变化.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
- 医疗服务研究 医疗服务研究
背景情况:
- 医疗保健服务整合是提高护理质量和协调的全球战略.
- 医疗服务提供商经常在质量上竞争,以吸引受监管的定价结构内的患者.
研究的目的:
- 调查医疗保健服务整合对护理质量的影响.
- 分析整合,竞争和患者选择之间的相互作用.
主要方法:
- 在价格管制下提供商竞争的经济建模.
- 分析整合对质量和协调的影响.
- 检查提供商和服务的不对称性.
主要成果:
- 整合可以通过捆绑支付提高协调利能力,但可能通过限制患者选择来软化竞争.
- 整合对质量的影响有所不同:它可以提高某些服务的质量,同时降低其他服务的质量,尤其是在没有协同作用的情况下.
- 对健康益处的整体影响取决于服务之间的质量分散与融合.
结论:
- 医疗保健整合在改善协调和潜在减少竞争之间存在复杂的权衡.
- 对质量和患者结果的净影响取决于特定的市场结构,提供者的行为,以及竞争减弱的程度.
- 竞争的削弱是一个关键因素;如果最小,整合更有可能带来更好的质量和患者的结果.
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