衡量初级保健领域的竞争-来自瑞典的证据
Sofie Vengberg1, Mio Fredriksson1, Ulrika Winblad1
1Health Services Research, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
PloS one
|July 15, 2024
概括
定义当地医疗保健市场是竞争改革的关键. 一种新的可变形状方法更好地捕捉了瑞典的初级保健竞争,揭示了许多需要政策关注的断.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健市场分析
- 主要护理政策的第一阶段.
背景情况:
- 医疗保健改革往往旨在通过提供者竞争来提高质量和效率.
- 当地医疗保健市场的空间定义 (例如,固定半径的圆圈) 可能不准确地反映实际的市场状况.
- 关于初级保健市场竞争的研究有限,这是医疗保健的关键组成部分.
研究的目的:
- 为医疗保健竞争分析完善当地市场的地理定义.
- 调查瑞典初级保健机构中提供者竞争的程度.
主要方法:
- 一项横截面研究利用了瑞典个人和初级保健提供者的综合数据.
- 使用固定半径 (1公里,3公里),可变半径和一种新的可变形状方法来定义当地市场.
- 使用赫芬达尔-希尔施曼指数和竞争对手计数量化了竞争.
主要成果:
- 固定半径市场定义不充分反映了竞争中的地理差异.
- 可变半径和可变形状方法显示了相似之处,但确定了不同的竞争者和竞争水平.
- 瑞典的初级保健在竞争中表现出很大的差异,有很多断和高度竞争的市场.
结论:
- 可变形状的市场定义显示了准确识别实际市场和竞争对手的前景,需要进一步调查.
- 瑞典的政策制定者必须确定未来的竞争促进和解决断性初级保健市场的条件.
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