摘要
本文目的旨在探究中国医疗费用过快增长的原因,指出医疗管理制度缺陷对社会医疗成本上升的影响。通过构建中国医疗行业的＂鲍莫尔成本病＂变量,提出行业中＂以药养医＂的代理变量,采用2002—2011的省级面板数据,验证了＂鲍莫尔变量＂和＂以药养医＂变量对医疗成本增长的影响机制。采用因素分解方法发现,鲍莫尔＂成本病＂贡献了医疗成本上升的8%~22%左右,而＂以药养医＂机制中住院率增长和过度用药上升导致了医疗成本上升5%左右。研究拓展了以往政策性研究对医疗成本上升的解释,并为医疗行业的成本核算制度、成本信息披露制度,以成本控制为医院绩效考评关键指标的激励机制的建设提供了实证证据。
The object of this paper is to understand the reasons of the excessively rapid increasing of the medical expense,and to explore the impact of the defect of healthcare administration on social healthcare cost. The'Baumol disease variable' is put forward to measure the unreasonable increase of labor costs in Chinese medical industry. Furthermore,the paper points out drug-dependent hospital operation are another factor to raise the abnormal costs of social health. Correspondingly,some proxy variables are proposed. An empirical model based on China's provincial panel data over the 2002-2011 periods shows the 'Baumol disease variable' and 'medicine for the medical representatives of variable effects on increase of medical costs. The analysis,based on factor decomposition method,reveals 'Baumol's cost disease' contributes around 8% to 22% of rising health care costs,and the drug-dependent hospital operation led to rising health care costs by about 5%. Expanding on the previous research approach,this study draws on the 2sls instrument variable estimation approach to identify the link between the healthcare administration institutional defects and the social healthcare cost increase. The study provides evidence for reforms of healthcare cost information disclosure,cost accounting and accountability in China's healthcare industry.
出处
《公共管理学报》
CSSCI
北大核心
2015年第1期84-93,156-157,共10页
Journal of Public Management
关键词
鲍莫尔“成本病”
以药养医
社会医疗成本
Baumol's Cost Disease,Drug-dependent Hospital Operation,Social Health Cost
