醫療價格管制與公民營醫院的品質研發及製程研發

Health Care Price Regulations, and Hospitals' Product and Process R&D

10.3966/054696002019060105002

王光正(Kuang-Cheng Andy Wang)；陳柏安(Po-An Chen)；林燕淑(Yan-Shu Lin)

醫療價格管制 ； 品質競爭 ； 醫院品質研發 ； 醫院製程研發 ； Health Care Price Regulation ； Quality Competition ； Hospitals' Quality R&D ； Hospitals' Process R&D

應用經濟論叢

105期（2019 / 06 / 01）

39-72 - 71

繁體中文

在醫療價格為政府管制下，本文討論不同競爭型態下醫院的品質提升與製程創新。在Hotelling品質競爭模型下，本文得到的重要結果為：第一、在醫院利他比例對稱且不為1時，政府訂定的醫療服務價格可矯正兩家醫院品質投入不足或過多的問題，使兩家醫院的品質提升與製程創新達到社會最佳投入水準。第二、政府訂定的醫療服務價格無法矯正兩家完全公營醫院（利他比例為1）品質投入的扭曲；完全公營醫院決定的品質水準會高於政府決定的最適品質水準。第三、在利他比例不對稱下，公營醫院（利他比例較高）的品質提升與製程研發投入量皆高於民營醫院（利他比例較低）兩者的投入量。政府訂定的醫療服務價格只能部分矯正一公營一民營市場下的多重扭曲，此時僅有次佳（second best）選擇。在政策意涵上，我們的結果顯示，若從品質提升與製程創新的角度來看，如果政府可以訂定醫療價格，則只要兩醫院利他比例程度一樣就可達社會最適品質提升與製程創新。

This study aims to compare quality and process R&D of hospitals under different competitive regimes, in which the price of health care service is regulated by a government. We obtain the following results under a Hotelling location model. Firstly, quality and process R&D investments of two hospitals could be the social optimal level under the regulated price if the degree of altruism of hospitals are symmetric but not equal to 1. Secondly, quality R&D of two perfectly public hospitals (the degree of altruism=1) would be overinvested even under regulated price. Lastly, provided that the degrees of altruism of two hospital are not equal, quality and process R&D investments of the public hospital (the more altruistic one) are both more than those of the private hospital (the less altruistic one) under the regulated price. This solution shows that only the second best levels of the quality and process R&D investments can be reached if there are multi distortions in a mixed oligopolistic health care market. The policy implication of this study is that, on the aspect of quality and process R&D investments of hospitals, given that the degrees of altruism are asymmetric, the social optimal quality and process R&D investments could be achieved if the health care price is regulated by the government.

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