醫療市場競爭的測量：從市場劃區與競爭指標著手

Measuring Competition in the Health Care Market: Starting with Market Area Definition and Competition Indicators

10.6288/TJPH2008-27-04-03

陳啟禎(Chi-Chen Chen)；鄭守夏(Shou-Hsia Cheng)

市場 ； 競爭指標 ； 醫院 ； market ； competition indicators ； hospital

台灣公共衛生雜誌

27卷4期（2008 / 08 / 01）

292 - 300

繁體中文

過去有大量研究探討市場競爭對醫院行為的影響，但結論卻不甚一致，而市場競爭程度的測量為主要的因素之一，其中造成差異的來源包括市場範圍的界定與競爭指標的選取。本文回顧市場範圍界定在概念上和方法學上的演進、競爭指標的發展，以及上述兩者在實證研究上的應用情形。綜合來說，在市場區域劃分方式上，研究者應該針對不同的研究目的選定適當的市場劃區方式；在市場競爭指標方面，靜態市場競爭指標如醫院家數或賀芬達指標最常被使用，然而在探討競爭對醫院行為影響時，應該考量其適用性。

Extensive empirical literature has examined the impact of competition on hospital behaviors; however, findings were inconclusive. One of the major reasons concerns the measure of competition, primarily resulting from market area definitions and the competition indicator selection. This study reviews the conceptual and methodological evolution of market area definitions, development of competition indicators, and their empirical applications. In conclusion, hospital market areas should be defined according to particular research issues. Static competition indicators, such as the number of hospitals or the Herfindahl-Hirschman Index (HHI) have been commonly employed in previous studies. The appropriateness of these indicators should be considered, especially for studies examining the impact of competition on hospital behaviors.

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