本文選題：醫(yī)療市場(chǎng) + 非對(duì)稱信息��； 參考：《武漢大學(xué)》2014年博士論文

【摘要】：隨著我國(guó)醫(yī)療改革的逐漸展開,醫(yī)療資源變得越來(lái)越豐富。但是“看病貴、看病難”的問(wèn)題并沒有得到有效的解決,反而有惡化的趨勢(shì)。盡管城市里的大醫(yī)院越來(lái)越多,規(guī)模也越來(lái)越大,但是患者到大醫(yī)院就診時(shí)需要等待的時(shí)間卻越來(lái)越長(zhǎng)。這一方面是由于人們更關(guān)注自身的健康問(wèn)題,因此對(duì)醫(yī)療服務(wù)的需求增加,另一方面也是由于醫(yī)療市場(chǎng)的體制存在問(wèn)題。本文主要討論醫(yī)療市場(chǎng)上的信息問(wèn)題對(duì)醫(yī)患關(guān)系、醫(yī)生行為以及醫(yī)療市場(chǎng)的影響。 本文的第一章是緒論部分。第二章主要是對(duì)非對(duì)稱信息以及激勵(lì)理論的一個(gè)綜述,簡(jiǎn)要回顧了非對(duì)稱信息理論的基本分析框架。第三章則是對(duì)醫(yī)療市場(chǎng)上的非對(duì)稱信息問(wèn)題的理論概覽和現(xiàn)狀描述,研究了醫(yī)療市場(chǎng)上不對(duì)稱信息的幾種不同的形式、非對(duì)稱信息對(duì)醫(yī)療市場(chǎng)的影響、信息披露解決非對(duì)稱信息問(wèn)題的效果以及我國(guó)醫(yī)療改革進(jìn)程中的激勵(lì)機(jī)制演變。 第四章到第七章從不同的角度闡述非對(duì)稱信息對(duì)醫(yī)生行為以及醫(yī)療質(zhì)量的影響。第四章分析不完全信息下的市場(chǎng)需求及其對(duì)醫(yī)療市場(chǎng)競(jìng)爭(zhēng)的影響�；颊咝枰罁�(jù)醫(yī)院的質(zhì)量來(lái)選擇合適的醫(yī)院,但是他們能夠獲得的關(guān)于醫(yī)院服務(wù)質(zhì)量的信息是不確切的,因此即使是質(zhì)量較低的醫(yī)院也不會(huì)失去全部患者。這種不對(duì)稱信息下的醫(yī)療市場(chǎng)結(jié)構(gòu)會(huì)影響醫(yī)院之間的質(zhì)量競(jìng)爭(zhēng)。結(jié)論是,只有當(dāng)醫(yī)院之間的服務(wù)質(zhì)量相差不大時(shí),醫(yī)院才有改進(jìn)質(zhì)量的動(dòng)力；而且,在通過(guò)醫(yī)療市場(chǎng)改革使得信息獲取變得容易時(shí),醫(yī)院改進(jìn)質(zhì)量的傾向會(huì)變得更強(qiáng)。 為了改善非對(duì)稱信息帶來(lái)的不利影響,醫(yī)療市場(chǎng)上的供給方會(huì)設(shè)計(jì)各種制度來(lái)解決問(wèn)題。第五章分析了醫(yī)院將規(guī)模作為信號(hào)發(fā)送機(jī)制導(dǎo)致的不均衡供求關(guān)系。產(chǎn)生這個(gè)問(wèn)題的原因一方面是患者對(duì)自身的疾病狀況不了解,另一方面則是患者的風(fēng)險(xiǎn)規(guī)避傾向。兩方面的原因使得患大病的患者不愿意選擇低水平醫(yī)院,而患小病的患者則愿意選擇高水平醫(yī)院。當(dāng)醫(yī)院的大規(guī)模對(duì)患者而言意味著高水平時(shí),大醫(yī)院就會(huì)一直處于供不應(yīng)求的狀態(tài)。 第六章分析了當(dāng)醫(yī)院把創(chuàng)新用作信號(hào)發(fā)送的機(jī)制是帶來(lái)的問(wèn)題。新的診療技術(shù)對(duì)患者而言往往意味著更高水平的診療水平,從而可以幫助醫(yī)院吸引更多患者。但是,新技術(shù)并不一定意味著高水平的技術(shù),而非對(duì)稱信息環(huán)境下患者并不能了解藥物的真實(shí)療效。制藥企業(yè)可以利用這種非對(duì)稱信息進(jìn)行無(wú)效創(chuàng)新(即實(shí)際上不能提高療效的創(chuàng)新)來(lái)誘導(dǎo)患者購(gòu)買新藥,進(jìn)而獲取利潤(rùn)。對(duì)競(jìng)爭(zhēng)市場(chǎng)而言,這種無(wú)效創(chuàng)新會(huì)帶來(lái)過(guò)多的購(gòu)買,帶來(lái)市場(chǎng)的福利損失。 第七章分析非對(duì)稱信息下對(duì)醫(yī)院(及醫(yī)生)對(duì)人力資本投資與市場(chǎng)宣傳投資的選擇。之所以出現(xiàn)這種選擇,是因?yàn)橘|(zhì)量的改進(jìn)需要花很長(zhǎng)的時(shí)間才能被患者了解,進(jìn)而為醫(yī)院帶來(lái)收入,而廣告宣傳投資則有助于更快地建立知名度。但是廣告宣傳帶來(lái)的知名度需要高水平的診療質(zhì)量來(lái)維持。因此,醫(yī)院需要在短期收益和長(zhǎng)期收益之間進(jìn)行權(quán)衡。除此之外,“干中學(xué)”現(xiàn)象的存在使得醫(yī)院有更強(qiáng)的傾向選擇市場(chǎng)宣傳投資,因?yàn)閺V告宣傳投資可以使醫(yī)院有臨床實(shí)踐機(jī)會(huì),進(jìn)而可以逐漸提高自身的診療水平。 第八章對(duì)全文進(jìn)行了總結(jié)與討論。
[Abstract]:With the gradual expansion of medical reform in China, medical resources have become more and more rich. But the problem of "expensive medical care, difficult to see the doctor" has not been effectively solved, but it has a worsening trend. Although the large hospitals in the city are increasing, the scale is getting bigger and bigger, but the time for the patients to be waiting for the hospital is getting more and more This is because people pay more attention to their own health problems, so the demand for medical services increases, and the other is the problem of the medical market system. This paper mainly discusses the effects of information on medical market, doctor behavior and medical market.
The first chapter of this article is the introduction part. The second chapter is a summary of asymmetric information and incentive theory, and briefly reviews the basic analysis framework of asymmetric information theory. The third chapter is a theoretical overview and current situation description of asymmetric information in medical market, and studies several kinds of asymmetric information on medical market. Different forms, the impact of asymmetric information on the medical market, the effect of information disclosure to solve asymmetric information problems and the evolution of incentive mechanism in the process of medical reform in China.
From the fourth chapter to the seventh chapter, the influence of asymmetric information on doctors' behavior and medical quality is explained from different angles. The fourth chapter analyzes the market demand under incomplete information and its impact on the medical market competition. Patients need to choose the suitable hospital according to the quality of the hospital, but they can obtain the quality of hospital service. The information is not accurate, so even the lower quality hospital will not lose all the patients. The medical market structure under the asymmetric information will affect the quality of the hospital. The conclusion is that only when the quality of service between hospitals is small, the hospital has the power to change the quality; moreover, it is through the medical market. When reform makes information access easier, the tendency to improve the quality of hospitals will become stronger.
In order to improve the adverse effects of asymmetric information, the supply side in the medical market will design a variety of systems to solve the problem. The fifth chapter analyzes the disequilibrium supply and demand relationship caused by the hospital scale as a signaling mechanism. The reason for this problem is that the patient is not aware of the disease status of the patient, on the other hand, The patient's risk aversion. Two reasons make the patients suffering from a large illness reluctant to choose a lower level hospital, and the patients with a small illness are willing to choose a high level hospital. When the hospital's large scale means a high level to the patient, the large hospital will always be in a state of short supply.
The sixth chapter analyses the problems that the hospital brings about when it is used as a signal transmission mechanism. The new diagnostic techniques often mean a higher level of diagnosis and treatment for the patient, which can help the hospital attract more patients. However, the new technology does not necessarily mean a high level of technology, but the patient is not in the asymmetric information environment. Understand the real effects of drugs. Pharmaceutical companies can use this asymmetric information to make null innovation (i.e., actually not improve the effectiveness of innovation) to induce patients to buy new drugs, and then gain profits. For the competitive market, this invalidity innovation will bring too much purchase and bring the welfare loss of the market.
The seventh chapter analyzes the choice of investment and marketing of human capital and market for hospitals (and doctors) under asymmetric information. The reason for this choice is that the improvement of quality takes a long time to be understood by the patient, and then brings income to the hospital. In addition to the existence of the phenomenon of "secondary school", hospitals have a stronger tendency to choose market publicity investment, because the advertising propaganda can make the hospital have clinical practice opportunities, And you can gradually improve the level of diagnosis and treatment.
The eighth chapter is a summary and discussion of the full text.
【學(xué)位授予單位】：武漢大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R197.3

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本文編號(hào)：1927506