广东省省市级综合医院最优规模实证研究

目的测量广东省省市级综合性医院最优规模,对比分析国外情况,分析差异产生的原因。方法应用适存分析法,数据为1995年～2004年10年间广东省省市级综合医院的医院数量百分比和医院产出百分比。结果规模超过700张病床的医院显示出规模经济。随着医院规模越来越大,规模经济的作用更加明显。结果与国外显著不同。结论最优规模对医院与社会有不同含义。我国医院持续扩大规模的原因,可能来自于人口多带来的医疗市场规模扩大和缺乏有效的医疗费用支付机制。两种原因对卫生政策有不同涵义,建议做进一步研究。

Empirical study on the optimal scale of provincial and municipal general hospitals in Guangdong province

Objective To measure the optimal scale of provincial and municipal general hospitals in Guangdong province,compare it with foreign countries,and analyze the reasons for the differences. Methods The number percentage and output ratio of provincial and municipal general hospitals in Guangdong province during 1995-2004 were analyzed by method of survival analysis.Results The hospi tals with more than 700 beds showed scale economies.The effect of scale economies was more obvious with the increase of hospital scale.There was significant difference between China and foreign countries. Conclusions The optimal scale means different for the hospital and the society.The reasons for expan sion of hospital scale in China may be the expansion of medical market due to population growth and the lack of effective payment mechanism for medical expenses.The two reasons have different meanings for health policy and should be further studied.