信息不对称背景下医患关系的伦理学思考

分析了信息不对称条件下的医患关系,从伦理学角度阐述了医患信息不对称导致医患之间道德风险的成因及防范原则,并从医务人员、患者、政府三方对道德风险的防范提出建议。     

城镇居民医疗保险中道德风险的防范与控制

诱导需求、过度消费和医患合谋等诱发的道德风险,严重影响了城镇居民医疗保险事业的健康发展.信息不对称是道德风险产生的根源,疾病治疗的不确定性为道德风险提供了滋生的土壤,传统付费方式的缺陷和以药养医的医疗服务价格补偿机制是引发道德风险的外部条件和内部动因.要加强对医疗服务供方和需方的有效约束与控制,增加博弈成本,防范和控制道德风险,推动城镇居民医疗保险事业持续、稳定、快速发展.     

信息不对称条件下患者的医疗消费行为

运用信息不对称理论，依据医学科学与医疗消费的特点，分析了患者医疗消费行为，以及产生的问题，并提出了应对措施。     

社会医疗保险的信息不对称问题探析

文章以第4次国家卫生服务调查结果及相关数据为依据,指出社会医疗保险中存在逆向选择和道德风险两类信息不对称困境.结合国际社会经验和我国国情,对信息不对称的防范机制做一定的探讨.     

信息不对称条件下患者择医就诊原因分析

在信息不对称条件下．患者选择医院就诊的原因是多方面的。笔者通过调查分析得知,患者的性别、年龄、文化程度、职业和月收入与择院原因、信息渠道、就诊预期和满意度等均有关系。     

信息不对称对医患关系的不良影响及其改善策略

医患间信息不对称源于医疗服务的不确定性、信息搜寻的高成本性和患者专业知识的匮乏等原因。医患间信息不对称容易引发医院从自身利益出发损害患者利益的道德风险,也导致患者在医疗市场中的逆向选择,从而无法通过消费者的选择对医院形成有效约束。缓解信息不对称,需要建立信息披露制度、构建医疗服务市场信誉机制,医院也要将信息沟通纳入日常管理。     

论我国医疗服务市场中的信息不对称

信息不对称是医疗服务市场中存在的现象,容易导致供给诱导需求、医疗服务和药品消费不合理以及医疗纠纷等。本文提出通过信息披露、第三方介入、激励机制建设、声誉机制建设、论理与道德约束等措施,来规范医疗服务市场,促进医药卫生体制改革顺利进行。     

信息不对称视野下的全科医生制度

我国目前医疗体系的一个显著特点就是医生与病人的关系基本上是随机配对,一次性的医患关系,医生面临着创收与医生的专业服务价值被低估的压力,形成了严重扭曲的医生激励与控制机制,导致了一系列难以解决的医疗问题,如“红包”、“用药过量”、“药价虚高”、“药品回扣”和“医患关系紧张”等。建立全科医生制度,在医生与患者之间建立起一个能够长期合作的关系,将形成良好的医生激励与控制机制,改善或解决目前存在的医患关系紧张等一系列问题,为建设和谐社会创造有利条件。1 医疗市场是一个信息明显不对称的市场信息不对称理论认为参与市场交易活动的人不具有完全     

信息不对称下公立医院过度医疗的治理

过度医疗作为医疗实践中的不良现象,是引发医疗纠纷和“看病贵”的重要原因。从信息不对称的角度,通过分析我国公立医院过度医疗治理现状,找出当前我国公立医院过度医疗治理存在的问题,提出信息不对称下公立医院过度医疗的治理模式。以期从根本上遏制公立医院过度医疗问题的发生。     

如何防范医疗保险中的道德风险

存在信息不对称的医疗保险市场很容易产生道德风险。在我国,医疗保险中的道德风险问题一直表现得非常突出,医生和患者为了各自利益的最大化而过度提供或过度索取医疗服务,造成了医疗费用不合理的大幅度增长,也带来了医疗资源的大量浪费。文章通过探讨在医疗保险中道德风险的表现、成因及其影响,对道德风险的防范提出了相应的对策。     

信息不对称对构建和谐医患关系的影响及对策:基于经济学的分析

在医学诊疗过程中,医患双方存在着医疗信息分布和掌握的不对称,这种情况直接影响着医患信任的建立和患者对医疗效果的评价.本文从经济学视角探讨了减少医患信息不对称程度,构建和谐医患关系的设想.     

论新型农村合作医疗制度的道德风险与对策

新型农村合作医疗制度同保险制度一样，也存在着道德风险的缺陷，文章说明了新型农村合作医疗制度中道德风险的概念与产生机理，提出了减少新型农村合作医疗中道德风险的对策。     

医疗保险中的道德风险分析与控制

医疗保险中的道德风险表现形式多种多样。文章从患方、医方两个方面分析了医疗保险中道德风险产生的具体原因，并从医方、保方、患方三个方面提出了一系列控制医疗保险中道德风险的政策措施。     

Moral hazard and selection for voluntary deductibles

This paper investigates whether the voluntary deductible in the Dutch health insurance system reduces moral hazard or acts only as a cost reduction tool for low‐risk individuals. We use a sample of 14,089 observations, comprising 2,939 individuals over seven waves from the Longitudinal Internet Studies for the Social sciences panel for the analysis. We employ bivariate models that jointly model the choice of a deductible and health care utilization and supplement the identification with an instrumental variable strategy. The results show that the voluntary deductible reduces moral hazard, especially in the decision to visit a doctor (extensive margin) compared with the number of visits (intensive margin). In addition, a robustness test shows that selection on moral hazard is not present in this context.     

Reverse payments,patent strength,and asymmetric information

Reverse payments (pay‐for‐delay) are payments from an originator to a generic pharmaceutical producer to settle a potential litigation. In many jurisdictions, these payments are banned. This study shows that when the parties' investments are considered and the information about the patent strength is asymmetric, reverse payments increase both the possibility of generic entry and the litigation rate—both of which increase consumer surplus and do not necessarily delay generic entry. Reverse payments typically increase consumer surplus when the asymmetry between the parties is low, the competitiveness in the market is soft, and their size is small. Results suggest that a ban per se may be suboptimal.     

Optimal compensation rule under provider adverse selection and moral hazard

Although healthcare provider payments have been studied extensively in the literature, little is known about the optimal compensation rule when, in addition to unobservable provider effort (moral hazard), the provider's ability type is also private information (adverse selection). We find that when only provider effort is unobservable, to induce the first‐best outcome the optimal compensation rule requires zero fee‐for‐service. When both provider moral hazard and adverse selection exist, the first‐best outcome will be infeasible. The second‐best compensation rule entails combined use of capitation, fee‐for‐service, and pay‐for‐performance.     

Mortality effects of containing moral hazard: Evidence from disability insurance reform

We exploit an age discontinuity in a Dutch disability insurance reform to identify the health impact of stricter eligibility criteria and reduced generosity. Our results show substantial adverse effects on life expectancy for women subject to the more stringent criteria. A €1,000 reduction in annual benefits leads to a 2.4 percentage points higher probability of death more than 10 years after the reform. This negative health effect is restricted to women with low pre‐disability earnings. We find that the mortality rate of men subject to the stricter rules is reduced by 0.7 percentage points. The evidence for the existence of substantial health effects implies that policymakers considering a disability insurance reform should carefully balance the welfare gains from reduced moral hazard against losses not only from less coverage of income risks but also from deteriorated health.     

Gatekeeping versus direct‐access when patient information matters

We develop a principal‐agent model in which the health authority acts as a principal for both a patient and a general practitioner (GP). The goal of the paper is to weigh the merits of gatekeeping versus non‐gatekeeping approaches to health care when patient self‐health information and patient pressure on GPs to provide referrals for specialized care are considered. We find that, when GPs incentives matter, a non‐gatekeeping system is preferable only when (i) patient pressure to refer is sufficiently high and (ii) the quality of the patient's self‐health information is neither highly inaccurate (in which case the patient's self‐referral will be very inefficient) nor highly accurate (in which case the GP's agency problem will be very costly). Copyright © 2009 John Wiley & Sons, Ltd.