医疗服务竞争:市场结构、竞争强度及其作用分析

利用市场集中程度指标－Herfindahl-Hirschman指数，测量某个省会城市、某个县和乡镇医疗服务的市场结构和竞争强度。结果表明，在所分析的省会城市，市场集中程度较低，存在竞争的基本条件。在县和乡，医疗服务市场高度集中，不存在竞争的基本条件。但是，市场的集中程度较低只是构成医疗服务竞争关系的条件之一，培育和规范市场，特别是组织强有力的医疗服务需方，是形成对等的供需关系和良好的市场结构的关键。国际经验表明，竞争可以带来多种可能的结果。在借鉴欧美国家利用市场机制控制医疗费用的做法时，应做深入分析，况且这些国家对医疗服务市场竞争也存在很在争论。

Competition in Medical Care: Market Structure, Competitiveness and Effects

In this paper, the market concentration of medical services was analyzed using Herfindahl - Hirschman Index (HHI). Data came from a capital city of a province, a county and a township. The results showed a relatively low market concentration in the city and much high concentrations in the county and township. The author argued that expected competition would not automatically occur in the low - concentration city if other preconditions, say the bargaining power of the demand , are not met. It should be cautions when the government wants to introduce market mechanism in health care following experiences in US and European countries.