我国医疗服务市场失灵的制度解释：基于组织竞争的视角

医疗服务是一个先天性失灵的市场,需要通过不断改进管制手段才能完善起来.我国医疗资源低效率配置反映了医疗服务市场的不完善.从制度角度分析医疗服务管制及管制方式,医疗服务组织促进专业化管制,专业化管制又影响医疗服务组织结构、规模及技术,组织的核心技术在专业化管制下不断延长,服务交叉,组织间竞争加剧.而且选择按项目支付的价格管制,使医疗服务组织能够从增加设备和服务项目的激励中获得垄断力；并且按项目付费削弱公立医院与基层卫生机构之间的合作意愿,强化了公立医院垄断,减少了医疗产业分工,从而降低了医疗服务市场活力,导致了医疗资源低效率配置.

Analysis of the hospital competition inefficiency in China though the institutional pillars

The health care market mechanism can be constructed through the reform the regulator because of the congenial defect in health market which can be reviewed from the medical resource allocation inefficiency.we use the institutional theory to explain the market failure in China.The structure,scale even the technical of the health care organization influenced by the regulation under the special dominate field,under the hospital and special evolving mutually,the core of technology chain in health organization has extended and the overlap service have intensified,which mean the more competition appear in health care market.But the health care price regulator combining the payment of the fee-for-service incent the public hospital compete with adopting the strategy to increase the investment in equipment and the new service project to gain the market power,moreover the public hospital are reluctant to corporate with the primary health facility because of the monopolistic state.while the public hospital strengthen its market power and reduce the division of the health care system through enlarging its size,the hospital competition make the market became less vigor and induce the medical source allocation inefficiency.