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台灣醫院產業的市場結構與發展趨勢分析

An Analysis of the Market Structure and Development of Taiwan's Hospital Industry

摘要


醫院產業的產值在1998年約為2,804億元,佔國內生產毛額的3.14%。同時,全民健保每年近3,000億的醫療支出中,醫院部門即超過三分之二,由此可知醫院產業在醫療服務市場之重要性。本文的主要目的,即是應用產業組織領域的分析架構,從市場結構、市場行為與市場表現三個面向,探討台灣醫院產業的發展趨勢。總結本文的分析顯示,支付制度對醫院市場的競爭本質,有密切的影響。而目前醫院產業與其他產業相比,最大的差異是醫院之間的競爭型態,主要以非價格為基礎。而未來研究醫院市場的重點,將以評估各項支付制度變革對醫院產業之影響為主。

並列摘要


Expenditures in the hospital sector totaled approximately NT$280.4 billion in 1998, representing 3.14% of GDP and nearly two thirds of the National Health Expenditures. These figures attest to the importance of the hospital industry in the overall health care market. In this paper, we use the structure-behavior-performance paradigm of industrial organization analysis to shed light on the trends in development of Taiwan's hospital industry. We conclude that the type of payment system adopted by the government exerts considerable influence on the market structure and nature of competition among hospitals. As opposed to other industries, the most distinct feature of the current hospital industry in Taiwan is that hospitals compete primarily on a nonprice basis. An important area of future research will therefore be to assess the economic impact resulting from the various proposed reforms in Taiwan's payment system.

參考文獻


Allen, R.(1992).Policy implications of recent hospital competition studies.Journal of Health Economics.11
Arrow, K. J.(1963).Uncertainty and the Welfare Economics of Medical Care.American Economic Review.53(5)
Bays, C. W.(1983).Why most private hospital are nonprofit.Journal of Policy Analysis and Management.2
Becker, E. R., Sloan, F. A.(1985).Hospital Ownership and Performance.Economic Inquiry.23
Cutler, D. M.(2000).The Changing Hospital Industry: Comparing Not-for-Profit and for-Profit Institution.Chicago:The University of Chicago Press.

被引用紀錄


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謝瑋恩(2016)。市場競爭對醫師職業規劃之影響〔碩士論文,淡江大學〕。華藝線上圖書館。https://doi.org/10.6846/TKU.2016.00152
翁宥榛(2014)。財團法人醫院是「財團」醫院嗎?〔碩士論文,淡江大學〕。華藝線上圖書館。https://doi.org/10.6846/TKU.2014.00498
邱鈺珊(2012)。總額支付制度對不同特性醫療院所用藥行為之影響:以高血壓藥品為例〔碩士論文,淡江大學〕。華藝線上圖書館。https://doi.org/10.6846/TKU.2012.00889
林祐孺(2011)。醫療院所誘發保險醫療支出差異性研究〔碩士論文,淡江大學〕。華藝線上圖書館。https://doi.org/10.6846/TKU.2011.00691

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