供給面誘發需求與醫療保健支出的關聯性

The Association between Supplier-Induced Demand and Health Care Expenditure

林炳文(Ping-Wen Lin)

《醫務管理期刊》 7卷2期 (2006/06) Pp. 137-154

https://doi.org/10.6174/JHM2006.7(2).137

摘要

三十多年來醫療經濟學家對誘發需求研究已蔚為風氣，研究方法亦有長足的進展。相關文獻上爭議的是供給面誘發需求(SID)程度大小，而非誘發需求存在性的問題。伴隨著供給面誘發需求的增加，醫師服務價格也跟著提高，導致醫療保健支出成長。本文旨在探討臺灣地區供給面誘發需求與實質醫療保健支出(hce)之問的關聯。實證結果顯示：(1)單獨考慮醫療資源與臺灣地區實質醫療保健支出之問的關聯時，SID假說並不存在；(2)一旦加入實質GDP解釋變數之後，在10%統計顯著水準下，臺灣地區醫師誘發需求一樣呈現不顯著，但實質GDP對hce成長有顯著影響；(3)臺灣地區實質醫療保健支出的所得彈性為0.1866，醫療保健服務為必需品；其政策涵義為政府應積極管理醫療保健及財務籌集，換句話說，政府應積極介入醫療保健市場。

關鍵字

醫師誘發需求假說 ； 代理人 ； 醫療保健支出 ； 道德危機 ； 供應效果

並列摘要

For more than three decades, many health economists have devoted themselves to the study of demand inducement and there has been a remarkable progress in the research method. The related issue in question is the level of demand inducement instead of the existence of demand inducement. An increased physician-induced demand was associated with higher prices for physician services, and thus makes health care expenditure grew accordingly. This paper aims to investigate the association between the supplier-induced demand and the real health care expenditure in Taiwan. The empirical study reveals the following: (1) No evidence is found to support the SID hypothesis when considering only the correlation between health care resources and real health care expenditure in Taiwan. (2) If the real GDP variable is taken into consideration, physician-induced demand appears insignificant while the effect of real GDP on the real health care expenditure is statistically significant at the 10% level. (3) The estimated income elasticity of real health care expenditure in Taiwan is 0.1866. The health care is defined as a necessity. This result has policy overtones for the conducting and financing of health care. In other words, the government's greater involvement in public health care is highly recommended.

並列關鍵字

Supplier-Induced Demand Hypothesis ； Agency ； Health Care Expenditure ； Moral Hazard ； Availability Effect

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