醫院非價格性競爭與市場結構：醫院購置高科技醫療儀器之實證研究

Hospital Nonprice Competition and Market Structure: An Empirical Study of Hospitals' Acquisition of High-tech Medical Equipment

蔡偉德(Wei-Der Tsai) ； 李一鑫(I-hsin Li)

《經濟論文》 30卷1期 (2002/03) Pp. 57-78

摘要

「醫療競武」－醫院競相以提供高科技醫療設備作為市場競爭的手段－一直是研究醫院競爭行為的焦點，因為這種非價格競爭的方式常被質疑是導致醫療成本上漲的原因之一。本研究探討醫院非價格性競爭（品質競爭）行為與市場結構的關聯，利用醫院市場擁有高科技醫療設備的數量作為衡量醫院提升品質從事競爭的代理變數，並以民國82年至民國88年台灣地區醫院醫療服務量與醫事機構現況之醫院追蹤資料，實證分析醫院市場的競爭程度，是否對醫院市場擁有高科技醫療設備的數量有所影響。在控制市場供需因素及保險制度的影響後，我們發現在市場競爭愈激烈的環境中，醫院擁有高科技醫療設備的數量愈多，顯示醫院市場存在醫療競武的行為。

關鍵字

醫院非價格性競爭 ； 市場結構 ； 高科技醫療儀器 ； 負二項分配固定效果迴歸模型

並列摘要

Competition among hospitals by means of acquiring hi-tech medical equipment, the so-called ”medical arms race,” has been a focus for research in health economics literature. The importance of the issue arises from its implications on medical expenditure. A medical arms race may lead to a surge in medical expenditure and thereby prompting a waste of resources. The purpose of this research is to empirically examine the medical arms race phenomena and its relationship with the market structure. More specifically, we test whether or not the degree of competition in the local medical market has a positive impact on a hospital's acquisition of hi-tech medical equipment. The empirical work is based on a panel of hospitals in Taiwan for the period 1993-1999. A fixed effects negative binomial regression model is set up as a vehicle for our empirical work. We find that the number of pieces of hi-tech equipment that a hospital has is positively associated with the degree of market competition.

並列關鍵字

Hospital nonprice competition ； Market structure ； Hi-tech medical equipment ； Fixed effects negative binomial regression model

參考文獻

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