健康管理联合体交易费用测度实证研究
AnEmpirical Study on the Measurement of Transaction Costs in Health Management Alliances
苗豫东 1牛亚冬 1任睿哲 1李向旭 2曾鑫 1李寅飞 3申战垒1
作者信息
- 1. 郑州大学公共卫生学院 河南 郑州 450001
- 2. 河南省医学科学院 河南 郑州 450003
- 3. 河南省人民医院 河南 郑州 450003
- 折叠
摘要
目的 以高血压和糖尿病患者的转诊治疗为线索,测量健康管理联合体交易费用.方法 基于威廉姆森-张五常分析范式建立健康管理联合体交易费用测度矩阵;通过典型抽样法,选取山东省N县健康管理联合体作为研究范例开展实证研究.结果 2023年,样本县健康管理联合体的交易费用总额达到6 726 700.00元,转诊每名患者平均产生交易费用3 846.00元.交易费用主要由牵头医院承担,占比为79.45％;疾控中心次之,为10.68％.业务协调成本在交易费用中占比最多,达到47.18％.样本病种转诊患者人均交易费用为700.90元.结论 健康管理联合体总交易费用规模较大,主要由牵头医院承担,同时,患者亦需承担相当的交易费用;应对措施包括完善服务整合机制,建立节约性制度供给路径,医保、医疗协同发力.
Abstract
Objective To measure the transaction costs of the health management alliance with the clue of the re-ferral treatment of patients with hypertension and diabetes.Methods Based on the Williamson-Zhang Wuchang analy-sis paradigm,a transaction cost measurement matrix of health management alliance was established.Through the typical sampling method,the health management alliance of County N in Shandong Province was selected as a re-search example to carry out empirical research.Results In 2023,the total transaction costs of the sampled health management alliance reached to 6 726 700.00 yuan,and the average transaction cost per referral patient was 3 846 yuan.The leading hospital accounted for 79.45％of the transaction cost,followed by the CDC.Meanwhile,busi-ness coordination cost accounted for 47.18％of the total transaction cost,and the average transaction cost per refer patient with hypertension or diabetes was 700.90 yuan.Conclusion The total transaction costs of the health manage-ment alliance was large,and it was mainly borne by the leading hospital.Patients also need to bear considerable transaction costs.The countermeasures included improving the service integration mechanism,establishing economi-cal system supply path,and coordinating actions between social health insurance system and health care system.
关键词
健康管理联合体/整合型医疗卫生服务体系/交易费用Key words
health management alliance/integrated delivery system/transaction cost引用本文复制引用
基金项目
国家社会科学基金一般项目(21BGL222)
出版年
2024
NETL
NSTL
万方数据