城市卫生资源配置的失衡——基于租值消散的视角

Unbalanced Allocation of Urban Health Resources—From the Perspective of Rent Dissipation

摘要: 城市医疗卫生资源的合理配置对强化社区医疗机构服务能力，促进患者合理分流，有序就医具有重要作用。论文借助新制度经济学的相关理论，在租值消散视角下以几何数学的形式论证了不同层级的医疗机构面对医疗价格规制时所采取的不同行为对卫生资源的吸附强度不同，形成了公立大型医院对资源的虹吸效应循环，造成了医疗资源的配置始终向公立三甲医院倾斜。建议建立灵敏有度的价格动态调整机制、取消社区医院“收支两条线”，加强落实分级诊疗制度，适当放宽对社区医疗机构业务范围的规制。

Abstract: The proper allocation of urban medical resources plays an important role in strengthening the ser-vice capacity of primary hospitals, promoting the rational shunt of patients and orderly seeking medical treatment. The paper uses the available body of New Institutional Economics theories to demonstrate that action taken by different grades of hospital in face of price control leads to differ-ent absorption strength to healthcare resources from the perspective of Rent-Dissipation, which resulting in a siphonic effect in tertiary hospitals. Thus the configuration of healthcare resource has always been inclined to tertiary hospitals. The research suggests establishing a sensitive price ad-justment mechanism, abolishing the “separation of revenue and expenditure” and improving per-formance and drive mechanism in primary hospitals, strengthening the implementation of hierar-chical system, appropriately canceling regulations on the business scope of primary hospitals.