A Comparison betweem Two Health Care Delivery Systems Using a Spatial Competition Model Approach
A Comparison betweem Two Health Care Delivery Systems Using a Spatial Competition Model Approach
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使用空间竞争模型方法比较两种医疗保健服务系统
DOI：
10.1080/21681376.2016.1209980
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Atsushi Yoshida
中科院分区：
文献类型：
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作者：
Kiheiji Nishida;Atsushi Yoshida
在日本，医院和诊所等医疗服务提供者的区域分布不合理是很明显的。本研究参照酒店式空间竞争模型，分析日本的服务收费补偿制度（FFSRS）或诊断程序组合/按日支付制度（DPC/PDPS）是否更适合解决这一问题。在FFSRS下，我们还考虑了两种竞争模式：在Stackelberg案例中，提供者可以控制医院就诊次数；在Nash案例中，提供者不能这样做。结果表明，三种竞争模式中，DPC/PDPS模式下的竞争最为激烈。为了缓解供应商的区位集中，我们还发现DPC/PDPS比FFSRS具有更好的机制。
Regional mal-distribution of healthcare providers such as hospitals and clinics is conspicuous in Japan. This study analyses whether Japan’s fee-for-service reimbursement system (FFSRS) or its diagnosis procedure combination/per-diem payment system (DPC/PDPS) is the better solution for the problem, with reference to the Hotelling-style spatial competition model. Under FFSRS, we also consider two modes of competition: the Stackelberg case, in which providers can control the number of hospital visits, and the Nash case, in which providers cannot do so. Results indicate that competition under DPC/PDPS is the most intensive of the three modes of competition. To relieve the locational concentration of providers, we also find that DPC/PDPS has a better mechanism than FFSRS.