政府、市场与医疗图书
Government Intervention and Market Mechanism: Empirical Studies on Health Care Reform in China
[内容简介] 本书紧密围绕如何缓解和解读“看病难、看病贵”的问题,就中国医疗卫生领域中的几个重要方面对“市场机制”作用与“政府干预”措施进行经济学评估,以期找到医疗卫生领域中市场配置和政府干预的最佳结合点,完善有关市场机制与政府干预的基本理论研究,为中国医疗卫生体制改革的实践提供了科学的决策参考和政策建议。
相关信息
摘要
ABSTRACT
后记
第1章 导论
1.1 政府干预与市场机制:一个中国医改不能回避的问题
1.2 主要概念的界定
1.2.1 市场机制
1.2.2 政府干预
1.2.3 中国医疗体制改革
1.2.4 “看病难、看病贵”
1.2.5 “内增活力”和“外加推力”
1.3 研究方法与研究思路
1.3.1 研究方法
(1)计量经济学方法
(2)案例分析方法
1.3.2 研究思路
第2章 以往研究评述
2.1 政府与市场的一般理论
2.2 医疗服务市场的特殊性
2.2.1 衍生需求
2.2.2 不完全竞争市场
2.2.3 外部性
2.2.4 信息不对称
2.3.5 不确定性
(1)经济规模
(2)风险选择
(3)道德风险
2.3 医疗卫生体制中政府与市场的定位
2.3.1 国际相关文献的观点
2.3.2 国内相关文献的观点
2.4 中国医疗卫生体制中政府与市场关系的历史沿革
2.4.1 1949~1978年政府干预为基础时期
2.4.2 1978~2003年转型时期
2.4.3 2003年起至今政府干预与市场机制兼有时期
2.4.4 历史沿革的总结
2.5 本章小结
第3章 “外加推力”与医疗产出
3.1 引言
3.2 文献回顾
3.3 实证方法
3.3.1 竞争与医疗市场产出分析
(1)市场定价
(2)政府定价
3.3.2 实证模型的设定和估计方法
3.4 基于宏观数据的实证分析
3.4.1 数据来源
3.4.2 定义变量
3.4.3 回归结果
3.5 基于微观数据的实证分析
3.5.1 数据来源
3.5.2 定义变量
3.5.3 回归结果
3.6 相关讨论
3.6.1宏观数据与微观数据
(1)同时使用的必要性
(2)基于宏观数据实证结果与基于微观数据实证结果的对比
3.6.2 门诊和住院结果的比较
(1)门诊服务和住院服务本身存在显著差别
(2)现行的医疗保险政策也可能导致竞争在住院服务上的影响异于门诊
3.6.3 与相关文献的对比
3.6.4 医疗服务市场竞争的衡量
3.7 本章小结
第4章 “内增活力”与医疗供给
4.1 “管办不分”与市场供给
4.1.1 “看病难、看病贵”
4.1.2 “管办不分”
4.2 “管办分开”的概念
4.2.1 “管办分开”概念
4.2.2 “管办分开”与市场供给
4.3 “管办分开”政策的实践概况
4.3.1 江苏省苏州市的实践
4.3.2 江苏省无锡市的实践
4.3.3 山东省潍坊市的实践
4.4 对潍坊市、无锡市和苏州市实践的宏观数据分析
4.4.1 研究设计
(1)数据来源
(2)模型
4.4.2 结果
(1)数据描述
(2)“管办分开”政策实施与卫生供给关系
(3)回归结果
4.5 相关讨论
4.5.1 “管办分开”政策和其他诸多改革措施
4.5.2 供给的效率和质量
4.6 本章小结
第5章 “覆盖全民”与人民健康
5.1 引言
5.2 医疗保险对健康的影响机制及相关实证研究回顾
5.2.1 医疗保险对健康的影响机制
5.2.2 现有因果研究结果
(1)国外因果研究结果
(2)国内因果研究结果
5.2.3 对现有因果研究评述
(1)健康的度量
(2)研究人群
(3)识别方法
(4)本章节的贡献
5.3 城镇居民基本医疗保险制度背景概述与数据
5.3.1 城镇居民基本医疗保险制度
(1)制度建立
(2)参保范围
(3)筹资机制
(4)保障范围
5.3.2 城居保入户调查数据(URBMIS)
5.4 数据描述和基本模型回归估计结果
5.4.1 数据描述
5.4.2 计量模型与估计结果
5.5 工具变量模型估计结果
5.5.1 工具变量
5.5.2 补助的约简影响
5.5.3 工具变量的有效性
5.5.4 两阶段最小二乘模型(2SLS)的估计结果
5.6 进一步研究
5.6.1 城居保对不同人群的影响
5.6.2 可能的影响渠道
5.6.3 对其他健康的更多影响
5.7 本章小结
第6章 “促进均等”与政府卫生支出(上)
6.1 引言
6.2 文献综述
6.2.1 国外研究内容与结论
(1)第一阶段是采用截面数据的跨国研究
(2)第二阶段是采用面板数据的跨国研究
(3)第三阶段是各国的省际研究
6.2.2 国内相关研究
6.3 中国政府卫生支出的相关情况
6.3.1 政府卫生支出与卫生总费用的关系
6.3.2 政府卫生支出在中央和地方上的划分
6.3.3 政府卫生支出的内容
6.4 研究设计
6.4.1 收入因素
6.4.2 需求因素
6.4.3 其他社会因素
6.5 数据和方法
6.6 结果
6.6.1 数据描述
6.6.2 主要回归结果
6.7 相关讨论
6.7.1 模型联立性问题
6.7.2 模型滞后性问题
6.8 本章小结
第7章 “促进均等”与政府卫生支出(下)
7.1 引言
7.2 数据和方法
7.2.1 数据来源
7.2.2 实证分析的基本框架
7.2.3 δ-收敛
7.2.4 β-收敛
7.3 本章小结
第8章 结论和政策建议
8.1 基于中国医改实践的发现
8.1.1 关于“外加推力”——市场竞争机制对医疗市场产出的影响
8.1.2 关于“内增活力”——公立医院管办分开改革对医疗服务供给的影响
8.1.3 关于“覆盖全民”——城镇居民基本医疗保险对人民健康的影响
8.1.4 关于“促进均等”——政府卫生支出地区差异的决定因素和收敛
(1)对地区差异决定因素的实证研究
(2)对地区差异收敛的实证研究
8.2 研究视角和实践方法的创新
(1)通过引入SCP分析框架分析了市场竞争对医疗产出的影响
(2)构建分年的政策效应模型,采用一阶差分的方法分析比较了不同形式的公立医院“管办分开”改革的影响
(3)利用“外生的”各地政府补助比例差异这个“自然实验”,通过2SLS回归估计了城镇居民基本医疗保险对参保个人健康的因果影响
(4)使用固定效用和动态面板模型,系统分析政府卫生支出地区差异的决定因素和收敛
8.3 政府与市场:不可分割的整体
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