Research On The Impact Of Hospital Competition On Medical Expenses

Health is the foundation of economic and social development,and it is also a necessary condition for promoting the all-round development of people.Realizing the people’s health and longevity is the common aspiration of the people,and it is also a symbol of the country’s prosperity and national rejuvenation.Chinese Fourteenth Five-Year Plan takes the comprehensive promotion of the construction of a healthy China as an important strategy.For the construction of healthcare undertakings,firstly we must improve the medical system.In order to match the medical system with the country’s economic development stage and make it meet the medical needs of people,China has carried out a series of medical reforms after the reform and opening up.The most typical document "Several Opinions on Deepening Health Reform" was Issued in 1992.This document is the beginning of Chinese medical field entering the stage of market-oriented reform.At this stage,the right to use the balance of income and expenditure is delegated to hospitals.Hospitals and doctors have the motivation to get income;the supply of medical resources continues to expand,and the total healthcare expenditure continues to increase,but the proportion of government health expenditures has repeatedly reached new lows.This has brought the problems of "expensive" and "difficult".Some scholars believe that these problems are caused by medical marketization and hospital competition;but some scholars believe that these problems are precisely caused by insufficient marketization and insufficient hospital competition.So,whether hospital competition is the cause of the problem of "expensive medical care" is a question that needs to be answered urgently,and it also becomes the focus of this article.The article sorted out the relevant literature on hospital competition and medical expenses,and found that domestic scholars usually focus on the competition between for-profit hospitals and non-profit hospitals,while ignoring the competition among all hospitals.So,this article takes the overall competition of all hospitals as the starting point for theoretical and empirical research.First,we analyze the market structure of Chinese medical industry based on the SCP paradigm,which mainly includes the scale of the supply and demand sides,market concentration and hospital density,and entry barriers.After that,it analyzes the behavior of hospitals,that is,the mechanism of hospital competition affecting medical expenses;at the same time,we also have researched the impact of financial subsidy income and traffic convenience on hospital competition behavior.Based on this,three hypotheses are put forward.Finally,using Chinese provincial panel data from 2010 to 2018,the research hypothesis was empirically tested.The research results show that:(1)Hospital competition will increase medical costs.Specifically,the number of hospitals per 100,000 population is positively related to medical expenses;the outpatient market concentration index constructed based on the service volume of public hospitals and private hospitals has an insignificant relationship with outpatient expenses,while the inpatient market concentration is related to medical expenses.The cost is significantly negatively correlated.(2)Financial subsidy income has a negative adjustment effect on regulating the relationship between hospital competition and medical expenses,that is,the increase in financial subsidy income will weaken hospital competition.(3)Transportation convenience has a positive moderating effect on the relationship between hospital competition and medical expenses,that is,improved transportation convenience will strengthen hospital competition,but this conclusion does not exist in the outpatient market.Based on the above research,the article puts forward policy recommendations,including:(1)Regulating the disorderly competition behavior of medical institutions and adhering to the public welfare attributes of basic medical and health services.(2)Gradually increase investment in the medical field.(3)Speed up the construction of high-speed railways,expressways and urban rail transit.(4)Speed up the pilot reform of the prepayment system.In addition,to scientifically design a drug procurement system,eliminate the barriers to entry in the medical field and accelerate the Reform of the Compensation incentive system in public hospitals is necessary.