Cuellar Alison Evans, Gertler Paul J
Jospeh P. Mailman School of Public Health, Columbia University, 600 W. 168th Street, 6th Floor, New York, NY 10032, USA.
J Health Econ. 2006 Jan;25(1):1-28. doi: 10.1016/j.jhealeco.2005.04.009. Epub 2005 Nov 23.
A striking development in the healthcare market place has been the formation of strategic relationships between hospitals and physicians. Hospital-physician integration appears to be a response to rapidly expanding managed care health insurance. We examine whether integration lead to efficiency gains from transaction cost economies thereby allowing providers to offer managed care insurance plans lower prices or whether integration is really a strategy to improve bargaining power and thereby increase prices. We find that integration has little effect on efficiency, but is associated with an increase in prices, especially when the integrated organization is exclusive and occurs in less competitive markets.
医疗保健市场中一个引人注目的发展是医院与医生之间形成了战略关系。医院与医生的整合似乎是对迅速扩张的管理式医疗健康保险的一种回应。我们研究整合是否会因交易成本经济而带来效率提升，从而使供应商能够为管理式医疗保险计划提供更低的价格，或者整合是否实际上是一种提高议价能力从而提高价格的策略。我们发现，整合对效率几乎没有影响，但与价格上涨有关，尤其是当整合后的组织具有排他性且发生在竞争较小的市场时。
