Hagen Terje P, Holom Geir Hiller, Amayu Kebebew N
Department of Health Management and Health Economics,University of Oslo,Oslo,Norway.
Health Econ Policy Law. 2018 Jan;13(1):50-67. doi: 10.1017/S1744133117000019. Epub 2017 Apr 6.
Setting prices for elective patient treatments in private for-profit (PFP) hospitals in traditional tax-funded health systems is challenging since both the organisation of these hospitals and the tasks they perform differ considerably from what we find in public hospitals. From the year 2000, Norway became one of a few countries to gradually implement a procurement system based on competitive tendering when outsourcing elective surgery. In this study we analyse the effect of introducing competitive tendering on the prices paid to PFP hospitals. Pricing data were collected from the formal contracts awarded to PFP hospitals and defined in terms of both absolute and relative prices. We found that PFP hospitals performed day surgeries at markedly lower prices than public hospitals and that competitive tendering triggered the price reduction. We speculate that the PFP hospitals' lack of acute services, less severe patient population, reduced teaching responsibilities and ability to streamline production, as well as other factors, explain the lower prices at PFP hospitals.
在传统税收资助的医疗体系中，为营利性私立医院的选择性患者治疗定价具有挑战性，因为这些医院的组织形式及其执行的任务与公立医院有很大不同。从2000年起，挪威成为少数几个在将选择性手术外包时逐步实施基于竞争性招标的采购系统的国家之一。在本研究中，我们分析了引入竞争性招标对支付给营利性私立医院的价格的影响。定价数据从授予营利性私立医院的正式合同中收集，并以绝对价格和相对价格来定义。我们发现，营利性私立医院进行日间手术的价格明显低于公立医院，并且竞争性招标引发了价格下降。我们推测，营利性私立医院缺乏急症服务、患者病情较轻、教学责任减轻以及生产流程简化能力等因素，以及其他因素，解释了营利性私立医院价格较低的原因。
