Tisdell C A, Adamson D
Rev Sci Tech. 2017 Apr;36(1):49-56. doi: 10.20506/rst.36.1.2608.
In this paper, the authors detail the structure and optimal management of health systems as influenced by the presence and level of fixed costs. Unlike variable costs, fixed costs cannot be altered, and are thus independent of the level of veterinary activity in the short run. Their importance is illustrated by using both single-period and multi-period models. It is shown that multi-stage veterinary decision-making can often be envisaged as a sequence of fixed-cost problems. In general, it becomes clear that, the higher the fixed costs, the greater the net benefit of veterinary activity must be, if such activity is to be economic. The authors also assess the extent to which it pays to reduce fixed costs and to try to compensate for this by increasing variable costs. Fixed costs have major implications for the industrial structure of the animal health products industry and for the structure of the private veterinary services industry. In the former, they favour market concentration and specialisation in the supply of products. In the latter, they foster increased specialisation. While cooperation by individual farmers may help to reduce their individual fixed costs, the organisational difficulties and costs involved in achieving this cooperation can be formidable. In such cases, the only solution is government provision of veterinary services. Moreover, international cooperation may be called for. Fixed costs also influence the nature of the provision of veterinary education.
在本文中,作者详细阐述了固定成本的存在和水平对卫生系统结构及最优管理的影响。与可变成本不同,固定成本无法改变,因此在短期内与兽医活动水平无关。通过单期模型和多期模型说明了它们的重要性。结果表明,多阶段兽医决策通常可设想为一系列固定成本问题。总体而言,显而易见的是,如果兽医活动要具有经济性,固定成本越高,兽医活动的净收益就必须越大。作者还评估了降低固定成本并试图通过增加可变成本来弥补的收益程度。固定成本对动物保健产品行业的产业结构以及私人兽医服务行业的结构具有重大影响。在前者中,它们有利于市场集中和产品供应的专业化。在后者中,它们促进了专业化程度的提高。虽然个体养殖户之间的合作可能有助于降低他们各自的固定成本,但实现这种合作所涉及的组织困难和成本可能非常巨大。在这种情况下,唯一的解决办法是政府提供兽医服务。此外,可能需要国际合作。固定成本还影响兽医教育的提供性质。