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医疗行业的市场结构和竞争:转型经济的结果。

Market structure and competition in the healthcare industry : Results from a transition economy.

机构信息

University of Economics in Bratislava, Dolnozemska cesta 1, 852 35, Bratislava, Slovakia.

Vienna University of Economics and Business, Welthandelsplatz 1, 1020, Vienna, Austria.

出版信息

Eur J Health Econ. 2018 Nov;19(8):1087-1110. doi: 10.1007/s10198-018-0959-1. Epub 2018 Feb 14.

DOI:10.1007/s10198-018-0959-1
PMID:29445942
Abstract

The present paper provides first empirical evidence on the relationship between market size and the number of firms in the healthcare industry for a transition economy. We estimate market-size thresholds required to support different numbers of suppliers (firms) for three occupations in the healthcare industry in a large number of distinct geographic markets in Slovakia, taking into account the spatial interaction between local markets. The empirical analysis is carried out for three time periods (1995, 2001 and 2010) which characterise different stages of the transition process. Our results suggest that the relationship between market size and the number of firms differs both across industries and across periods. In particular, we find that pharmacies, as the only completely liberalised market in our dataset, experience the largest change in competitive behaviour during the transition process. Furthermore, we find evidence for correlation in entry decisions across administrative borders, suggesting that future market analysis should aim to capture these regional effects.

摘要

本文为转型经济体提供了医疗行业市场规模与企业数量之间关系的首个经验证据。我们针对斯洛伐克大量不同地理位置的市场,在考虑当地市场间空间相互作用的情况下,针对医疗行业的三个职业,估计了支持不同数量供应商(企业)所需的市场规模门槛。我们的实证分析涵盖了三个时期(1995 年、2001 年和 2010 年),这些时期代表了转型过程的不同阶段。我们的研究结果表明,市场规模与企业数量之间的关系在不同行业和不同时期都有所不同。具体而言,我们发现药房作为我们数据集中唯一完全自由化的市场,在转型过程中经历了最大的竞争行为变化。此外,我们发现证据表明行政边界的进入决策存在相关性,这表明未来的市场分析应旨在捕捉这些区域效应。

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本文引用的文献

1
Competition among health care providers: helpful or harmful?医疗服务提供者之间的竞争:有益还是有害?
Eur J Health Econ. 2016 Apr;17(3):229-33. doi: 10.1007/s10198-015-0736-3.
2
Geographic distribution of physicians in Portugal.葡萄牙医生的地理分布。
Eur J Health Econ. 2010 Aug;11(4):383-93. doi: 10.1007/s10198-009-0208-8. Epub 2009 Dec 11.
3
Entry and regulation: evidence from health care professions.准入与监管:来自医疗行业的证据
Rand J Econ. 2008 Winter;39(4):949-72. doi: 10.1111/j.1756-2171.2008.00045.x.
4
The geographic distribution of physicians revisited.重新审视医生的地理分布。
Health Serv Res. 2005 Dec;40(6 Pt 1):1931-52. doi: 10.1111/j.1475-6773.2005.00440.x.
5
More on the geographical distribution of physicians.
J Health Econ. 1987 Dec;6(4):365-74. doi: 10.1016/0167-6296(87)90021-x.
6
Do physicians locate as spatial competition models predict? Evidence from Alberta.医生的分布是否如空间竞争模型所预测的那样?来自艾伯塔省的证据。
CMAJ. 1993 Apr 15;148(8):1301-7.