East Asian Institute, National University of Singapore, Singapore.
Department of Asian and Policy Studies, The Education University of Hong Kong, Hong Kong.
Health Policy Plan. 2019 Feb 1;34(1):37-46. doi: 10.1093/heapol/czz001.
The rapid diffusion of medical technologies is widely recognized as a key driver of healthcare cost escalation. The excessive duplication of technologies gives rise to the so-called medical arms race. Conventional wisdom tends to explain this phenomenon by external reimbursement mechanisms and hospitals' competitive strategies, but has largely neglected the role played by health regulations that may also affect hospitals' technology adoption decisions. This study sheds new light on the medical arms race with evidence from China, which has witnessed an unprecedented expansion of big tertiary hospitals and a keen pursuit of expensive medical technologies. Chinese hospitals aggressively pursue high-tech medical equipment as an opportunistic reaction to the peculiar health regulatory environment. By analysing a panel dataset collected from Shenzhen City, this study reveals a series of important impacts of the medical arms race in Chinese public hospitals. High-tech medical equipment is found to lead to an increase in hospital revenues and patient volumes, but no significant impact is noted on unit costs. While high-tech medical equipment is associated with a discernible improvement in clinical outcomes, no contribution to hospitals' operational efficiency is noted. These findings are interpreted in the context of the broader health regulatory framework and China's public hospital reforms.
医疗技术的快速普及被广泛认为是医疗成本上升的主要驱动因素。技术的过度重复导致了所谓的医疗军备竞赛。传统观点倾向于将这种现象解释为外部报销机制和医院的竞争策略，但在很大程度上忽略了可能影响医院技术采用决策的健康法规所发挥的作用。本研究通过来自中国的证据，为医疗军备竞赛提供了新的视角。中国见证了大型三甲医院的空前扩张和对昂贵医疗技术的强烈追求。中国医院积极追求高科技医疗设备，这是对特殊医疗监管环境的机会主义反应。通过对深圳市收集的面板数据集进行分析，本研究揭示了中国公立医院军备竞赛的一系列重要影响。研究发现，高科技医疗设备会导致医院收入和患者量的增加，但对单位成本没有显著影响。虽然高科技医疗设备与临床结果的明显改善有关，但对医院的运营效率没有贡献。这些发现是在更广泛的健康监管框架和中国公立医院改革的背景下进行解释的。
