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关于受约束医院市场中等待时间和质量之间权衡的注释。

A note on the trade-off between waiting times and quality in a constrained hospital market.

机构信息

Department of Economics and Business, University of Catania, Catania, Italy.

Department of Management, Economics and Industrial Engineering, Politecnico di Milano, Milan, Italy.

出版信息

Health Econ. 2021 Jan;30(1):180-185. doi: 10.1002/hec.4171. Epub 2020 Oct 4.

Abstract

While aging population and technological innovation are expected to increase healthcare demand in the future, increase in healthcare spending is not likely to be sustainable in times of fiscal constraint. This might lead to a tightening of hospital capacity and, potentially, to higher patient waiting times. This paper studies waiting times and quality in a healthcare market where semi-altruistic hospitals operate at full capacity. We show that in this context a trade-off between waiting times and quality emerges which, if hospitals dislike patients to wait, decreases the incentive for the quality of care. We also show that, when hospitals operate at full capacity, standard waiting time policies involving targets and penalties (e.g., "Targets and Terror" in England) can meet the target at the expense of a lower quality of care, with relevant implications for the empirical evaluation of waiting time policy.

摘要

虽然人口老龄化和技术创新预计将增加未来的医疗保健需求,但在财政紧张时期,医疗保健支出的增加不太可能持续。这可能导致医院容量紧张,并可能导致患者等待时间延长。本文研究了在一个半利他医院满负荷运转的医疗市场中,等待时间和质量之间的权衡取舍。我们表明,在这种情况下,等待时间和质量之间存在权衡取舍,如果医院不喜欢患者等待,就会降低对护理质量的激励。我们还表明,当医院满负荷运转时,涉及目标和惩罚的标准等待时间政策(例如英国的“Targets and Terror”)可以以降低护理质量为代价来达到目标,这对等待时间政策的实证评估具有相关影响。

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