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医疗资源配置:私人医生模式案例分析

On resource allocation in health care: The case of concierge medicine.

机构信息

Goldman School of Public Policy, University of California, Berkeley, United States.

The Wharton School, University of Pennsylvania, United States.

出版信息

J Health Econ. 2023 Jul;90:102776. doi: 10.1016/j.jhealeco.2023.102776. Epub 2023 Jun 1.

Abstract

Resource allocation generally involves a tension between efficiency and equity, particularly in health care. The growth in exclusive physician arrangements using non-linear prices is leading to consumer segmentation with theoretically ambiguous welfare implications. We study concierge medicine, in which physicians only provide care to patients paying a retainer fee. We find limited evidence of selection based on health and stronger evidence of selection based on income. Using a matching strategy that leverages the staggered adoption of concierge medicine, we find large spending increases and no average mortality effects for patients impacted by the switch to concierge medicine.

摘要

资源分配通常涉及效率和公平之间的紧张关系,特别是在医疗保健领域。采用非线性价格的独家医师安排的增长导致消费者细分,理论上对福利产生了模糊的影响。我们研究了礼宾医学,即医生只为支付保留费的患者提供护理。我们发现基于健康的选择的证据有限,而基于收入的选择的证据更强。通过利用礼宾医学的交错采用的匹配策略,我们发现对于受礼宾医学转变影响的患者,其支出大幅增加,但平均死亡率没有影响。

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