Finkler S A
Health Serv Res. 1979 Winter;14(4):281-9.
Empirical studies of the hospital industry have produced conflicting results with respect to the shape of the industry's long run average cost (LRAC) curve. Some of the studies have found a classical U-shaped curve. Others have produced results indicating that the LRAC curve is much closer to being L-shaped. Some theoretical support exists for both sets of findings. While classical theory predicts that the LRAC curve will be U-shaped, Alchian has presented theoretical arguments explaining why such curves would be L-shaped. This paper reconciles the results of these studies. The basis for the reconciliation is recognition of the failure of individual hospitals to produce all their individual product lines at efficient volumes. Such inefficient production is feasible and perhaps common, given the incentive structure which exists under current cost reimbursement systems. The implication of this paper is that large hospitals may have a greater potential for scale economies than has previously been recognized.
关于医院行业的实证研究在该行业长期平均成本（LRAC）曲线的形状方面得出了相互矛盾的结果。一些研究发现了经典的U形曲线。另一些研究则得出结果表明LRAC曲线更接近于L形。这两组发现都有一定的理论支持。虽然经典理论预测LRAC曲线将是U形的，但阿尔钦提出了理论观点来解释为什么这样的曲线会是L形的。本文调和了这些研究的结果。调和的基础是认识到个别医院未能以有效产量生产其所有的个别产品线。考虑到当前成本报销制度下存在的激励结构，这种低效率生产是可行的，甚至可能很普遍。本文的含义是，大型医院可能比以前所认识到的具有更大的规模经济潜力。
