医院竞争对社会办医的医疗质量和费用影响及其机制探索研究OA

Objective To investigate the impact of hospital competition on the quality of care and medical expenses in private hospitals and its mechanisms.Methods Based on the Structure-Conduct-Performance(SCP)framework,the case study method was used to conduct in-depth interviews at four tertiary-level private hospitals in Chengdu to construct a theoretical framework to explain the mechanism underlying the effects of hospital competition on the quality of care and medical expenses in private hospi-tals.Results When facing intense hospital competition,private hospitals will proactively improve the quality of care,primarily by attracting and cultivating talent,enhancing technology,and strengthening internal management.In terms of medical expenses,since most private hospitals are designated health insurance providers,the prices of their medical services are constrained by insur-ance pricing.Thus,private hospitals generally do not reduce medical expenses to attract patients.Conclusion The theoretical framework of the relationship between hospital competition and the quality of care and medical expenses was refined from the pri-vate hospitals'perspective.Hospital competition improves the quality of care by altering hospital conduct(talent,technology,and management),which can provide a theoretical reference for resolving long-standing debates on the relationship between hospital competition,quality of care,and medical expenses,and optimizing policies related to private hospitals.