平台理论视角下的互联网与“分级诊疗”

 
投稿时间: 2015-12-25  最后修改时间: 2016-01-04  摘要点击次数: 2901  全文下载次数: 1920
 
引用本文:杜创.平台理论视角下的互联网与“分级诊疗”[J].中国卫生政策研究,2016,9(1):58-64
杜创
中国社会科学院经济研究所 北京 100836
基金项目:国家社会科学基金(14BGL145)
 
 摘要:本文运用产业经济学中的平台理论对当前我国推进分级诊疗的难点、互联网促进分级诊疗的可能性及其可行模式进行了分析,得出结论:分级诊疗的主要障碍为事业单位体制下医生对医院的依附关系、医院分级管理制度与医院平台正外部性三者的相互作用,使三甲医院"强者愈强"、基层"弱者愈弱";互联网医疗平台促进医生走出体制自由执业,有助于破除传统医院平台的正外部性,实现分级诊疗;互联网医疗平台采取双层结构,"大平台套小平台",是推动分级诊疗的可行模式。 
  关键词:分级诊疗  平台理论  互联网医疗
 
Internet and “tiered health care system” in China: A platform theory perspective
DU Chuang
Institute of Economics, Chinese Academy of Social Sciences, Beijing 100836, China
 
 Abstract:We explore the difficulty of the possibility of the way to a "tiered health care system" in China. This means that high-end hospitals treat "serious" diseases and community ones and/or individual clinics focus on "non-serious" diseases. The exploration is done using a new theoretical framework in industrial economics, the platforms theory. The research achieved three main results which are as follows: Firstly, it shows that three main obstacles to build a "tiered health care system" comprise the employment relationship between doctors and hospitals, hierarchical hospital system, and positive hospital platform externalities, whose interaction enhance the high-end hospitals to be stronger and community ones to become weaker. Secondly, internet medical platforms will help doctors to leave the high-end public hospitals, build individual clinics, and thus achieve a "tiered health care system". Finally, the "two-tier structure", adopted by some internet medical platforms, is a possible way to build the "tiered health care system", and means a large platform including many small professional platforms on one hand and patients on the other hand. 
 keywords:Tiered health care system  Platform theory  Internet medical