The formation mechanism of transaction costs in national regional medical centers and policy implications
10.3969/j.issn.1674-2982.2024.12.003
- VernacularTitle:国家区域医疗中心交易费用的形成机理与政策启示
- Author:
Yu-dong MIAO
1
;
Dong-fang ZHU
;
Jian-ping HU
;
Jian WU
Author Information
1. 郑州大学公共卫生学院 河南郑州 450001
- Publication Type:Journal Article
- Keywords:
National regional medical center;
Transaction costs;
Formation mechanism;
Policy implications
- From:
Chinese Journal of Health Policy
2024;17(12):14-20
- CountryChina
- Language:Chinese
-
Abstract:
In recent years,China has actively promoted the construction of National Regional Medical Centers ( NRMCs) with the aim of optimizing the layout of healthcare service systems,balancing the allocation of healthcare resources,and improving the quality and efficiency of medical services.The establishment of NRMCs is the result of macro-environmental changes and the interaction among multiple stakeholders,reflecting a complex institutional spectrum and its evolution,which consequently gives rise to"hidden"yet significant transaction costs.This paper analyzed the macro-environment,interest stakeholders,and behavioral choices underlying the construction of NRMCs,clarified the formation mechanism of NRMCs,and constructed an institutional spectrum based on their real operational context.Drawing on Williamson-Zhang Wuchang Framework for decomposing transaction costs,this study deconstructed the transaction costs associated with NRMCs into four categories:central-local collaboration costs,incentive-constraint costs,business collaboration costs,and behavioral transformation costs.Finally,this paper proposed strategies to reduce these transaction costs from four perspectives:strengthening the coordination of institutional design between central and local governments,enhancing operational management synergy between government and output-input hospitals,promoting service provision synergy between output-input hospitals,and facilitating information search synergy between suppliers and demanders.
