目的: 探究公立医疗机构完成集采任务的动力,分析影响集采工作效果的因素,为政府实施监管及相关决策提供参考。方法: 分析14家三级公立医院前五批国家组织集采药品采购情况,基于博弈论的角度,通过构建政府与医院的博弈模型,求出其纳什均衡解。结果: 在医院落实集采政策方面,存在政府监管力度不强、公立医院药品报量逐批下降、参与积极性不高等问题。结论: 建议优化政府监管机制,加大日常监管力度,完善激励与约束制度,提高医疗机构纯收益等。

Objective: The paper explores the motivation of public medical institutions to complete the task of centralized procurement, analyzes the factors affecting the effect of centralized procurement, and provides a reference for the government to implement supervision and decision-making. Methods: Based on the game theory, the paper analyzes the first five batches of state-organized drug procurement in 14 provincial public hospitals by constructing the game model between government and hospitals. Results: In terms of the implementation of the centralized procurement policy in hospitals, there were problems such as insufficient government supervision, decrease of drug amount declaration in public hospitals and low participation enthusiasm. Conclusion: It is suggested optimizing the government supervision mechanism, strengthening the daily supervision, improving the incentive and restraint system, and improving the net revenue of medical institutions.