本文建立一個醫療市場存在兩家醫院,院內各有一位專診醫師的模型架構,令醫療產業內的醫院同時擁有兩種互為替代的醫療資源:健保局補助項目的普通藥品和病患需全額自費的特殊藥品,醫院擁有者可藉由不同的代理授權機制,讓院內專診醫師在醫療市場上進行Cournot的數量競爭。專診醫師會依據誘因契約參數的設計,為自身獲取最佳的效用,也為醫院賺取更高的利潤。 代理授權之契約設計型式,分別以競爭醫院的利潤和本院使用的藥物總量作為誘因契約參數之設計,討論專診醫師對普通藥品和特殊藥品的銷售選擇,並比較不同契約下的醫院利潤、醫師效益和社會福利。 最後,不論是站在醫院擁有者或者是院內專診醫師的立場,皆會偏好與同業處於競爭立場,希望競爭對手也使用誘因契約設計,且最好是以醫院藥品總量作為誘因契約設計。而在特定的需求條件下,社會的立場亦是如此。 This model established a health care market with two hospitals. Each hospital has one physician in charge. The hospital provides two kinds of substituable medicine. One is called general medicine which is subsidized by Bureau of National Health Insurance. The other is called special medicine which is paid fully by the patient. The hospital owner can apply two different incentive contracts on its physician, either its rival’s profit or the hosipital’s own quantity sold. The market is playing the Cournot quantity competition. We found that both the hospital owner and the physician will prefer that the rival hospital also use the incentive contract, as well as the delegation design is the hospital’s own quantity. Also, when the market demand is large enough, the result holds from the social point of view.