Abstract
This article reconsiders reimbursement reductions for pharmacies in medical malls from the perspective of demand-source concentration and relative demand-fluctuation risk. Recent reimbursement policy has treated pharmacies in medical malls similarly to pharmacies located in front of large hospitals by calculating prescription concentration rates as if multiple medical institutions within a medical mall were a single medical institution. However, a medical mall is not simply a smaller version of a large hospital. A hospital-front pharmacy may appear to depend on one institution, but its prescriptions are generated by multiple departments and a large patient base. In contrast, a pharmacy in a medical mall receives prescriptions from several independent clinics and may still depend heavily on a small number of demand sources. This article proposes a demand-source concentration and relative demand-fluctuation risk model to evaluate this structural difference. The model indicates that prescription concentration rates and profit margins alone are ins ufficient to assess the risk structure of pharmacies in medical malls. Reimbursement reduction policy should therefore be understood not merely as a price adjustment, but as a market-design problem concerning evaluation units, evaluation indicators, incentives, and the behavior of actors within outpatient healthcare platforms.
