基于博弈论的公立医院分级诊疗服务策略.pdfVIP

第 20 卷 第 2 期 工 业 工 程 Vol. 20 No. 2 2017 年 4 月 Industrial Engineering Journal April 2017 doi: 10.3969/j.issn.1007-7375.e16-1041 基于博弈论的公立医院分级诊疗服务策略 王 宁，苗 瑞，江志斌 (上海交通大学 机械动力工程学院，上海 200240) 摘要: 针对公立医院分级诊疗状况，以病人对医疗服务理性感知为前提，建立双寡头两阶段博弈模型，研究在政府 和医疗市场共同调控下，不同级别医院针对同种疾病提供医疗服务的战略决策问题。运用子博弈精炼纳什均衡分析 了两家医院的利益权衡过程。研究表明：不同级别医院可通过差异化医疗服务质量和价格获得最优利润，政府差异 化医疗报销比例，有利于三级医院病人的适当分流。研究能够为公立医院定价和医疗报销政策的制定提供理论 支撑。 关键词: 分级诊疗；博弈论；医疗报销 中图分类号: C934 文献标志码: A 文章编号: 1007-7375(2017)02-0026-06 Grading Medical Service Strategy for Public Hospitals Based on Game Theory WANG Ning, MIAO Rui, JIANG Zhibin (School of Mechanical Engineering, Shanghai JiaoTong University, Shanghai 200240, China) Abstract: Aiming at hierarchical medical service between public hospitals, a duopoly game model is established based on patients’ rational perception of healthcare service. The model studies the strategic choices of different grade hospitals that face the same disease treatment under co-regulation of government and healthcare market. The sub-game perfect Nash equilibrium is applied in the analysis of the profit trade off between two hospitals. Results show that hospitals can differentiate quality and price of service to get optimal profits and that government can differentiate reimbursement ratio to promote bypass of patients in third-grade hospital. The research can support pricing and reimbursement decision