Game Theory on Stakeholders in the Construction of County-level Medical Alliance under the Background of Hierarchical Diagnosis and Treatment System

doi:10.12114/j.issn.1007-9572.2020.00.085

Abstract

Abstract: The county-level medical alliance has received increasing attention from the government departments in recent years.However，due to the inadequate supervision system，the low enthusiasm of participants，and the unreasonable interest distribution mechanism，the implementation process of the medical alliance has been hindered.It is of great significance to analyze the stakeholders and their conflicts of interest to further promote the construction of county-level medical alliance.Using the theory of stakeholders and game theory，this research constructed two models of central government-local government model and local government-county-level medical institutions-patients model to study the relationship between the central government and local government，and game relationship between local government，county-level medical institutions and patients.It was found that the central government's supervision and management of local government，the costs paid by local government and county-level medical institutions，the rewards and penalties for county-level medical institutions，and the costs paid by patients and the benefits they received would affect the construction of county-level medical alliance.Therefore，government departments should improve the evaluation and incentive mechanism and act as the leader in coordinating the interests of all parties.The propaganda of the medical alliance policy should be strengthened to make relevant groups take the initiative to become participants.The county-level medical institutions should help each other and jointly improve patient satisfaction with medical treatment.

Key words: Medical alliance, Hierarchical diagnosis and treatment, Stakeholder, Game theory

摘要： 近年来县域医疗共同体（医共体）受到政府部门的日益重视，但监督管理体制不健全、参与者积极性不高、利益分配机制不合理等问题阻碍了医共体的推行进程。分析县域医共体建设中的利益相关者及其利益冲突，对进一步推进县域医共体建设具有重要意义。本研究采用利益相关者和博弈论的理论，构建了“中央政府-地方政府”和“地方政府-县级医疗机构-患者”2个模型，研究中央和地方政府，以及地方政府、县级医疗机构、患者三方之间的博弈关系。发现中央政府对地方政府的监督管理和激励程度，地方政府和县级医疗机构付出的成本，对县级医疗机构的奖罚，患者付出的成本及得到的收益等均会影响县域医共体建设的进程。因此，政府部门应完善考核激励机制，做协调各方利益的主导者；加强医共体政策的宣传力度，让相关群体主动成为参与者；县级医疗机构之间需要互相帮扶，共同提升患者就医满意度。

关键词: 医疗共同体, 分级诊疗, 利益相关者, 博弈论

HE Guangxiu,TANG Shaoliang. Game Theory on Stakeholders in the Construction of County-level Medical Alliance under the Background of Hierarchical Diagnosis and Treatment System　[J]. Chinese General Practice, 2020, 23(13): 1611-1614. DOI: 10.12114/j.issn.1007-9572.2020.00.085.
何光秀,汤少梁. 分级诊疗背景下县域医疗共同体建设中的利益相关者博弈研究[J]. 中国全科医学, 2020, 23(13): 1611-1614. DOI: 10.12114/j.issn.1007-9572.2020.00.085.

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