本刊未與任何網站以及單位個人合作,謹防受騙!

  • 作者投稿
  • 在線編輯
  • 專家審稿
  • 聯系我們
行業新聞

分級診療背景下三級醫院重癥患者康復期轉診的演化博弈分析

Evolutionary game analysis of the referral of convalescent critically ill patients in tertiary hospitals in the context of hierarchical diagnosis and treatment

作者:

姚心怡   溫宗良   盧亞娟

單位:

徐州,徐州醫科大學管理學院;徐州醫科大學附屬醫院

關鍵詞:

三級醫院;重癥患者康復期;轉診;政府協調;分級診療制度;演化博弈

分類號:

R197

DOI:

10.3969/j.issn.2095-7432.2023.01.004

出版年,卷(期),頁碼:2023,13 (1):21-26

下載全文

摘要:

目的 分析三級醫院重癥患者康復期,醫保部門、醫院、患者三方之間的利益關系,探討政府不同協調策略下,醫院和患者策略的演化路徑及其影響因素。方法 通過構建醫保部門、醫院和患者三方的演化博弈模型,利用Matlab軟件進行仿真分析。結果 醫保部門積極補貼策略下,更易形成醫患雙方共贏的局面;消極補貼策略下,則易導致衛生總費用增加但患者難下轉的惡性循環,進而導致患者對三級醫院的信賴感下降。結論 明確政府在推進分級診療中的協調主體地位;充分發揮醫療保險的經濟杠桿作用;推進基層醫療衛生機構的設施建設和家庭醫生簽約服務;通過多種手段更好地宣傳和落實分級診療措施。

英文摘要:

Objective To analyze the interest relationships among healthcare security authorities, hospitals, and patients during the recovery period of critically ill patients in tertiary hospitals and to explore the evolution path and influencing factors of hospital and patient strategies under different coordination strategies of the government authorities. Methods The evolutionary game model involving healthcare security authorities, hospitals and patients was established, and simulation analysis was performed using the Matlab software. Results An active subsidy strategy by healthcare security authorities helps form a win-win situation for both hospitals and patients; in contrast, a passive subsidy strategy may lead to a vicious circle, in which the total health cost increases, but patients are difficult to be transferred to lower-level hospitals, which in turn leads to a decline in patients' trust in tertiary hospitals. Conclusions Government authorities should play a central role in promoting hierarchical diagnosis and treatment. Medical insurance should be given a full play to economic leverage. The construction of facilities in grassroots medical institutions and the family doctor contracting services should be promoted. Hierarchical diagnosis and treatment should be advocated and implemented through a variety of means.

基金項目:

國家社會科學基金項目(19BGL251);江蘇省博士后科研資助計劃資助項目(2021K629C);江蘇省研究生科研與實踐創新計劃資助項目(KYCX21_2636

作者簡介:

服務與反饋:

大鸡吧操我逼逼