社会医疗保险付费方式的博弈分析  

Analysis of payment system in social health insurance by game theory

作　　者：李军山[1] 江可申[1] 陈和利[2] 

机构地区：[1]南京航空航天大学经济与管理学院,南京210026 [2]江西中医学院经济与管理系,南昌330006

出　　处：《系统工程理论与实践》2008年第11期36-42,共7页Systems Engineering-Theory & Practice

基　　金：国家自然科学基金(70563003)

摘　　要：社会医疗保险存在多个博弈主体,其中社保机构和医院之间围绕医疗保险(费用)付费方式的博弈,决定了医疗服务的数量、质量和价格.基于双方的效用函数,以消除医院道德风险和自选择为目的,运用博弈理论推出了最优付费方式的博弈均衡解.最后给出了一个算例,结果表明此付费方式有效、可行.该方式结算程序非常简单,管理成本低,适于行政效率不高的国家和地区.There are several players in social health insurance. The game between social health insurance organization and hospital decides quantity, quality and price of health service. On the basis of the two sides＇ utility function a first best payment system has been provided to eliminate moral hazard and self-selection from hospital by game theory. The payment system, acting on routine information available, is very simple and suitable for those inefficient country and region.

关 键 词：道德风险 自选择 付费方式 博弈 

分 类 号：F840.684[经济管理—保险]