分级诊疗下二三级医院服务资源整合的演化博弈分析  

Evolutionary game of resources integration on secondary hospital and tertiary hospital in tiered medical care system

作　　者：宋之杰[1] 郭燕平[1] 吉增良 王运波 夏莹 SONG Zhi-jie;GUO Yan-ping;JI Zeng-liang;WANG Yun-bo;XIA Ying(School of Economics and Management,Yanshan University,Qinhuangdao Hebei 066004,China;Xingtai Ninth Hospital(Jvlu County hospital),Xingtai Hebei 055250,China)

机构地区：[1]燕山大学经济管理学院,河北秦皇岛066004 [2]邢台市第九医院(巨鹿县医院),河北邢台055250

出　　处：《中国卫生政策研究》2018年第2期44-51,共8页Chinese Journal of Health Policy

基　　金：河北省社会科学基金项目(HB16GL083)

摘　　要：分析不完全信息下患者就医行为与医生诊疗决策过程,据此构建患者首诊二三级医院与医生诊疗策略的演化博弈模型。其次,运用Matlab对影响患者首诊决策和医生诊疗博弈系统均衡的相关影响因素进行仿真分析。结果表明:促进二三级医院间的分工与合作、降低疑难重症患者就诊二级医院的效用损失、提升复杂型多发病患者在二级医院的就医体验、加强疑难重症患者的疾病预防,均有助于博弈结果向减少患者无序、混乱、错位的就医、形成二三级医院整合型医疗服务系统的方向发展。The paper analyzed the decision-making process of the doctor s treatment and patient s decision-making.Then established the evolutionary game model of patient s and the secondary-tertiary hospital doctor s strategy.The Matlab simulation software were used to analyze the influencing factors of patient-doctor strategy-making system.We proposed the advice reducing critical patient s utility loss diagnosed in secondary hospital,improving medical experience of common patient in secondary hospital,strengthening disease prevention of critical patient,and promoting labor division and cooperation between secondary and tertiary hospital to make result develop towards reduction the disorderly,chaotic and dislocated medical need and an integrated secondary and tertiary system.

关 键 词：分级诊疗 二三级医院 资源整合 演化博弈 

分 类 号：R197[医药卫生—卫生事业管理]