家庭医生签约制下农村基层医疗服务资源整合的演化博弈分析  

Evolutionary game of resources integration on rural basic medical institution in family physician signing model

作　　者：郭燕平 张微[2] 宋之杰[3] 刘洪涛 江婷 GUO Yan-ping;ZHANG Wei;SONG Zhi-jie;LIU Hong-tao;JIANG Ting(School of Management Engineering and Business, Hebei University of Engineering, Handan Hebei 056038, China;Beijing Institute of Science and Technology Information, Beijing 100000, China;School of Economics and Management, Yanshan University, Qinhuangdao Hebei 066004, China;Xingtai Ninth Hospital/Jvlu County Hospital, Jvlu Hebei 055250, China)

机构地区：[1]河北工程大学管理工程与商学院,河北邯郸056038 [2]北京市科学技术情报研究所,北京100000 [3]燕山大学经济管理学院,河北秦皇岛066004 [4]邢台市第九医院/巨鹿县医院,河北巨鹿055250

出　　处：《中国卫生政策研究》2018年第12期35-44,共10页Chinese Journal of Health Policy

基　　金：河北省社会科学基金项目(HB16GL083)

摘　　要：本文分析了农村家庭医生签约服务的困境,构建了家庭医生签约服务需求方与供给方的演化博弈模型;运用Matlab对影响居民签约决策和家庭医生努力程度博弈系统均衡的相关影响因素进行仿真分析。结果表明:增强居民签约家庭医生的积极性,提升居民签约个性化服务包的比例,降低因家庭医生"懒散"给签约居民带来的效用损失,缩减家庭医生提供基本医疗服务所需的"努力"工作成本,加强有效签约的奖励,推动健康管理效果不理想的惩罚机制,均有助于博弈结果向居民签约家庭医生的整合型基层医疗服务方向发展。The paper analyzed the dilemma of rural family physician signing model. Then established the evolutionary game model of residents and the rural family physician s strategy. The Matlab simulation software were used to analyze the influencing factors of residents and family physician strategy-making system. We proposed the advice enhancing the enthusiasm of signing the family physician, increasing the proportion of residents signing the personalized service package, reduction of utility loss caused by family physician s “lazy” strategy, the cost reduction of basic medical service provided by family physician, improving the award of effective signing and the punishment mechanism of not ideal health management to make result develop towards the residents signing the family physician and an integrated basic medical service system.

关 键 词：家庭医生签约制 基层医疗 资源整合 演化博弈 

分 类 号：R197[医药卫生—卫生事业管理]