政府规制下的医患纠纷演化博弈模型  

The evolutionary game model of medical dispute under the regulation of the government

作　　者：管欣[1] 张哲薇 陈张蕾 高杨[1] GUAN Xin;ZHANG Zhewei;CHEN Zhanglei;GAO Yang(School of Management,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学管理学院

出　　处：《系统工程理论与实践》2019年第12期3151-3162,共12页Systems Engineering-Theory & Practice

基　　金：兰州大学中央高校基本科研业务费专项资金重点项目(17LZUJBWZD011);兰州大学中央高校基本科研业务费专项资金自由探索项目(17LZUJBWZY034);国家自然科学基金面上项目(71874074);甘肃省哲学社会科学规划重点项目(ZD004)~~

摘　　要：医患纠纷已成为制约和谐社会发展的重要矛盾,而在解纷过程中政府规制行为会对双方策略的选择产生重要的影响.通过构建医患双方演化博弈模型,分析了不同程度的政府规制对医患双方策略演进的影响.研究结果表明:政府规制程度不同会导致医患双方产生不同的策略组合,对医院和患者各方的规制程度决定了市场环境中医院的执业状态和患者的行为选择;政府提升对医院的规制效力、加大对患者的规制力度,能够逐步提高医院规范执业的概率,能够不断规范患者的维权途径和方式,使双方行为趋向于规范化;患者的"医闹"行为在一定程度上是对医院执业状态的揭露;在医患纠纷事件中政府自身定位的差异决定了其规制策略的差异,这会导致医患双方行为演进的结果出现较大的不同.最后结合莆田系医院事件和福建南平医闹事件,分别讨论了政府规制程度不足及规制策略失当情境下医患双方行为的演进结果.The medical dispute has been the important contradiction restricting the development of harmonious society,while government regulation will play an important role in strategy choice of both sides when resolving disputes.This article analyzes the influence of the degrees of governmental regulation to doctor-patient strategies by building the doctor-patient evolution game model.The study results indicate that different degrees of regulation result in different strategy profile,different regulation efforts to doctor and patient will determine the operation status and behavior choice separately.The government’s improvement of the regulation standard to hospitals and patients will gradually raise the probability of hospitals to operate specifically,regulate patients’routes and ways to safeguard legal rights,and finally normalized the behaviors of both sides.The behaviors of"medical disturbance"are somehow a way to expose the operation status of hospitals;different self-positioning of the government in medical disputes determines different strategies,which resulted in a relatively big difference in the results of the medical disputes.Finally,this article discusses the evolution results under the circumstances of insufficient governmental regulation and improper regulation strategies combing with the Putian Medical Group and Medical Dispute in Nanping,Fujian.

关 键 词：医患纠纷 政府规制 演化博弈 

分 类 号：F224.32[经济管理—国民经济]