政府监管下的医院医疗信息分享演化博弈分析  

Evolutionary Game Analysis of Medical Information Sharing Based on the Government Regulation

作　　者：张强[1] 王丽亚[1] 耿娜[1] 江志斌[1] ZHANG Qiang;WANG Li-ya;GENG Na;JIANG Zhi-bin(School of Mechanical Engineering,Shanghai Jiao Tong University,Shanghai 200240,China)

机构地区：[1]上海交通大学机械与动力工程学院,上海200240

出　　处：《运筹与管理》2020年第1期23-31,共9页Operations Research and Management Science

基　　金：国家自然科学基金重点项目(71432006)。

摘　　要：在分析政府监管下医院间医疗信息分享特征的基础上,结合我国当前正在推行的医联体医院间信息分享运作模式,引入梅特卡夫定律并考虑患者评价的影响,分析了监管部门与医院各自的利益组成,建立了监管部门与医院两者之间的演化博弈模型,并采用复制动态方程研究了不同情形下医院间信息分享的演化博弈轨迹.研究表明,政府通过监管并建立激励惩罚机制等引导措施对医院最终达到的演化稳定态具有极大影响;降低医院主体信息分享的风险成本、规范提高医院分享信息的质量、引导患者增强对医院信息分享的关注、制定有吸引力和威慑力的奖惩政策,是促进医院医疗信息分享的关键.研究结果可为政府监管部门预测医院间的信息分享趋势和制定精准化政策以促进分享提供参考.Medical and health services are a knowledge-intensive industry that requires effective information sharing.At present,the problem of“high expense and difficulties in medical”has become a heated social prob-lem in China,and medical information sharing is one of the most important ways to solve the problem.However,there still exist lots of barriers in medical information sharing among hospitals,especially for the lack of govern-ment incentives and regulation.In this paper,based on the analysis of the characteristics of hospital medical information sharing under government regulation,the problem of medical information sharing is studied.With the hospital information sharing process of the Medical Consortium in China,we introduce the Metcalfe’s law and patients’supervision,and the interests of the governments and hospitals are analyzed.An evolutionary game model between hospitals and governments is established and the equilibrium state under different conditions are studied by solving the replicator dynamic equations.The results show that the government has great influence on the evolutionary stable state of the hospital through supervising and establishing the incentive and punishment mechanism.Reducing the risk cost of information sharing,standardizing and improving the quality of information sharing in the hospital,encouraging patients to supervise hospitals behavior of information sharing,making attractive reward and proper punishment policy are the key factors to promote the medical information sharing.The results can provide a reference for governments to evaluate the information sharing trend of the hospital and to establish incentive and punishment mechanism to stimulate medical information sharing.

关 键 词：管理科学 演化博弈 演化稳定策略 医疗信息分享 政府监管 

分 类 号：R197.3[医药卫生—卫生事业管理] C93-03[医药卫生—公共卫生与预防医学]