基于委托代理理论的医疗激励契约研究  

Research on Medical Incentive Contract Based on Principal-Agent Theory

作　　者：苏强[1] 陈淼 SU Qiang;CHEN Miao(School of Economics and Management,Tongji University,Shanghai 200092,China)

机构地区：[1]同济大学经济与管理学院,上海200092

出　　处：《运筹与管理》2021年第7期203-209,217,共8页Operations Research and Management Science

基　　金：国家自然科学基金资助项目(71432007,71972146)。

摘　　要：医患之间的高度信息不对称性是导致医患矛盾的重要原因。现有研究基于信息不对称情况下医患之间的委托代理关系模式,针对可能导致的道德风险问题设计了不同的医疗激励机制,但是没有充分考虑医疗服务的不确定性和异质性。本文考虑医方努力的不同动机,提出二维努力水平的概念,以医患双方效益最大化为目标,对患方就医过程中的医患博弈时序进行研究,在医方具有信息优势的条件下设计了不同情况下的医疗激励契约模型。数值分析结果表明,医方的固定医疗收益、收益提成比例和二维努力水平等激励参数与医方努力产出的边际收支系数、医患双方的风险偏好程度以及随机因素的扰动程度等均存在显著的相关关系。The high degree of information asymmetry between doctors and patients is an important cause of doctor-patient conflicts.The existing research is based on the principal-agent relationship model between doctors and patients under the condition of information asymmetry.Different medical incentive mechanisms are designed for the possible moral hazard problems,but the uncertainty and heterogeneity of medical services are not fully considered.Considering the different motives of doctors’efforts,this paper proposes the concept of two-dimensional effort level.Under the condition that doctors have information superiority,this paper studies the order of doctor-patient game in the process of medical service and designs different medical incentive contracts in different situations for the purpose of maximizing the benefits of both doctors and patients.The results of numerical analysis show that there are significant correlations among the doctor’s fixed medical income,the proportion of income and the level of two-dimensional effort and marginal balance coefficient of doctors’outputs,the degree of risk preference of both sides and the degree of disturbance of the random factors.

关 键 词：信息不对称 努力水平 风险偏好系数 激励机制 委托代理理论 

分 类 号：C931.1[经济管理—管理学]