合作与竞争模式下延时敏感患者转诊策略与医院决策行为研究  

Referral Strategy of Delay Sensitive Patients and Hospital Decision-Making Behavior Under Cooperative and Competitive Modes

作　　者：孙微[1] 张凯婷 李世勇[1] SUN Wei;ZHANG Kaiting;LI Shiyong(School of Economics and Management,Yanshan University,Qinhuangdao 066004)

机构地区：[1]燕山大学经济管理学院,秦皇岛066004

出　　处：《系统科学与数学》2025年第2期513-529,共17页Journal of Systems Science and Mathematical Sciences

基　　金：国家自然科学基金项目(71971188);教育部人文社会科学研究项目(22YJCZH086);河北省自然科学基金项目(G2022203003,G2023203008)资助课题。

摘　　要：针对医疗资源供需不匹配情形下的分级诊疗体系,提出两种模式:三级医院与政府办管型社区医院组成的合作模式及三级医院与市场办管型社区医院组成的竞争模式.通过构建三阶段Stackelberg排队博弈模型,分析延时敏感患者、社区医院、三级医院间的动态决策过程,进而给出患者转诊率、社区医院服务能力规划、三级医院下转患者率或定价策略.研究发现,合作模式下,如果三级医院重视患者等待时间,并积极转诊轻症患者,其效益反而会增加;竞争模式下,患者转诊率、社区医院服务能力、三级医院利润均更高,即适当的竞争可以促进各方寻求更优策略.数值结果表明,当三级医院患者数较多时,竞争模式下总患者等待时间更小,当社区医院患者数较多时,合作模式更优.For the mismatch between supply and demand of medical resources in the hierarchical medical system,two modes are proposed:The cooperation mode composed of a tertiary hospital and a government-run and managed community hospital,and the competition mode composed of a tertiary hospital and a market-run and managed community hospital.Through the construction of a three-stage Stackelberg queueing game model to analyze the dynamic decision-making process among delay-sensitive patients,a community hospital and a tertiary hospital,which will give the patient referral rate,the community hospital's service capacity planning,the tertiary hospital's transfer patient rate or pricing strategy.It is found that under the cooperative mode,if the tertiary hospital emphasizes the waiting time of patients and actively refers patients with minor illnesses,and its benefit will be increased.Under the competitive mode,the patient referral rate,service capacity of the community hospital and the profit of the tertiary hospital are higher,which means that the appropriate competition can promote each part to seek for a more optimal strategy.Numerical results show that when the number of patients in the tertiary hospital is large,the total patient waiting time is smaller in the competitive mode,and when the number of patients in the community hospital is large,the cooperative mode is more favorable.

关 键 词：延时敏感患者 分级诊疗 排队博弈 转诊率 服务能力 定价 

分 类 号：R197.3[医药卫生—卫生事业管理]