Service competition in two-tier healthcare markets with heterogeneous patients balking  

作　　者：Yuanbing Miao Xiaoqing Cai Yanfei Lan Ruiqing Zhao Yinlian Zeng 

机构地区：[1]College of Management and Economics,Tianjin University,Tianjin,300072,China [2]School of Data Science,The Chinese University of Hong Kong,Shenzhen,518172,China [3]Shenzhen Research Institute of Big Data,Shenzhen,518172,China [4]College of Urban Transportation and Logistics,Shenzhen Technology University,Shenzhen,518118,China

出　　处：《Journal of Management Science and Engineering》2025年第1期18-36,共19页管理科学学报(英文版)

基　　金：supported by the National Natural Science Foundation of China(Grant numbers 72271177,72331009,72192805).

摘　　要：Recently,public and private providers within two-tier healthcare markets have engaged in a fierce competition for patients,which is significantly influenced by patients'multifaceted sensitivities to delays and payments,particularly when patients'potential balking is considered.However,existing literature studying the two-tier healthcare market often presupposes patients as homogeneous or one-dimensionally heterogeneous,and neglects their balking behavior.In stark contrast,this paper delves into the combined effects of patients’delay-and payment-sensitive heterogeneities,alongside their joining or balking decisions,on the service competition dynamics within the two-tier healthcare market.Leveraging a game-theoretic framework,we initially derive subgame equilibria,both inclusive and exclusive of patient balking,uncovering that patient balking can lead to a subgame perfect Nash equilibrium in the presence of two-dimensional patient heterogeneity.Intriguingly,our findings further suggest that the non-profit public provider may,counterintuitively,curtail its service capacity despite budgetary adequacy,contradicting the conventional assumption that such providers would fully allocate funds towards patient care.Ultimately,from a patient welfare standpoint,we find heightened payment heterogeneity discrimination proves detrimental to patients,whereas increased differentiation in delay heterogeneity benefits them.This revelation underscores a pressing social issue inherent in the two-tier healthcare market model:It has the potential to exacerbate healthcare disparities rooted in economic inequalities within the population.

关 键 词：OR in health services Queuing theory Game theory Joining-or-balking behavior 

分 类 号：R197.1[医药卫生—卫生事业管理]